Ill-health is often considered as a poverty trap, especially when it affects income-earners. Access to very limited and low quality health services can worsen the situation. Like most developing countries, Bangladesh still lags behind in terms of achievement of health related MDG targets. The impact of ill-health in the context of Bangladesh is not only short-term well-being decline but these also have longer-term significant negative impact on households’ overall resilience.
This qualitative study, conducted in the CHT explores the health-seeking behaviour and the treatment-seeking process of Adivashi in Bandarban district, the existing health services, coping strategies adopted by the people in cases of ill-health (diseases, accident, illness) and their (short and long-term) impacts on households’ livelihood and resilience. This study was conducted in two phases: the first phase explored the health-seeking process and existing health services, and the second phase investigated coping strategies in response to sickness and their impact on households’ resilience.
The main findings of this study underscore the significant negative impact of ill-health. This impact is multiplied by the longer-term effects of the coping strategies adopted by the extreme poor households during the period of their suffering and treatment-seeking process. This study also confirms and contributes to earlier work arguing that the recovery period from ill-health of indigenous groups in the CHT is longer and more uncertain than the national average (MICS 2009; Rahman and Kielmann 2012). The research identified that often the outcome of the health-seeking behaviour and treatment-seeking process is affected by issues of inaccessibility, limited and low quality health services which critically impinge on income-earners’ chance and time of recovery through different coping strategies. The main message of this paper is that coping strategies adopted by the extreme poor following a health shock are often not sufficient to allow households to maintain a stable economic status. In fact such shocks often contribute to the decline in their economic status. The paper concludes that health training and savings facilities would be appropriate interventions which can sustainably help the extreme poor in the Chittagong Hill Tracts mitigate the impact of ill-health on their long-term resilience.
Rupa Datta; Sayeed Hasan Raza; Maitrot, M. The effects of extreme poor Adivashi income-earners&#8217; ill-health on the resilience of their households: A qualitative analysis from the CHT. Shiree Working Paper No. 18. Shiree, Dhaka, Bangladesh (2014) 41 pp.