Bangladesh has long been a focal point in both national and international climate change discussions, given its high vulnerability to the impacts of climate change. The country is home to one of the world’s largest deltaic systems, with a 710 km coastal stretch that places approximately 40 million people at risk from frequent cyclones, storm surges, floods, droughts, and sea-level rise. Over the past decade, research has indicated a marked increase in the frequency, intensity, and variability of these disasters. In coastal regions, disaster risk has been further heightened due to poorly planned and managed urban expansion, environmental degradation, deforestation, rapid settlement, and poor governance.

In response to these pressing challenges, the Centre for Disability in Development (CDD) implemented the “Inclusive Impact Chain Analysis for Risk-Informed Development Planning for Healthcare Sector in Bangladesh (ICA & RID)” project, specifically targeting Teknaf Municipality and Baharchara Union in Teknaf Upazila, Cox’s Bazar District. This initiative was funded by the Global Initiative on Disaster Risk Management (GIDRM), an initiative commissioned by the German Federal Ministry for Economic Cooperation and Development (BMZ) and implemented by the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ). The project was awarded to the Centre for Climate Change & Environmental Research (C3ER) at BRAC University, which conducted a thorough and inclusive Impact Chain Analysis (ICA) in the designated study areas.

The primary objective of this study was to operationalise the concept of Impact Chain Analysis as a method for identifying vulnerable Critical Infrastructure (CI) within Bangladesh’s healthcare sector. This cross-sectional assessment adopted a mixed-methods approach, integrating both quantitative and qualitative research methodologies. The study incorporated various methods, including literature reviews, household surveys, national and local workshops, Key Informant Interviews (KIIs), and the Impact Chain Analysis of critical infrastructure and vulnerable populations within the study locations.

The relatively novel ICA method yielded valuable insights, providing a comprehensive understanding of climate change vulnerability among various stakeholders and aiding in the identification of appropriate adaptation measures. The ICA framework facilitated the identification of climate change impacts on health and healthcare infrastructure, alongside potential adaptation measures encompassing all vulnerable population groups within a single impact chain. Moreover, impact chain diagrams illustrated the clear relationships between each component (hazards, exposure, sensitivity, vulnerability, etc.), aiding in the formulation of appropriate adaptation measures and recommendations to mitigate climate change risks and vulnerabilities.

Furthermore, the application of ICA in the study locations enabled community engagement in identifying climate risks and vulnerabilities related to human health and healthcare infrastructure, thus facilitating more informed decision-making to minimise these risks.

Following the data collection process, which included a household survey and impact chain analysis, the study team conducted data analysis using MS Excel and SPSS (data analysis software). The findings of the household survey were visually presented through various diagrams and charts, while the impact chain analysis diagram was illustrated using MS Visio.

The study’s overall findings highlight the extreme vulnerability of the study area to climate change-induced events, particularly cyclones, storm surges, and landslides, and the exacerbating impact of non-climatic or anthropogenic factors such as wild elephant attacks and kidnappings. The majority of the population in the study area struggles with poverty and illiteracy, with limited knowledge of the trends of climate change-induced disasters. The impact of climate change on human health was clearly delineated, with vector-borne diseases (e.g., dengue), water-borne diseases (e.g., diarrhoea, dysentery), and heat-related illnesses (e.g., stroke) identified as major climate change-induced health issues among respondents. In addition to physical health concerns, the study underscored numerous mental health issues, including frustration, depression, and stress.

The study also emphasised the vulnerability of healthcare infrastructure and services to the impacts of climate change, revealing a disparity in the man-hospital ratio and compromised health-seeking behaviour due to an inadequate number of health infrastructures. Additionally, the study highlighted the lack of inclusivity for persons with disabilities and other vulnerable groups in most healthcare infrastructures, exacerbating challenges during disaster periods.

Adaptive measures suggested by respondents included the need for increased public education and awareness of climate change impacts and associated adaptation measures through participation in awareness-raising campaigns, training events, and workshops. The study highlighted the community’s heavy reliance on self-funding for adaptation to increased disaster impacts, with minimal external support.

The major recommendations proposed by the study encompass the revision and effective implementation of existing policy and legislative frameworks, ensuring easy accessibility of health services and facilities, initiatives to reduce community vulnerability, provision of capacity-building training and awareness-raising sessions, and ensuring inclusive health and other services for vulnerable communities.

The findings and recommendations of this study are intended to guide the government, non-governmental organisations, relevant authorities, and policymakers in implementing necessary initiatives to minimise the impacts of climate change-induced disasters and associated vulnerabilities. Moreover, the study presents the advantages and disadvantages of implementing the ICA method, underscoring its potential for identifying and analysing the impacts of climate change across various sectors. This introduces the possibility of employing ICA in other sectors to conduct similar research and take necessary steps to mitigate sectoral risks.

For a comprehensive exploration of the findings and recommendations, the full report is available for download by clicking the button below. This document also delves into the broader applications of the ICA method, paving the way for holistic climate risk assessments and mitigation strategies across diverse sectors.