Community-Scale Assessment of Flood-Related Public Health Vulnerability Using Multi-Criteria AHP in Northwestern Bangladesh

Abstract. Bangladesh faces heightened flood vulnerability due to climate change, particularly in riverine areas where health impacts are severe. The study aims to estimate the public health vulnerability in Dimla Upazila (Nilphamari district) using the Analytical Hierarchy Process (AHP), incorporating expert-weighted indicators: socio-demographics, WASH infrastructure, healthcare access, flood intensity, relief availability, and adaptation capacity. 315 households from six unions were randomly selected and structured survey were performed in 2019. Results reveal the contribution of all indicators to public health vulnerability whereas flooding intensity has been the most influencing factor, followed by relief accessibility, healthcare service accessibility, WASH infrastructure availability, and the adoption of adaptation capacity. The findings indicate that the northern region (Purba Chhatnai) exhibits the highest vulnerability due to its low socioeconomic status and limited access to relief services. In contrast, Tepa Kharibari—a centrally located union adjacent to the river—experiences frequent flooding but demonstrates moderate vulnerability owing to robust DRR measures, underscoring that physical exposure alone does not determine health risks. This study pioneers an integrated approach that connects household-level vulnerabilities, infrastructure robustness, and post-disaster responses to reveal previously unrecognized patterns in public health vulnerability in flood-prone regions worldwide. The findings demonstrate that combining proactive risk reduction with reactive emergency measures significantly enhances community health resilience, offering a transformative approach to disaster management. Furthermore, the research outcomes can assist policymakers in identifying gaps within the existing public health infrastructure of flood-prone areas, enabling the adoption of targeted DRR interventions to foster healthier and more resilient communities.