Assessing the Effects of Households' Slow and Rapid Onset Disaster-Related Displacement on Quality Antenatal and Delivery Care Service Utilization in Rural Bangladesh

Households’ recurrent displacement caused by climate-related slow and rapid-onset disasters affects Bangladeshi mothers’ health adversely and is a concern for SDG's targets. Our study for the first time examines the effects of households’ displacement on using quality antenatal care (QANC) and health center-based delivery (HCbD) care and draws comparisons by displacement status and nature of disasters. We used multivariate logistic regression to identify the factors associated with maternal healthcare service utilization using cross-sectional survey data of 2400 mothers, including 1200 displaced caused by slow and rapid-onset disasters, and 1200 non-displaced households, both from riverine and coastal regions. Results show that mothers' healthcare use is adversely affected both directly and indirectly. Only 6% and 15% of slow and rapid-onset disaster-related displaced household mothers respectively had QANC, which is almost three times lower compared to riverine and coastal non-displaced household mothers. Mothers from slow-onset disaster-induced displaced households mothers had an HCbD rate of only 20%, which is 51%, 17%, and 30% points lower than that of mothers from non-displaced riverine, coastal displaced, and coastal non-displaced households respectively. While mothers’ higher education, higher marital age, husbands’ higher education, households’ larger income, more use of ANC, and lesser time, costs and distance to reach doctors are conducive to heightened QANC and HCbD rates, displaced mothers’, particularly who displaced by slow-onset disasters in riverine areas, have the highest vulnerabilities for those aspects. Spotting the multiple effects of displacement, an inter-ministerial collaborative measure to ensure the availability of medical doctors and nurses at local health facilities and to extend the coverage of maternal allowance for displacement-prone regions are suggested policy responses.