Bangladesh has become a remarkable example of development resilience, with consistent, significant improvements in economic and other human development indicators. Climate change is increasingly threatening many of these hard-earned gains, particularly in the country’s coastal regions. Rising sea levels, salinity intrusion, cyclones, flooding, prolonged heat, and erratic rainfall are no longer distant environmental concerns—they have become everyday realities for millions of people. While climate change affects entire communities, women and girls often bear a disproportionate share of the burden because of existing social, economic, and cultural inequalities. Gender disparities in climate impacts, particularly on women’s health, are rarely discussed in national and global policy forums.
Climate change is also a public health challenge
Bangladesh is among the countries most exposed to climate-related hazards. Nearly 40 million people live in Bangladesh’s coastal zone, where climate change is already affecting agriculture, freshwater availability, livelihoods, and public health (Bangladesh Delta Plan 2100; World Bank, 2022). Climate discussions frequently focus on damaged embankments, agricultural losses, disappearing livelihoods, or infrastructure resilience. These are undoubtedly important. However, an equally urgent crisis often remains invisible -- the impact of climate change on women’s health.
Across coastal Bangladesh, environmental changes influence nearly every aspect of women's daily lives. Women travel longer distances to collect drinking water when water near their homes becomes saline, care for sick family members during climate-related illnesses, manage households under increasingly difficult conditions, and often sacrifice their own health needs to ensure that other family members are cared for first. Floods and cyclones restrict their mobility, often forcing them to forgo healthcare.
Their unpaid care work is rarely counted in economic statistics, yet it quietly supports community resilience during every climate shock. Studies have consistently shown that women spend significantly more time than men on unpaid care and domestic work, particularly during and after climate-related disasters, limiting their opportunities for education, paid employment, and healthcare (UN Women, 2023; ILO, 2022).
When pregnancy becomes more dangerous
One of the clearest examples of climate-related health vulnerability can be seen during pregnancy. During the monsoon season or after cyclones, roads may become impassable, boats may stop operating, and health facilities may be several hours away. Even when services remain available, transportation costs often increase beyond what poorer households can afford. So, these women are frequently deprived of essential maternal healthcare, including antenatal care, delivery with skilled attendants, and emergency obstetric services, risking their lives.
Additionally, research conducted in coastal Bangladesh has linked increasing salinity in drinking water with elevated sodium intake among pregnant women, contributing to higher risks of gestational hypertension and pre-eclampsia (Khan et al., 2011; WHO, 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—one of South Asia’s major public health success stories (WHO, UNICEF, UNFPA, World Bank, & UNDESA, 2023). 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 continuity of essential reproductive and maternal health services before, during, and after climate events.
The silent burden of menstrual health
In many climate-vulnerable communities, access to safe water, sanitation facilities, and privacy becomes increasingly difficult during floods, cyclones, or periods of prolonged water scarcity. Girls and women often struggle to maintain menstrual hygiene when toilets are damaged, freshwater is unavailable, or sanitary products become unaffordable.
For adolescent girls, these challenges extend beyond physical discomfort. Feelings of embarrassment, anxiety, and fear frequently accompany menstruation, particularly when schools lack adequate sanitation facilities or when displacement forces families into crowded shelters with limited privacy.
Some girls choose to miss school during menstruation. Others reduce food or water intake to avoid using inadequate toilets, negatively affecting their educational participation, confidence, and overall well-being.
These experiences remind us that climate adaptation is not only about strengthening embankments or improving disaster forecasting. It is also about ensuring dignity, privacy, and basic health needs for women and girls.
Mental health deserves equal attention
The psychological consequences of climate change receive far less attention than physical health impacts. Again, women are disproportionately affected by the care burden, limited access to maternal and menstrual health, on top of the financial worries created by climate change. Mothers often carry the emotional burden of ensuring food security, caring for children and older family members, and managing household responsibilities under increasingly uncertain conditions. Repeated or prolonged climate change often forces young family members to migrate, leaving women with greater caregiving responsibilities.
This constant uncertainty can contribute to anxiety, emotional exhaustion, and depression. Yet mental health services remain limited, particularly in rural coastal areas where specialized support is often unavailable.
Climate adaptation must become gender-responsive
Bangladesh has earned international recognition for reducing disaster-related mortality through investments in early warning systems, cyclone shelters, and community preparedness. However, the next generation of climate adaptation requires a broader understanding of resilience.
Resilience is not measured only by the number of embankments constructed or cyclone shelters built. It is equally reflected in whether pregnant women can safely reach healthcare during emergencies, whether adolescent girls can continue attending school with dignity, whether families have reliable access to clean drinking water, and whether women can recover physically and emotionally after disasters. In other words, climate resilience must be people-centered, gender-responsive, and health-focused.
Women as leaders of climate resilience
Conversations about climate vulnerability often portray women primarily as victims. But, across Bangladesh, women are also among the country’s most important agents of resilience.
In coastal villages, women have developed countless ways of adapting to changing environmental conditions. They carefully manage scarce freshwater, diversify household income through home-based enterprises, preserve food during periods of uncertainty, support neighbors during disasters, and ensure children continue their education despite repeated disruptions. Women’s participation as community health volunteers, teachers, and local government representatives is critical in disaster preparedness and recovery.
Yet these contributions often remain invisible in planning and decision-making. Women remain underrepresented in many local adaptation and mitigation committees. Policies designed without women’s perspectives risk overlooking the realities of everyday life in climate-vulnerable communities.
Investing in health is investing in resilience
Mass immunization, community-based healthcare, maternal health programs, and improvements in primary healthcare have contributed significantly to the country’s development progress. Climate change now demands that these investments evolve.
Healthcare systems must become climate resilient by ensuring uninterrupted essential services during environmental emergencies. This includes maintaining maternal healthcare, reproductive health services, vaccination programs, nutrition support, mental health care, and access to safe water and sanitation even during floods, cyclones, and prolonged heatwaves.
Digital health technologies, mobile outreach services, community clinics, and trained frontline health workers can all play an important role in reaching vulnerable populations when conventional services are disrupted. Equally important is ensuring that climate adaptation funding explicitly includes health system strengthening rather than treating health as a secondary concern.
Protecting women’s health should not be viewed as a sectoral issue confined to the Ministry of Health. It is 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.
Five priorities for building Bangladesh better
As Bangladesh prepares for an increasingly uncertain climate future, five priorities deserve particular attention.
First, integrate women’s health into climate adaptation planning. 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. Health indicators should be included alongside infrastructure and environmental targets.
Second, strengthen climate-resilient primary healthcare. Community clinics and primary health centers should be equipped to continue delivering essential services during disasters. This includes emergency transportation, reliable electricity, safe water, adequate medical supplies, and trained personnel capable of responding to climate-related health challenges.
Third, improve water, sanitation, and hygiene infrastructure. 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, expand women’s participation in climate governance. 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, strengthen social protection for climate-vulnerable households. Climate shocks often deepen poverty and force families into difficult coping strategies. 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.
A whole-of-society approach
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. Universities can train the next generation of public health and climate professionals. Civil society organizations can amplify community voices and strengthen accountability. The private sector can contribute through innovation in health technologies, clean water solutions, and sustainable infrastructure. 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. They seek reliable healthcare, clean drinking water, safe sanitation, secure livelihoods, accessible transportation during emergencies, and opportunities to participate in decisions that affect their lives. These are not only fundamental rights but also essential foundations of sustainable development.
Protecting women's health is therefore not an additional item on the development agenda. It is 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 us to imagine the kind of nation we want to create over the coming decades. It is an opportunity to move beyond rebuilding after disasters and instead invest in systems that protect people before crises occur. It challenges us to recognize that resilience is not measured only by stronger roads, embankments, or buildings, but also by healthier mothers, confident adolescent girls, accessible healthcare, and communities where every individual 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 is a Lecturer in the Department of Public and Community Health at Frontier University Garowe, Somalia. She can be reached at marufa@frontier.edu.so