Understanding primary healthcare access challenges for married women: A comparative analysis between a flood-induced and a non-flood-induced in Bangladesh

Introduction: Aligned with Sustainable Development Goals 3 and 13, the Government of

Bangladesh has emphasized equitable access to healthcare, yet married women in rural

flood-induced s still face significant barriers to utilizing primary healthcare services. While

existing research highlights some challenges, few studies offer a comparative analysis

between flood-induced and non-flood-induced s. Therefore, this study aims to make a

comparative analysis of healthcare access challenges faced by married women between

flood-induced and non-flood-induced s

Methods: A mixed-method design was employed, incorporating quantitative and qualitative

approaches. A household survey was conducted with 200 married women using stratified

random sampling in Paikgachha (flood-induced) and Fultola (non-flood-induced) upazilas.

For the qualitative component, in-depth interviews and focus group discussions were

conducted with purposively selected participants who experienced healthcare barriers. The

Social Ecological Model guided both data collection and analysis. Quantitative data were

analyzed using descriptive statistics, while qualitative data were analyzed using the

Framework approach.

Findings: Quantitative findings find that only 2 % of women in the flood-induced reported

access to primary healthcare during floods, compared to 84 % in the non-flood area.

Women in flood s also reported higher rates of service disruption, transport unavailability,

and reliance on informal care. Qualitative analysis identified four overarching themes: (i)

individual-level challenges such as low health awareness and physical limitations; (ii)

family-level barriers like lack of spousal support and prioritization of household needs; (iii)

community-level issues including religious restrictions and seasonal isolation; and (iv)

organizational barriers such as facility closures, staff absenteeism, and inadequate

infrastructure.

Conclusion: The study offers critical insights into how flood vulnerability, gender norms,

and systemic limitations intersect to hinder healthcare access for married women in rural

Bangladesh. The findings call for geographically sensitive and gender-responsive health

interventions to address these inequalities.

• Supervision