Healthcare-seeking behaviours of climate-induced internally displaced people and non-displaced people in Bangladesh

Climate-related extreme events, including floods and riverbank erosion, affect the livelihoods for millions of rural Bangladeshis and force them to change their usual place of residence permanently. However, little is known about healthcare-seeking behaviors of the large and growing number of climate-induced internally displaced people. This thesis explores the displacement disadvantages and healthcare-seeking behaviors of people whose households have experienced displacement due to floods and riverbank erosion, and those whose households have not experienced such displacement. Data for this thesis were collected using a cross-sectional survey from 1,200 randomly selected households, 600 from two displacement-prone districts and 600 from two non-displacement-prone districts, located in the north-western mainland regions of Bangladesh. It draws comparisons between the displaced and the non-displaced, between those displaced suddenly (displacement occurred at short notice due to a natural disaster) and those displaced gradually (resettlement process occurred gradually in anticipation of a natural disaster), and by the frequency of past displacement. Multiple logistic regression was used to identify the effect of displacement and other predictors on each outcome measure relating to the utilization of healthcare services. The results show that the displaced experience multiple disadvantages compared to the non-displaced. The disadvantages of the displaced are intensified by sudden displacement and increased number of displacements. The displaced have reduced healthcare options, which, in turn, affects their healthcare-seeking behaviors. The children of climate-displaced parents are less likely to be treated by a trained provider during illness than those of non-displaced parents. Moreover, the utilization of health facilities for antenatal, delivery and postnatal care services is significantly lower among displaced mothers than among non-displaced mothers. The findings have important implications for enhancing healthcare-seeking behavior of the climate-affected Bangladeshi people, and for the effectiveness of maternal and child healthcare related programs.