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Access, Exclusion and Health Outcomes: Maternal and Child Health Vulnerabilities of Nomadic Bede Communities in Bangladesh

Sarker SMS · 24 Sept 2026

Abstract

Abstract Maternal and child health outcomes remain critical indicators of public health, yet inequities persist among marginalized populations excluded from mainstream systems. This study focuses on the Bede community in Bangladesh, a historically nomadic and stigmatized group, to examine how institutional neglect, cultural practices and economic deprivation intersect to shape maternal and child health vulnerabilities. A qualitative design was employed, with purposive sampling of 38 respondents including mothers, traditional healers and community leaders in Mathurapur Union, Rajshahi Division. Data were collected through in-depth interviews and analyzed thematically using the six-phase framework of Braun and Clarke (2006), ensuring interpretations remained grounded in the participants’ lived experiences. The analysis was guided by three distinct theoretical lenses Eco-Social Theory which explains how poverty and exclusion are embodied as biological and psychological strain, Feminist Political Ecology which highlights how gendered norms and cultural traditions intersect with structural inequalities and the Social Determinants of Health Framework which situates health outcomes within broader socioeconomic and institutional structures. Findings revealed systemic barriers such as discriminatory treatment in hospitals, unaffordable costs, reliance on unsafe home deliveries, vaccination gaps, nutritional deficiencies and inadequate preventive care. These outcomes align with Sustainable Development Goals (SDGs) particularly SDG 3 (Good Health and Well-Being), SDG 5 (Gender Equality), and SDG 10 (Reduced Inequalities) underscoring the urgent need for inclusive, equity-focused health strategies.