Health coping strategies of the people vulnerable to climate change in a resource-poor rural setting in Bangladesh

Abstract

BackgroundAmong the many challenges faced by the people of Bangladesh, the effects of climate change are discernibly threatening, impacting on human settlement, agricultural production, economic development, and human health. Bangladesh is a low-income country with limited resources; its vulnerability to climate change has influenced individuals to seek out health coping strategies. The objectives of the study were to explore the different strategies/measures people employ to cope with climate sensitive diseases and sickness.MethodsA cross-sectional study was conducted among 450 households from Rajshahi and Khulna districts of Bangladesh selected through multi-stage sampling techniques, using a semi-structured questionnaire supplemented by 12 focus group discussions and 15 key informant interviews.ResultsRespondents applied 22 types of primary health coping strategies to prevent climate related diseases and sickness. To cope with health problems, 80.8% used personal treatment experiences and 99.3% sought any treatments available at village level. The percentage of respondents that visited unqualified health providers to cope with climate induced health problems was quite high, namely 92.7% visited village doctors, 75.9% drug stores, and 67.3% self-medicated. Ninety per cent of the respondents took treatment from unqualified providers as their first choice. Public health facilities were the first choice of treatment for only 11.0% of respondents. On average, every household spent Bangladesh Currency Taka 9,323 per year for the treatment of climate sensitive diseases and sickness. Only 46% of health expenditure was managed from their savings. The rest, 54% expenditure, was supported by using 24 different sources, such as social capital and the selling of family assets. The rate of out-of-pocket payment was almost 100%.ConclusionPeople are concerned about climate induced diseases and sickness and sought preventive as well as curative measures to cope with health problems. The most common and widely used climate health coping strategies among the respondents included self-medicating and seeking the health service of unqualified private health care providers. Per family spending to cope with such health problems is expensive and completely based on out of pocket payment. There is no fund pooling, community funding or health insurance program in rural areas to support the health coping of the people. Policies are needed to reduce out-of-pocket payment, to improve the quality of the unqualified providers and to extend public health services at rural areas and support climate related health coping. Collection of such knowledge on climate related health coping strategies can allow researchers to study any specific issue on health coping, and policy makers to initiate effective climate related health coping strategies for climate vulnerable people.

Climate Change Impacts in Agricultural Communities in Rural Areas of Coastal Bangladesh: A Tale of Many Stories

“…The findings of this paper are consistent with those of other research work on health, ecological, economic, and social network impacts in coastal settings in Bangladesh [26,76,79,81,82]. The present paper identified the consequential occurrence of different orders of impacts on six surveyed agricultural communities.…”

Local Expert Perceptions of Migration as a Climate Change Adaptation in Bangladesh

“…There is no especial reason why they should have: Bangladesh's history, from long before independence, involves interconnecting migration, poverty, livelihoods, and calamity from environmental hazards and from conflict, amongst other factors. Migration, even when principally forced rather than voluntary, in the respondents' views, is used to cope with and adapt to a wide variety of circumstances including but not limited to climatic influences, a viewpoint corroborated by the literature on Bangladesh [27,39,41,[63][64][65]. The literature beyond Bangladesh also aligns with this view [1][2][3]5,8,25,26] including for locations such as small islands [9,[22][23][24] and the Sahel [19][20][21].…”

“…Bangladesh is frequently labeled as being amongst the most vulnerable countries to climate change [27][28][29][30][31]. One consequence could be that about 20 per cent of the entire country eventually becomes submerged due to sea-level rise and subsequent erosion, with the loss of coastal land projected to reach up to 3% by the 2030s, 6% by the 2050s, and 13% by 2080 [32].…”

Public Health Perspectives due to Climate Change in Bangladesh

“…Research projects that, Bangladesh will be one of the worst victims of climate change A number of studies indicated that climate change has 1 affecting general health of the population in Bangladesh . Climate change increases the incidences of water borne and air borne diseases and changes in the climatic condition is suitable for bacteria, parasites and disease vectors to breed 4 very rapidly . The magnitude of malaria, dengue, childhood diarrhoea and pneumonia is very high among the affect 3 communities in Bangladesh.…”

“…The magnitude of malaria, dengue, childhood diarrhoea and pneumonia is very high among the affect 3 communities in Bangladesh. Climate change is also responsible for severe health problems like dehydration, malnutrition and heat related morbidity among the children 4 and elderly population . In Bangladesh, so far number of health problems like colds, coughs, fevers, dysentery, headaches, skin diseases, burning sensations, conjunctivitis, jaundice, Hepatitis-B, skin burns/blistering, asthma, typhoid, pox, weight loss, rheumatism/aching, pneumonia are 4 associated with extreme weather events .…”