Community-scale assessment of flood-related public health vulnerability using multi-criteria AHP in Northwestern Bangladesh

Abstract

Bangladesh is one of the worst victims of climate change that increases flood vulnerability, particularly in riverine areas (the central- northern part of Bangladesh), where health impacts are severe. This empirical study aims to estimate the public health vulnerability of Dimla Upazila (Nilphamari district) for flood hazards using the analytical hierarchy process (AHP), incorporating expert- weighted indicators: socio-demographics, WASH infrastructure, healthcare access, flood intensity, relief availability, and adaptation capacity. A total of 315 households from six unions were randomly selected and structured questionnaire survey were performed in 2019. Results reveal that the contribution of all indicators to public health vulnerability and flooding intensity has been the most influential factor, followed by relief accessibility, healthcare service accessibility, WASH infrastructure conditions, and the adoption of adaptation strategies. This study indicates that the Purba Chatnai and the Khoga Kharibari (northern part of the Upazila) exhibit the highest vulnerability due to their low socio-economic status and limited relief access. On the other hand, Tepa Kharibari, a centrally located union adjacent to the river, experiences frequent flooding but demonstrates moderate vulnerability for its robust DRR measures, underscoring that physical exposure alone does not determine health risks. By connecting household-level vulnerabilities, infrastructural robustness, and post-disaster responses, this study demonstrates that integrating reactive and proactive measures is essential for reducing public health vulnerability to floods, offering insights relevant to Bangladesh and other flood-prone settings. This study distinguishes among structural deficits, capacity gaps and coordination failures- which framework is also transferable to other flood- prone regions. This can enhance community health resilience and can offer a transformative approach to disaster management. Furthermore, the research can assist policymakers and other relevant stakeholders in identifying gaps and enable them to adopt targeted DRR interventions to foster healthier and more resilient communities.