Bangladesh is cited as a striking example of development resilience, having recorded consistent and significant gains in economic and other human‑development indicators. Climate change, however, is increasingly jeopardising many of these hard‑won advances, especially in the nation’s coastal zones, where rising sea levels, salinity intrusion, cyclones, flooding, prolonged heat and erratic rainfall have become everyday realities for millions of people. While the impacts affect entire communities, women and girls often shoulder a disproportionate share of the burden because of pre‑existing social, economic and cultural inequalities, and gender disparities in climate effects—particularly on women’s health—are seldom addressed in national or global policy forums.
Climate change is also a public health challenge
Bangladesh is among the nations most exposed to climate‑related hazards. Approximately 40 million people live in the country’s coastal zone, where climate change is already affecting agriculture, freshwater availability, livelihoods and public health, according to the Bangladesh Delta Plan 2100 and a World Bank report published in 2022.
Climate discussions often focus on damaged embankments, agricultural losses, disappearing livelihoods or infrastructure resilience, but an equally urgent crisis— the impact of climate change on women’s health— frequently remains invisible.
Across coastal Bangladesh, environmental changes affect almost every facet of women’s daily routines. They must travel farther to obtain drinking water when local sources become saline, tend to family members suffering from climate‑related illnesses, manage households under increasingly harsh conditions, and frequently place their own health needs secondary to those of other relatives.
Floods and cyclones further limit women’s mobility, often compelling them to forgo medical care.
Unpaid care work performed by women is seldom reflected in economic statistics, yet it underpins community resilience during each climate shock. Research consistently indicates that women devote considerably more time than men to unpaid care and domestic duties, especially during and after climate‑related disasters, which restricts their access to education, paid employment and health services (UN Women, 2023; ILO, 2022).
One of the most evident instances of climate‑related health vulnerability occurs among pregnant women. During monsoon periods or following cyclones, road networks can become impassable, boat services may be suspended, and health facilities can lie several hours away.
Even when medical services remain operational, transportation expenses often rise beyond the means of low‑income households, leaving many women without essential maternal care such as antenatal visits, deliveries attended by skilled personnel, and emergency obstetric treatment, thereby endangering their lives.
Research in coastal Bangladesh has linked rising salinity in drinking water to increased sodium intake among pregnant women, contributing to higher risks of gestational hypertension and pre‑eclampsia, according to Khan et al. (2011) and the World Health Organization (2024).
In Bangladesh, the maternal mortality ratio declined from approximately 434 deaths per 100,000 live births in 2000 to around 123 in recent estimates, marking one of South Asia’s major public health success stories, according to 2023 data from the WHO, UNICEF, UNFPA, World Bank, and UNDESA. Protecting these achievements now requires recognizing climate resilience as an integral component of maternal healthcare.
Health systems must be prepared not only to respond after disasters but also to ensure the continuity of essential reproductive and maternal health services before, during, and after climate events.
In numerous climate‑vulnerable communities, floods, cyclones and prolonged water scarcity increasingly impede access to safe water, sanitation facilities and privacy. Consequently, girls and women often find it difficult to maintain menstrual hygiene when toilets are damaged, freshwater is unavailable or sanitary products become unaffordable.
Adolescent girls face more than physical discomfort during menstruation; they often experience embarrassment, anxiety and fear, particularly in schools that lack adequate sanitation facilities or in displacement contexts where families are confined to crowded shelters with limited privacy.
Some girls opt to miss school while they are menstruating, and others limit their food or water consumption to avoid using inadequate toilet facilities. Both practices are reported to undermine their participation in education, diminish confidence and harm overall well‑being.
These experiences underscore that climate adaptation extends beyond reinforcing embankments or improving disaster forecasting; it must also guarantee dignity, privacy and basic health services for women and girls.
Psychological impacts of climate change attract considerably less attention than its physical health effects. Women continue to bear a disproportionate share of the care burden, face limited access to maternal and menstrual health services, and confront financial anxieties linked to climate change. Mothers frequently shoulder the emotional responsibility of securing food, caring for children and elderly relatives, and managing household duties amid growing uncertainty. Prolonged or repeated climate‑related disruptions often compel younger family members to migrate, thereby increasing women’s caregiving obligations.
The ongoing uncertainty can foster anxiety, emotional exhaustion and depression. Nevertheless, mental‑health services remain scarce, especially in rural coastal regions where specialised support is often unavailable.
Bangladesh has received international recognition for lowering disaster‑related mortality by investing in early‑warning systems, cyclone shelters and community‑preparedness programmes. Yet officials note that the next generation of climate adaptation will demand a broader conception of resilience.
Resilience cannot be gauged solely by the count of embankments erected or cyclone shelters constructed. It is equally evident when pregnant women can reach medical care safely during emergencies, adolescent girls can continue their education with dignity, families maintain reliable access to clean drinking water, and women are able to recover physically and emotionally after disasters; thus, climate resilience must be people‑centered, gender‑responsive and health‑focused.
Discussions of climate vulnerability frequently depict women chiefly as victims. Yet throughout Bangladesh, women also rank among the nation’s key agents of resilience.
In coastal villages, women have devised numerous strategies to cope with shifting environmental conditions. They meticulously conserve limited freshwater supplies, broaden household earnings through home‑based enterprises, safeguard food stocks during uncertain periods, assist neighbours when disasters strike and keep children in school despite repeated interruptions.
Their roles as community‑health volunteers, teachers and local‑government representatives are essential to both disaster preparedness and post‑event recovery.
Nevertheless, such contributions frequently go unnoticed in planning and decision‑making processes. Women continue to be under‑represented on many local adaptation and mitigation committees, and policies crafted without women’s perspectives risk overlooking the everyday realities of climate‑vulnerable communities.
Mass immunisation, community‑based health services, maternal‑health programmes and improvements to primary healthcare have played a major role in the country’s development progress. Climate change now requires that these investments be adapted.
Healthcare systems need to achieve climate resilience by guaranteeing continuous delivery of essential services during environmental emergencies. This entails preserving maternal and reproductive health care, vaccination programmes, nutrition assistance, mental‑health services and access to safe water and sanitation throughout floods, cyclones and prolonged heatwaves.
Digital health technologies, mobile outreach programmes, community clinics and trained frontline health workers are all capable of reaching vulnerable groups when standard services are interrupted.
It is also crucial that climate‑adaptation financing explicitly incorporates health‑system strengthening, rather than relegating health to a secondary priority.
Protecting women’s health should not be viewed as a sectoral issue confined to the Ministry of Health, but rather as being closely connected to agriculture, education, water management, social protection, local governance, disaster risk reduction, and economic development. A healthier population is better equipped to withstand climate shocks, recover from disasters, and contribute productively to society.
As Bangladesh prepares for an increasingly uncertain climate future, five priorities deserve particular attention.
First, climate adaptation planning must integrate women's health. National and local climate strategies should explicitly address maternal health, reproductive healthcare, menstrual health, nutrition, mental wellbeing, and gender-based violence as core components of resilience. Additionally, health indicators should be included alongside infrastructure and environmental targets.
Second, primary healthcare must be made climate-resilient by equipping community clinics and primary health centers to maintain essential services during disasters. This preparation entails ensuring emergency transportation, reliable electricity, safe water, adequate medical supplies, and trained personnel who are capable of responding to climate-related health challenges.
Third, improve water, sanitation, and hygiene infrastructure, as access to clean water and safe sanitation remains fundamental for women’s health. Investments in climate-resilient WASH infrastructure should prioritize schools, healthcare facilities, cyclone shelters, and remote communities where women and girls face the greatest barriers.
Fourth, women's participation in climate governance must be expanded. Women should have meaningful representation on disaster management committees, in local government planning, in water resource management, and in climate adaptation initiatives. Their lived experiences provide valuable knowledge that can improve policy effectiveness.
Finally, the text calls to strengthen social protection for climate-vulnerable households, noting that climate shocks often deepen poverty and force families into difficult coping strategies. It adds that responsive and inclusive social protection programs can reduce financial insecurity while helping women maintain access to healthcare, nutritious food, education, and essential services during times of crisis.
No single institution can address the complex relationship between climate change and women’s health. Government agencies, development partners, research institutions, civil society organizations, local governments, and communities all have important roles to play.
Researchers can generate evidence that informs better policy, while universities train the next generation of public health and climate professionals. Civil society organizations can amplify community voices and strengthen accountability. Additionally, the private sector can contribute through innovation in health technologies, clean water solutions, and sustainable infrastructure, and development partners can support long-term investments that prioritize locally led adaptation.
Most importantly, communities themselves must remain at the center of decision-making. Policies are strongest when they reflect the realities, priorities, and aspirations of the people they are intended to serve.
Building Bangladesh better means leaving no woman behind
Bangladesh’s future will not be determined solely by economic growth, modern infrastructure, or technological advancement. It will also depend on whether development remains inclusive, equitable, and resilient in the face of growing climate uncertainty.
Women living in climate-vulnerable regions are not asking for extraordinary privileges, but rather reliable healthcare, clean drinking water, safe sanitation, secure livelihoods, accessible transportation during emergencies, and opportunities to participate in decisions affecting their lives. These needs represent both fundamental rights and essential foundations of sustainable development.
Protecting women's health is therefore not an additional item on the development agenda. It remains central to achieving many of Bangladesh’s national aspirations, including improved public health, greater gender equality, stronger local governance, enhanced climate resilience, and sustained economic progress.
The theme of Building Bangladesh Better invites people to imagine the kind of nation they want to create over the coming decades. It provides an opportunity to move beyond rebuilding after disasters and instead invest in systems that protect people before crises occur.
The initiative challenges individuals to recognize that resilience is not measured solely by stronger roads, embankments, or buildings. It is also measured by healthier mothers, confident adolescent girls, accessible healthcare, and communities where every person can thrive despite environmental change.
By placing women’s health at the heart of climate adaptation, Bangladesh can safeguard decades of development progress while building a future that is not only stronger and more resilient, but also more just, inclusive, and compassionate.
Md Al-Mamun is a Research Associate at the BRAC Institute of Governance and Development (BIGD), BRAC University. He can be reached at md.mamun@bracu.ac.bd
Marufa Alam, a lecturer in the Department of Public and Community Health at Frontier University Garowe, Somalia, can be reached at marufa@frontier.edu.so.
Why it matters
Protecting women's health and integrating gender-responsive strategies into climate adaptation planning are essential for safeguarding Bangladesh's long-term development resilience and public health progress.