Exploring the healthcare challenges and preparedness during disaster in south-western coastal areas in Bangladesh: a qualitative study

Objective To explore the challenges with healthcare services access, delivery and preparedness in the south-western coastal areas of Bangladesh, focusing on the experiences of communities and service providers. Design, participants and methods An exploratory qualitative study was conducted, involving four focus group discussions (FGDs) with community people and 29 key informant interviews (KIIs) with different types of stakeholder, including the Upazila Health and Family Planning Officer, Social Welfare Officers, Union Parishad Chairman (local government member), Local Project Implementation Officers, Upazila Nirbahi Officers and non-government organisation (NGO) representatives. FGDs and KIIs were conducted with purposively selected participants between December 2022 and October 2023. Semi-structured guides were employed to facilitate the sessions and interviews. The duration of FGDs ranged from 1 to 1.5 hours, whereas individual interviews lasted between 40 and 60 min. The collected data were analysed manually using a phenomenological approach to explore participants’ lived experiences and perceptions. Setting The study was conducted in south-western coastal Bangladesh, in Shyamnagar and Ashashuni Upazilas of Satkhira district, and Mongla and Rampal Upazilas of Bagerhat district. Results We explored two main themes, challenges in healthcare access and delivery during disasters and preparedness strategies adopted by government, NGOs and communities. Healthcare access was constrained by poor transportation, riverine locations, limited ambulances, financial barriers and inadequate local facilities and supplies. Weak emergency response systems and facility readiness further delayed delivery of healthcare, particularly for maternal and injury services. Preparedness included government mobile and union-level medical teams, NGO medical camps and community-led informal care. Despite these efforts, the lack of infrastructure, planning and resources highlights the need for strengthened coordination and targeted interventions to ensure equitable, timely healthcare delivery in coastal Bangladesh. Conclusion The findings of this study demonstrated that effective collaboration among government authorities, NGOs and local communities with clearly defined roles is essential to ensure healthcare delivery during climate-related natural hazards. Such coordination enables efficient use of resources and addresses community needs. Policymakers should develop strategies to establish and maintain functional preparedness systems, strengthening disaster response and ensuring timely healthcare access.