Maternal Health Service Continuity During Extreme Weather Events in Rohingya Refugee Camps in Bhasan Char, Bangladesh

Climate change is an escalating threat to maternal and newborn health. Extreme weather events disrupt antenatal, emergency obstetric, and postnatal care while damaging health infrastructure and displacing the workforce. WHO, UNICEF, and UNFPA have jointly called for urgent action, noting that pregnant women and newborns face some of the gravest climate-related risks yetremain largely absent from preparedness planning. Bangladesh, among the world's most climate-vulnerable countries, experiences recurrent cyclones and storm surges that periodically interrupt routine health services.Bhasan Char, a silt island in the Meghna estuary, represents an exceptional convergence of climatic and population vulnerability. Since December 2020, approximately 35,000 Forcibly Displaced Myanmar Nationals (FDMN/Rohingya), about half of them women and girls, have been relocated from the Cox's Bazar camps. With an average elevation of 2.84 meters, the island faces storm-surge inundation risk exceeding three meters and active erosion along its southern shoreline. Maternal and newborn services are delivered by government and humanitarian partners under RRRC coordination, while obstetric referral to the mainland depends on sea transport that becomes hazardous in rough weather, making continuity of on-island services critical for survival.The island's short history documents recurrent disruption: Cyclone Sitrang (2022) damaged over one thousand shelters; Cyclone Mocha (2023) prompted precautionary evacuation of roughly 30,000 residents; and Cyclone Remal (2024) flooded residential clusters and damaged water and sanitation infrastructure. These reveal two disruption pathways: evacuation with service suspension, and physical damage to facilities and lifeline systems.Yet no study has systematically examined how maternal health service utilization, emergency obstetric outcomes, workforce availability, and infrastructure readiness vary between normal and cyclone-affected periods. The proposed study used exploratory qualitative study using semi-structured key informant interviews (KIIs). Data collection was done from September-October 2026. A total of nine (n=9) key informants, including health workers (n=3), managers (n=2), community leaders (n=2), and service users (n=2), were purposively recruited and interviewed. The aim of the study was to describe how extreme weather changes maternal health service delivery on Bhasan Char and idntify barriers, coping strategies and preparedness measures used by health services.