Reproductive health challenges in coastal Bangladesh: a silent threat of water salinity.

Abstract

Introduction: Salinity intrusion in coastal Bangladesh presents an escalating public health concern, disproportionately affecting women's health. This study explores the association between salinity exposure and reproductive health problems among women of reproductive age, highlighting the need for targeted interventions and sustainable water management.

Study settings: The study was conducted in Gabura Union, Shyamnagar subdistrict of Satkhira district, a coastal area of Bangladesh highly vulnerable to saline intrusion. Data collection focused on assessing the impact of salinity, particularly reproductive health issues among women, while also evaluating access to fresh water, distance of health care facilities and practice to manage these challenges.

Methods: A cross-sectional study design was employed to assess the reproductive health impacts of salinity on women of reproductive age (18-49 years). A simple random sampling technique was employed to collect data from 234 household surveys.

Results: The findings revealed that water-dependent occupations (OR 3.916, 95% CI 1.944-7.888, p < 0.001), distance of safe drinking water (OR 12.621, 95% CI 4.150-38.385, p < 0.001), and distance of nearest health facility (OR 2.640, 95% CI 1.831-5.045, p = 0.003) were positively associated with an increased likelihood of reproductive health problems. These results highlight the significant role of environmental and resource constraints in exacerbating reproductive health challenges in salinity-affected regions.

Implications: The study identifies a strong association between salinity exposure and reproductive health issues, emphasizing the need for mobile health clinics specializing in reproductive health care, telemedicine services, subsidized household water filtration systems, and expanded rainwater harvesting projects in coastal areas. This study acknowledges certain limitations, including reliance on self-reported data, which may be subject to recall bias, and its cross-sectional design, which restricts causal interpretation. Future research should consider incorporating biomarker analysis, longitudinal designs, and appropriate comparison groups to strengthen causal inferences.