Exploring the Reproductive Health Challenges of Women in Coastal Cox’s Bazar:A Public Health Perspective

Background: Women living in coastal areas of Bangladesh face distinctive reproductive health challenges due to various reasons. Although maternal health indicators have improved nationally, evidence from coastal settings such as Cox’s Bazar remains limited. This study assessed reproductive health status, healthcare utilization and access-related barriers among women of reproductive age in coastal Cox’s Bazar. Materials and methods: A community-based cross-sectional survey was conducted among 318 women aged 15–49 years in selected coastal communities of Cox’s Bazar Sadar Upazila, Bangladesh following purposive sampling technique from August 2025 to January 2026. Data were collected regarding sociodemographic characteristics, reproductive health service utilization, family planning practices, healthcare access, and climate-related barriers using a semi structured questionnaire. Binary logistic regression analysis was performed to identify factors associated with Antenatal Care (ANC) 4/4+ utilization, reporting unadjusted and adjusted odds ratios (ORs) with 95% Confidence Intervals (CIs). Results: The mean age of participants was 31.7 ± 6.9 years, and all respondents had experienced at least one pregnancy. While 81.8% of women attended at least one ANC visit during their last pregnancy, only 21.4% completed four or more visits. Home delivery was reported by 40.6% of participants, although 74.5% received skilled birth attendant support. Postnatal care utilization was reported by 65.7%, and 75.8% of women were using a family planning method, predominantly short acting methods. Cost (63.8%) and distance to health facilities (41.2%) were the most commonly reported barriers to care, and 56.9% of participants missed healthcare visits due to environmental disruptions. In the adjusted model, higher secondary education or above (AOR = 4.89, 95% CI: 2.57–9.99) employment outside the home (AOR = 2.32, 95% CI: 1.17–4.60) and higher household income (>10,000 BDT) (AOR = 2.12, 95% CI: 1.03–4.37) were significantly associated with ANC 4/4+ utilization, while maternal age was not. Conclusion: Women in coastal Cox’s Bazar experience moderate reproductive health service coverage alongside persistent socioeconomic, geographic, and climate related barriers. Strengthening education, women’s empowerment, climate resilient, community-based reproductive health services and improving service continuity are essential to addressing these gaps. Chatt Maa Shi Hosp Med Coll J; Vol.25 (2); July 2026; Page 68-74