Healthcare Capabilities in Disasters and Spatial-social Inequalities: A Case Study of Nijhum Dwip (Island) of Bangladesh

Abstract

This study examines the health and healthcare accessibility of locals on the remote island of Nijhum Dwip under Noakhali district of Bangladesh. The research employed a multi-strategy methodology, using diverse methods: a household survey (sample size of 118), three focus group discussions (FGDs), five key informant interviews (KIIs), and observational techniques to collect data from ten villages in Nijhum Dwip. Data analysis indicates that 70.4% of Nijhum Dwip people acquire medications from drugstores without consulting a physician and around one-fourth (25.5%) of the respondents have access to governmental or private healthcare services, and 4.1% of them consult Kabiraj. A significant proportion (84.7%) of childbirth takes place with the involvement of untrained midwives. In Nijhum Dwip, 79.4% of the population is living in poverty, deterring their ability to afford fundamental medical care (which exceeds USD 13 per treatment) and costly transportation (each journey about USD 26). Merely 66.3% of residents can get access to medical facilities during cyclones; of them, only 18.1% seek treatment at healthcare centres, while 81.9% procure drugs without contacting a physician. The research highlights two primary determinants of healthcare access in Nijhum Dwip: spatial disparities and disasters, both necessitating targeted intervention to enhance the health and wellbeing of local people. So, it is crucial to construct healthcare centers in Nijhum Dwip so that residents would not have to travel far to receive medical care. To lessen the effects of disasters and the island's spatial-social inequality, more roads, cyclone centers and educational facilities should be built. 

The Dhaka University Journal of Earth and Environmental Sciences, Vol. 14(2), 2025, P 17-31