Salinity intrusion in coastal Bangladesh has serious population health implications, which are yet to be clearly understood. The study was undertaken through the 'Assessing Health, Livelihoods, Ecosystem Services and Poverty Alleviation in Populous Deltas' project in coastal Bangladesh. Drinking water salinity and blood pressure measurements were carried out during the household survey campaign. The study explored association among Socio-Ecological Systems (SESs), drinking water salinity and blood pressure.High blood pressure (prehypertension and hypertension) was found significantly associated with drinking water salinity. People exposed to slightly saline (1000-2000 mg/l) and moderately saline (≥2000 mg/l) concentration drinking water had respectively 17% (p < 0.1) and 42% (p < 0.05) higher chance of being hypertensive than those who consumed fresh water (<1000 mg/l). Women had 31% higher chance of being hypertensive than men. Also, respondents of 35 years and above were about 2.4 times more likely to be hypertensive compared to below 35 years age group. For the 35 years and above age group, both prehypertension and hypertension were found higher than national rural statistics (50.1%) for saline water categories (53.8% for slightly and 62.5% for moderate saline). For moderate salinity exposure, hypertension prevalence was found respectively 21%, 60% and 48% higher than national statistics (23.6%) in consecutive survey rounds among the respondents. Though there was small seasonal variation in drinking water salinity, however blood pressure showed an increasing trend and maximum during the dry season. Mean salinity and associated hypertension prevalence were found higher for deep aquifer (21.6%) compared to shallow aquifer (20.8%).Localized increase in soil and groundwater salinity was predicted over the study area. Shallow aquifer salinity increase was projected based on modelled output of soil salinity. Rather than uniform increase, there were localized extreme values. Deep aquifer salinity was also predicted to exhibit increasing trend over the period. Study findings and recommendations are suggested for immediate and planned intervention.

Climate change affects almost all aspects of human life, including health. This is particularly true in densely populated and low lying deltas such as Bangladesh. However, the climate‐health nexus is a relatively poorly explored domain of research, which is a cause for concern given the country's intrinsic vulnerability to climatic impacts. The impact of climate change on human health and well‐being can be manifested through different pathways and can be categorized as being direct or indirect, mediated through complex biophysical and social dynamics. The direct effects of climate change that have been observed in Bangladesh include morbidity and mortality due to heat stress, cyclones, floods, droughts and other weather extremes at different spatio‐temporal scales. The indirect effects adopt more complex routes which includes, threatening food and water security due to salinity intrusion, and spread of infectious diseases due to changes in vector and pathogen ecology. Social dynamics in Bangladesh, such as those related to gender roles, poverty and power relations, also influence how the effects of climate change are experienced by different segments of the society. The Government of Bangladesh has a number of measures already in place, efforts that have been complemented by local interventions. Evidence to take robust health policy decisions related to climate change is limited and scattered, while there is a lack of multidisciplinary research efforts. Considering these limitations, generating and summarizing scientific evidence is vital for informing a resilient health system against future public health concerns in climate vulnerable countries such as Bangladesh and in other low‐income regions. This article is categorized under: Assessing Impacts of Climate Change > Evaluating Future Impacts of Climate Change

No abstract

Bangladesh, one of the most disaster-prone countries in the world is also severely exposed to climate change (CC) impacts with a multitude of health complexities. Health adaptation to CC is thus a serious issue in Bangladesh, but not explored properly from a health system and policy environment perspective. In order to address this gap and provide a holistic picture of the overall scenario, this scoping review explores CC impacts on the population health in Bangladesh and discusses the policy environment and health system preparedness against such climatic challenges. A total of 28 articles were reviewed following Arksey and O’Malley’s scoping review framework. A “5-point scale” was devised to assess CC integration in the health sector Operational Plans (OPs). Though the country made significant progress in different health indicators, poverty and income inequality have kept marginal communities out of many health provisions. There are four major stakeholders in the health system. The government sector is handicapped by poor governance, bureaucratic processes, and staff shortages; and primarily focuses on the public sector only. National Health Policy (NHP) governs the health system through 29 sectoral OPs, that put CC as a major cross-cutting issue. About 25% of the OPs have fully integrated CC and other OPs have significant CC co-benefits. In Bangladesh CC was linked to increased morbidity and mortality, diarrhea, cholera, skin problems, respiratory infections, malaria, dengue, kala azar, pre-eclampsia, and hypertension. Significant research gaps exist on child health, migrant health, and mental health. Integration of research evidence into policy, planning and program design is largely absent. However, prioritizing health for the National Adaptation Plan is an essential step towards establishing a climate-resilient health system.

No abstract