Inequities in Healthcare Seeking Among Migrants and Residents of Climate Affected Coastal Area of Bangladesh

Abstract

Background:Climate change induced sea level rise, increased soil salinity and poor socio-economic condition have triggered migration around the world. So far, the impact of migration on health and healthcare utilization have not been studied adequately especially in Bangladesh. Our study examines impact of migration on healthcare seeking behavior of people living in low-lying coastal areas of Bangladesh. Methods:We analyzed data from Chakaria, Health and Demographic Surveillance System, 2017-18. Univariate analysis and regression analysis were conducted to assess the determinants of migration. Finally, we assessed differences in health care seeking behavior between migrants in low-lying coastal areas and plain areas. Stata version 14 was used for analysis. Results:In terms of determinants of migration, adults, males, educated, unemployed and poor were significantly more like to migrate compared to children, females, people with little education, those engaged in agriculture or other occupations and wealthier households. For pregnancy related services healthcare utilization was significantly lower in coastal areas compared to the plains. In terms of utilization of maternal and child health services, service use was 2-28 % lower among residents of low-lying coastal regions and 13-70% lower among coastal migrants compared to those living in plains. Conclusion:Our findings suggest that in terms of maternal health services there was geographic inequity in service utilization favoring the residents of plains and being a migrant significantly increases the geographical disadvantage in terms of maternal health services. The existing inequity indicates the necessity of immediate action to address the health and healthcare utilization of residents of coastal area with special attention to the migrants in Bangladesh.

Climate justice for the southwestern coastal region of Bangladesh

“…People of the southwestern coastal region of Bangladesh (SWCRB) are already trying to adapt to the effects of CCSLR, such as saltwater intrusion, agricultural loss, and high intensity cyclones. The most vulnerable people are the most susceptible to the effects of climate change, such as people inhabiting areas with compromised security, poor financial conditions, limited awareness of human rights, areas at a geographical disadvantage, and those that contributed the least to climate change (Didar-Ul Islam et al, 2015;Dasgupta et al, 2017;Khanam et al, 2022). Environmental disasters caused by climate change cause stress on these developing countries and lead to social and economic stresses including lack of access to clean water, food, employment, and loss of homes and farms (Alam et al, 2020).…”