Women's Health Related Vulnerabilities in Natural Disaster Affected Areas of Bangladesh

Abstract

<p><b>Background</b></p> <p>Natural disasters have a wide range of adverse health effects on disaster survivors, particularly women who are considered vulnerable compared to men in this context worldwide. There is a paucity of literature regarding women's physical and mental health conditions and how their health is affected in disaster-prone areas of Bangladesh, one of the most vulnerable and disaster affected countries due to its environmental and socio-economic position.</p> <p><b>Aim</b></p> <p>The aim of this study was to explore the physical and mental health of disaster-affected women as well as their prevalence and level of post-traumatic stress disorder (PTSD) symptoms. The study also sought to understand the main associated factors that affected women's health in the disaster-prone areas of Bangladesh as well as their experiences of disasters.</p> <p><b>Methods</b></p> <p>This study used a mixed methods convergent research design. Participants (n = 413) were recruited using a systematic random sampling approach from two disasteraffected regions, Upazilas of <i>Sarankhola</i> and <i>Sagata</i>, in Bangladesh. A structured survey was used with the health measures Short-Form 12 (SF-12) and Impact of Event Scale-Revised (IES-R), followed by qualitative interviews with disaster-affected women who had previously completed the survey (n = 24). Qualitative data collection adopted purposeful convenient sampling techniques and included semi-structured interviews. Quantitative data were analysed using descriptive, bivariate, and multivariate statistics in SPSS while qualitative data were thematically analysed. The pillar integration process was utilised in the final stage to integrate and interpret the overall study findings.</p> <p><b>Results</b></p> <p>This thesis explored the health and well-being of disaster-affected women in Bangladesh using a mixed methods approach. The quantitative survey data highlighted participants' significant poor physical and mental health outcomes as well as significant differences between groups of participants who witnessed casualties, lost family members or relatives, relocated to shelters and sacrificed their food during disasters. There was a significant difference in mental health outcomes with the women who visited a medical practitioner reporting high prevalence of lower mental health scores compare to the women who did not visit medical practitioners. In addition, participants were identified with significant PTSD symptoms and there is a difference in the prevalence of PTSD symptoms between geographical areas in the study. Three major themes with additional subthemes were identified from the qualitative interview responses. These were <i>Trauma, Fear</i>, and <i>Gender-based vulnerabilities during disasters</i>. The integration process identified six main themes to interpret the overall findings. Physical health and well-being, mental health and wellbeing, emotional distress, socio-cultural vulnerabilities, environmental vulnerabilities,and gendered vulnerabilities. These integrated themes expand our understanding by explaining the associated causes and consequences of natural disasters on women's overall health and well-being in Bangladesh.</p> <p><b>Conclusions</b></p> <p>To our knowledge, this is the first study in Bangladesh to look at physical health, mental health, and post-traumatic stress disorder (PTSD) symptoms using valid health measures, including SF-12, and IES-R, in two different geographical areas. During the growing global concern of the natural disasters-inclined health threat to women, this research provides an important, initial platform to explore the physical and mental health outcomes as well as PTSD symptoms of disaster-affected women in Bangladesh. Given the overall health and well-being conditions as well as related health vulnerabilities of participants reported in this research, and the increasing frequency of disasters in this region, further research in this area is essential.</p>