Bangladesh’s unique climate vulnerability is well-investigated but the mental health impacts of climate change remain relatively unexplored. Three databases were searched for English primary qualitative studies published between 2000 and 2020. Out of 1202 publications, 40 met the inclusion criteria. This systematic review applies a systems approach to further understand Bangladesh’s ‘climate-wellbeing’ network. The literature indicates diverse factors linking environmental stress and mental ill-health including four key themes: (1) post-hazard mental health risks, (2) human (im)mobility, (3) social tension and conflict, and (4) livelihood loss and economic hardship. This systems analysis also revealed that people’s mental wellbeing is strongly mediated by socio-economic status and gender. The article illustrates how multiple pathways may amplify stress, anxiety, violence, and psychological damage. Greater recognition of the ‘climate-wellbeing’ connections, and incorporation of mental health in current climate action and policy frameworks, will be an effective way to achieve a more sustainable future.
Secure potable water is indispensable to life. The presence of salinity in potable water has become a serious problem worldwide and it is essential to ensure secure potable water, particularly in the coastal areas of Bangladesh. In this work, 48 (forty-eight) harvested rainwater samples were assessed from Upazila (sub-district) of Mongla and Sarankhola, Bagerhat district, Bangladesh during the monsoon (May) and post-monsoon (October) periods. The objective was to examine the effect of seasonal variations on the quality of harvested rainwater. The harvested rainwater was analyzed for fecal coliform, total coliform, lead (Pb), zinc (Zn), pH, and turbidity. The mean pH in monsoon and post-monsoon periods was 6.93 and 7.24, respectively, which was within both the WHO guideline and Bangladesh Drinking Standard. In the monsoon season, turbidity levels in samples met the Bangladesh water quality standard but 10% of the harvested rainfall samples had Pb levels that exceeded the WHO drinking water limit. The turbidity of harvested rainwater in post-monsoon exceeded the WHO and Bangladesh Drinking Standard by 21% (10 out of 48) and 6% (3 out of 48), respectively. The fecal coliform of harvested rainwater exceeded both WHO and Bangladesh Drinking Standard by 56% (27 out of 48) and 67% (32 out of 48) in the monsoon and post-monsoon, correspondingly. Conversely, total coliform of harvested rainwater exceeded both the WHO and Bangladesh Drinking Standard by 67% (32 out of 48) and 79% (38 out of 48), accordingly in the monsoon and post-monsoon seasons. The Zn was below the WHO and Bangladesh Drinking Standard but Pb exceeded the WHO guideline in the monsoon and post-monsoon by 15% (7 out of 48) and 17% (8 out of 48), respectively. Pb is toxic to humans and children are especially vulnerable. The harvested rainwater should be treated effectively to reduce the toxicity and danger posed by Pb, fecal coliform, and total coliform before it is fit for drinking purposes.
Bangladesh stands out as a climate change hot spot due to its unique geography, climate, high population density, and limited adaptation capacity. Mounting evidence suggests that the country is already suffering from the effects of climate change which may get worse without aggressive action. Here, we use an ensemble of high-resolution (10 km) regional climate model simulations to project near-term change in climate extremes, mainly heat waves and intense rainfall, for the period (2021–2050). Near-term climate projections represent a valuable input for designing sound adaptation policies. Our climate projections suggest that heatwaves will become more frequent and severe in Bangladesh under the business-as-usual scenario (RCP8.5). In particular, extremes of wet-bulb temperature (a temperature and humidity metric important in evaluating humid heat stress) in the western part of Bangladesh including Bogra, Ishurdi, and Jessore are likely to exceed the extreme danger threshold (according to U.S. National Weather Service criterion), which has rarely been observed in the current climate. The return periods of extreme heat waves are also significantly shortened across the country. In addition, country-averaged rainfall is projected to increase by about 6% during the summer months, with the largest increases (above 10%) in the eastern mountainous areas, such as Sylhet and Chittagong. Meanwhile, insignificant changes in extreme rainfall are simulated. Our results suggest that Bangladesh is particularly susceptible to climate extremes in the near future, in the form of extreme heat waves over the western part of the country.
Bangladesh is a country of natural disasters and climatic hazards, which frequently affect its inhabitants’ lives and livelihoods. Among the various risks and disasters, floods are the most frequent hazard that makes haor households vulnerable. Therefore, this study was undertaken to estimate livelihood vulnerability to flooding within the flood-prone haor ecosystem in Bangladesh. Primary data were collected from 100 haor households each from Kishoreganj, Netrokona, and Sunamganj districts (N?=?300) by applying a multistage random sampling technique. Data were collected through face-to-face interviews using a pretested structured questionnaire. The Livelihood Vulnerability Index (LVI) and the Intergovernmental Panel on Climate Change (IPCC) framework of vulnerability were applied to compare vulnerabilities among the selected haor-based communities. The empirical results revealed that haor households in Sunamganj district were more vulnerable to flood hazard and natural disaster in terms of food, water, and health than households in the other two districts. Taking into account the major components of the LVI, the IPCC framework of vulnerability indicated that households in Sunamganj district were the most vulnerable due to their lowest adaptive capacity and highest sensitivity and exposure. These findings enable policymakers to formulate and implement effective strategies and programs to minimize vulnerability and enhance resilience by improving the livelihoods of the vulnerable haor households of Bangladesh, especially those in Sunamganj district.
Non-migration is an adaptive strategy that has received little attention in environmental migration studies. We explore the leveraging factors of non-migration decisions of communities at risk in coastal Bangladesh, where exposure to both rapid- and slow-onset natural disasters is high. We apply the Protection Motivation Theory (PMT) to empirical data and assess how threat perception and coping appraisal influences migration decisions in farming communities suffering from salinization of cropland. This study consists of data collected through quantitative household surveys (n?=?200) and semi-structured interviews from four villages in southwest coastal Bangladesh. Results indicate that most respondents are unwilling to migrate, despite better economic conditions and reduced environmental risk in other locations. Land ownership, social connectedness, and household economic strength are the strongest predictors of non-migration decisions. This study is the first to use the PMT to understand migration-related behaviour and the findings are relevant for policy planning in vulnerable regions where exposure to climate-related risks is high but populations are choosing to remain in place.
This study aims to explore the impact of climate change on health, including local adaptation strategies. A mixed-method approach has been used in this study. The results reveal that increasing the frequency of flooding, severity of riverbank erosion and drought, and rising disease outbreak are the highest indicators of climate change perceived by riverine island (char) dwellers, which is similar to the observed data. It also uncovers, approximately all respondents encounter several health-related issues during different seasons where prevailing cold and cough with fever, skin diseases, and diarrhoea are the leading ailments. Several adaptation strategies are accommodated by char inhabitants in order to enhance resilience against the climate change health impacts, but the paucity of money, disrupted communication, lack of formal health-care centre are the most obstacles to the sustainability of adaptation. This research recommends that healthcare-associated project should be performed through proper monitoring for exterminating char dwellers’ health issues.
Floods are the most common hazard in Bangladesh adversely affecting the lives and livelihoods of millions of riverine people. Flood-affected households adopt a variety of post-disaster mitigation measures, to the best of their ability, in recognition that similar events are likely to occur again in the future. However, little is known about what drives a household to adopt risk mitigation measures after experiencing a severe flood. The objective of this study was to investigate the determinants of households’ decisions on the implementation of flood risk mitigation measures, following the severe flood in 2017 in northern Bangladesh. The data used for this study were collected from the right bank of the Teesta River in Bangladesh through a survey of 377 households and six key informant interviews. Most of the households (83.3%) adopted at least one risk mitigation measure from either structural or nonstructural categories after the 2017 flood. Binary logistic regression models provide useful insights into the determinants of the implementation of mitigation measures and intention to implement mitigation measures in future. The results showed that the perceived probability of flood, perceived preparedness, flood experience, exposure to flood, membership, household head’s sex, income source, and landownership significantly influenced households to implement mitigation measures in the post-disaster period. Additionally, the intention to implement mitigation measures was influenced by the membership and education of households. This study contributes in terms of useful information about the determinants of post-disaster mitigation measures in riverine areas of Bangladesh. These findings can be used to target specific households to promote disaster risk reduction interventions.
BACKGROUND: Climate change influences patterns of human mobility and health outcomes. While much of the climate change and migration discourse is invested in quantitative predictions and debates about whether migration is adaptive or maladaptive, less attention has been paid to the voices of the people moving in the context of climate change with a focus on their health and wellbeing. This qualitative research aims to amplify the voices of migrants themselves to add nuance to dominant migration narratives and to shed light on the real-life challenges migrants face in meeting their health needs in the context of climate change. METHODS: We conducted 58 semi-structured in-depth interviews with migrants purposefully selected for having moved from rural Bhola, southern Bangladesh to an urban slum in Dhaka, Bangladesh. Transcripts were analysed using thematic analysis under the philosophical underpinnings of phenomenology. Coding was conducted using NVivo Pro 12. FINDINGS: We identified two overarching themes in the thematic analysis: Firstly, we identified the theme “A risk exchange: Exchanging climate change and health risks at origin and destination”. Rather than describing a “net positive” or “net negative” outcome in terms of migration in the context of climate change, migrants described an exchange of hazards, exposures, and vulnerabilities at origin with those at destination, which challenged their capacity to adapt. This theme included several sub-themes-income and employment factors, changing food environment, shelter and water sanitation and hygiene (WaSH) conditions, and social capital. The second overarching theme was “A changing health and healthcare environment”. This theme also included several sub-themes-changing physical and mental health status and a changing healthcare environment encompassing quality of care and barriers to accessing healthcare. Migrants described physical and mental health concerns and connected these experiences with their new environment. These two overarching themes were prevalent across the dataset, although each participant experienced and expressed them uniquely. CONCLUSION: Migrants who move in the context of climate change face a range of diverse health risks at the origin, en route, and at the destination. Migrating individuals, households, and communities undertake a risk exchange when they decide to move, which has diverse positive and negative consequences for their health and wellbeing. Along with changing health determinants is a changing healthcare environment where migrants face different choices, barriers, and quality of care. A more migrant-centric perspective as described in this paper could strengthen migration, climate, and health governance. Policymakers, urban planners, city corporations, and health practitioners should integrate the risk exchange into practice and policies.
INTRODUCTION: Global climate change has produced growing natural disasters across the world especially in Global South. Different countries experience varied vulnerabilities depending on their geographical location, economic status and ability of management. In a highly disaster susceptible developing country like Bangladesh, many individuals experience a greater rate of natural disasters with devastating health effects. Compare with men, women have a higher incidence of mortality and health effects following natural disasters. The study aims to explore women’s experience of physical and psychological health vulnerabilities with primary causes in natural disaster-affected areas of Bangladesh. METHODS AND ANALYSIS: This is an exploratory mixed-method study comprising survey and in-depth interviews with equal priority to identify physical and psychological health vulnerabilities of women living in natural disaster-affected areas of Bangladesh. Quantitative data will be collected using self-administered sociodemographic and perceived severity instrument, 12-item Short-Form, Impact of Event Scale-Revised and Brief Coping Scale, while specific open-ended guidelines will be used for the qualitative part. The instruments will be translated into Bangla following the Brislin (1970) model of translation. The survey will be administered in paper copies, with at least 384 respondents, whereas 30 participants will be in-depth interviewed using an audio recorder. Survey data will be analysed using SPSS V.25 following descriptive and inferential statistics as required. The recorded open-ended responses will be transcribed and analysed using thematic analysis. Finally, both data sets will be integrated and synthesised according to the sequential mixed-method approach. ETHICS AND DISSEMINATION: The study has been reviewed and approved by the Human Research Ethics Committee of the University of New England. The results will be actively disseminated through peer-reviewed journals, conference presentations, social media, the internet and various community engagement activities.
Existing efforts to ensure safe water access in coastal Bangladesh are challenged by increasing freshwater salinity. This research explored/explores safe water consumption choices in coastal Bangladesh, which data are scarce to date, using a mixed-methods approach. In 2014, a cross-sectional survey was conducted in southwestern coastal Bangladesh (n=261) and data was generated on water supply and consumption. Data collection also involved 29 in-depth interviews of household care givers and focus group discussions were performed with three community groups. Descriptive statistics were applied to analyse quantitative data and thematic analysis was used for qualitative data. The survey showed that 60% of the study population used tube well water while 40% used pond water for drinking. It was observed that for cooking purposes, the use of pond water was slightly higher than the tube well water. Only 13% of the respondents mentioned that their drinking water tasted salty whereas 6% of the respondents reported health problem (diarrhoea, dysentery, gastric issues and skin problems) after using these water sources. The qualitative data reveals that water available for drinking and cooking is causing a serious threat to this coastal community, particularly during the dry season. In-depth assessments indicated that drinking water choices were less driven by concerns for health than practical issues such as travel distance and time taken and taste. The palatability of water was an important determinant of choice for drinking and other domestic uses. Furthermore, the utility of alternative options for safe drinking water is driven by beliefs and traditions and source maintenance. Given the increasing salinisation of freshwaters in many low-lying countries and likely exacerbation related to climate change-induced sea level rise, therefore, promotion of low saline drinking water along with salt reducing interventions consider that community beliefs and practices must be a made priority.
Levees protect floodplain areas from frequent flooding, but they can paradoxically contribute to more severe flood losses. The construction or reinforcement of levees can attract more assets and people in flood-prone area, thereby increasing the potential flood damage when levees eventually fail. Moreover, structural protection measures can generate a sense of complacency, which can reduce preparedness, thereby increasing flood mortality rates. We explore these phenomena in the Jamuna River floodplain in Bangladesh. In this study area, different levels of flood protection have co-existed alongside each other since the 1960s, with a levee being constructed only on the right bank and its maintenance being assured only in certain places. Primary and secondary data on population density, human settlements, and flood fatalities were collected to carry out a comparative analysis of two urban areas and two rural areas with different flood protection levels. We found that the higher the level of flood protection, the higher the increase of population density over the past decades as well as the number of assets exposed to flooding. Our results also show that flood mortality rates associated with the 2017 flooding in Bangladesh were lower in the areas with lower protection level. This empirical analysis of the unintended consequences of structural flood protection is relevant for the making of sustainable policies of disaster risk reduction and adaptation to climate change in rapidly changing environments.
Exposure to extreme climate events causes population displacement and adversely affects the health of mothers and children in multiple ways. This paper investigates the effects of displacement on whether a child is delivered at a health center, as opposed to at home, and on postnatal care service utilization in Bangladesh. Using cross-sectional survey data from 599 mothers who gave birth in the three years prior to the date of interview, including 278 from households which had previously been displaced and 231 from households which had not been displaced, we use multivariate logistic regression to identify the factors associated with maternal healthcare service utilization. The results show that displaced households’ mothers are only about a quarter as likely to deliver at a health center as mothers from non-displaced households. The use of health center-based delivery decreases as the numbers of past displacements increases. Higher number of previous children, lower use of antenatal care during pregnancy, lower household income, and lack of access to radio/television also significantly reduce a mother’s likelihood of delivery at a health center. Displaced mothers are also substantially less likely to use postnatal care services for their neonates, especially those supplied by trained providers. Use of health facilities for delivery, use of antenatal care services, and previous number of children are other important predictors of postnatal care service utilization for neonates. In light of these findings, relocation of local health facilities with basic and emergency care provisions to areas in which the displaced have resettled, reinforcement of Family Planning services, and extension of coverage of the Maternity Allowance benefits in the displacement-prone mainland riverine areas are recommended policy responses.
OBJECTIVE: Floods are one of the most common types of disasters in Bangladesh and lead to direct and indirect impacts on health. The aim of the study was to assess the impact of floods on Maternal and Newborn Healthcare (MNH) utilization in Bangladesh between the years 2011 and 2014. METHODS: We used variables from the Bangladesh Demographic and Health Survey 2014 data and georeferenced data of floods between 2011 and 2014 from the Emergency Events Database. Multivariate logistic regression was used to determine whether the flood-affected exposures were significant in predicting differences in MNH utilization. RESULTS: The odds for the received antenatal care by skilled providers, institutional deliveries, deliveries by c-section, and postnatal care of the babies were significantly lower (Unadjusted OR?=?0.81, 0.88, 0.83, and 0.82 respectively; P?0.05) in the flood-affected area than the non-affected area. Additionally, the odds of postnatal checkup of women was statistically significant (P?0.001) and less likely to be received in flood-affected area (OR?=?0.76). The odds of all indicators were significantly lower (OR?1) for the women living in the twice and four times flooded areas compared to the once flooded areas. CONCLUSIONS FOR PRACTICE: The study shows that floods can have a negative impact on MNH utilization. In addition, repeated floods have a worse impact on MNH utilization than incidental floods. Extra effort should be put on ensuring access to MNH of women in flood-affected areas.
OBJECTIVES: Pneumonia is a significant contributor to mortality and morbidity in children aged <5 years, and it is also one of the leading causes of hospitalisation for children in this age group. This study assessed the association between climate variability, patient characteristics (i.e. age, sex, weight, parental education, socio-economic status) and length of stay (LOS) in hospital for childhood pneumonia and its economic impact on rural Bangladesh. STUDY DESIGN: An ecological study design was used. METHODS: Data on daily hospitalisation for pneumonia in children aged <5 years (including patient characteristics) and daily climate data (temperature and relative humidity) between 1st January 2012 and 31st December 2016 were obtained from the Matlab Hospital (the International Centre for Diarrhoeal Disease Research, Bangladesh) and the Bangladesh Meteorological Department, respectively. A generalised linear model with Poisson link was used to quantify the association between climate factors, patient characteristics and LOS in hospital. RESULTS: The study showed that average temperature, temperature variation and humidity variation were positively associated with the LOS in hospital for pneumonia. A 1°C rise in average temperature and temperature variation during hospital stay increased the LOS in hospital by 1% (relative risk [RR]: 1.010, 95% confidence interval [CI]: 1.001-1.018) and 9.3% (RR: 1.093, 95% CI: 1.051-1.138), respectively. A 1% increase in humidity variation increased the LOS in hospital for pneumonia by 2.2% (RR: 1.022, 95% CI: 1.004-1.039). In terms of economic impact, for every 1° C temperature variation during the period of hospital stay, there is an addition of 0.81 USD/day/patient as a result of direct costs and 1.8 USD/day/patient for total costs. Annually, this results in an additional 443 USD for direct and 985 USD for total costs. CONCLUSIONS: Climate variation appears to significantly contribute to the LOS in hospital for childhood pneumonia. These findings may help policymakers to develop effective disease management and prevention strategies.
This paper aims to scrutinize in what way peri-urbanization triggers climate change vulnerabilities. By using spatial analysis techniques, the study undertakes the following tasks. First, the study demarcates Dhaka’s-the capital of Bangladesh-peri-urban growth pattern that took place over the last 24-year period (1992-2016). Afterwards, it determines the conformity of ongoing peri-urban practices with Dhaka’s stipulated planning documents. Then, it identifies Dhaka’s specific vulnerabilities to climate change impacts-i.e., flood, and groundwater table depletion. Lastly, it maps out the socioeconomic profile of the climate change victim groups from Dhaka. The findings of the study reveal that: (a) Dhaka lacks adequate development planning, monitoring, and control mechanisms that lead to an increased and uncontrolled peri-urbanization; (b) Dhaka’s explicitly undefined peri-urban growth boundary is the primary factor in misguiding the growth pockets-that are the most vulnerable locations to climate change impacts, and; (c) Dhaka’s most vulnerable group to the increasing climate change impacts are the climate migrants, who have been repeatedly exposed to the climate change-triggered natural hazards. These study findings generate insights into peri-urbanization-triggered climate change vulnerabilities that aid urban policymakers, managers, and planners in their development policy, planning, monitoring and control practices.
Malaria occurrence in the Chittagong Hill Tracts in Bangladesh varies by season and year, but this pattern is not well characterized. The role of environmental conditions on the occurrence of this vector-borne parasitic disease in the region is not fully understood. We extracted information on malaria patients recorded in the Upazila (sub-district) Health Complex patient registers of Rajasthali in Rangamati district of Bangladesh from February 2000 to November 2009. Weather data for the study area and period were obtained from the Bangladesh Meteorological Department. Non-linear and delayed effects of meteorological drivers, including temperature, relative humidity, and rainfall on the incidence of malaria, were investigated. We observed significant positive association between temperature and rainfall and malaria occurrence, revealing two peaks at 19 °C (logarithms of relative risks (logRR) = 4.3, 95% CI: 1.1-7.5) and 24.5 °C (logRR = 4.7, 95% CI: 1.8-7.6) for temperature and at 86 mm (logRR = 19.5, 95% CI: 11.7-27.3) and 284 mm (logRR = 17.6, 95% CI: 9.9-25.2) for rainfall. In sub-group analysis, women were at a much higher risk of developing malaria at increased temperatures. People over 50 years and children under 15 years were more susceptible to malaria at increased rainfall. The observed associations have policy implications. Further research is needed to expand these findings and direct resources to the vulnerable populations for malaria prevention and control in the Chittagong Hill Tracts of Bangladesh and the region with similar settings.
BACKGROUND: Dengue, a febrile illness, is caused by a Flavivirus transmitted by Aedes aegypti and Aedes albopictus mosquitoes. Climate influences the ecology of the vectors. We aimed to identify the influence of climatic variability on the occurrence of clinical dengue requiring hospitalization in Zone-5, a high incidence area of Dhaka City Corporation (DCC), Bangladesh. METHODS AND FINDINGS: We retrospectively identified clinical dengue cases hospitalized from Zone-5 of DCC between 2005 and 2009. We extracted records of the four major catchment hospitals of the study area. The Bangladesh Meteorological Department (BMD) provided data on temperature, rainfall, and humidity of DCC for the study period. We used autoregressive integrated moving average (ARIMA) models for the number of monthly dengue hospitalizations. We also modeled all the climatic variables using Poisson regression. During our study period, dengue occurred throughout the year in Zone-5 of DCC. The median number of hospitalized dengue cases was 9 per month. Dengue incidence increased sharply from June, and reached its peak in August. One additional rainy day per month increased dengue cases in the succeeding month by 6% (RR = 1.06, 95% CI: 1.04-1.09). CONCLUSIONS: Dengue is transmitted throughout the year in Zone-5 of DCC, with seasonal variation in incidence. The number of rainy days per month is significantly associated with dengue incidence in the subsequent month. Our study suggests the initiation of campaigns in DCC for controlling dengue and other Aedes mosquito borne diseases, including Chikunguniya from the month of May each year. BMD rainfall data may be used to determine campaign timing.
Floods are one of the greatest hazards in Bangladesh. It is assumed that people who reside in a riverine area have adapted to flood pulses. However, in most cases, household-level risk-reduction strategies are inadequate for ensuring a livelihood resilient to floods. This is because riverine people are exposed to recurrent floods, which increases their vulnerability to floods. In order to formulate effective risk-reduction policies and programs for riverine areas, it is crucial to measure flood risk at the local level. This study, therefore, aims to assess the flood risk of riverine households. A multi-dimensional integrated flood risk assessment framework was adopted to quantify household-level flood risk. Using a systematic random sampling technique, 377 respondents from the right bank of the Teesta River in Bangladesh were interviewed to characterize flood hazards, exposure to floods, and their vulnerability and capacity to absorb flood risk. The survey also includes key informant interviews. The collected data were aggregated using a composite index, while comparing the components of flood risk. Descriptive and analytical statistics were also computed. The results showed that flood risk was higher in downstream areas, followed by upstream areas and the midstream segments of the right bank of the Teesta River. The degree of flood risk in these three clusters was significantly different. A significant negative correlation was observed between vulnerability and capacity. No significant associations were found between the exposure and vulnerability components. The multivariate analysis suggested that households’ perceived preparedness was influenced by their ability to responds to floods. The empirical approach presented in this study could be used to assess flood risk in other regions, especially where data is scarce.