Health problems and utilization of health services among Forcibly Displaced Myanmar Nationals in Bangladesh

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Abstract

Background

Access to and utilization of health services have remained major challenges for people living in low- and middle-income countries, especially for those living in impaired public health environment such as refugee camps and temporary settlements. This study presents health problems and utilization of health services among Forcibly Displaced Myanmar Nationals (FDMNs) living in the southern part of Bangladesh.

Methods

A mixed-method (quantitative and qualitative) approach was used. Altogether 999 household surveys were conducted among the FDMNs living in makeshift/temporary settlements and host communities. We used a grounded theory approach involving in-depth interviews (IDIs), focus group discussions (FGDs), and key informant interviews (KIIs) including 24 IDIs, 10 FGDs, and 9 KIIs. The quantitative data were analysed with STATA.

Results

The common health problems among the women were pregnancy and childbirth-related complications and violence against women. Among the children, fever, diarrhoea, common cold and malaria were frequently observed health problems. Poor general health, HIV/AIDS, insecurity, discrimination, and lack of employment opportunity were common problems for men. Further, 61.2% women received two or more antenatal care (ANC) visits during their last pregnancy, while 28.9% did not receive any ANC visit. The majority of the last births took place at home (85.2%) assisted by traditional birth attendants (78.9%), a third (29.3%) of whom suffered pregnancy- and childbirth-related complications. The clinics run by the non-governmental organizations (NGOs) (76.9%) and private health facilities (86.0%) were the most accessible places for seeking healthcare for the FDMNs living in the makeshift settlements. All participants heard about HIV/AIDS. 78.0% of them were unaware about the means of HIV transmission, and family planning methods were poorly used (45.2%).

Conclusions

Overall, the health of FDMNs living in the southern part of Bangladesh is poor and they have inadequate access to and utilization of health services to address the health problems and associated factors. Existing essential health and nutrition support programs need to be culturally appropriate and adopt an integrated approach to encourage men’s participation to improve utilization of health and family planning services, address issues of gender inequity, gender-based violence, and improve women empowerment and overall health outcomes.

Related collections

Most cited references 25

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The Rohingya people of Myanmar: health, human rights, and identity.

Syed S Mahmood, Emily Wroe, Arlan Fuller … (2017)

The Rohingya people of Myanmar (known as Burma before 1989) were stripped of citizenship in 1982, because they could not meet the requirement of proving their forefathers settled in Burma before 1823, and now account for one in seven of the global population of stateless people. Of the total 1·5 million Rohingya people living in Myanmar and across southeast Asia, only 82 000 have any legal protection obtained through UN-designated refugee status. Since 2012, more than 159 000 people, most of whom are Rohingya, have fled Myanmar in poorly constructed boats for journeys lasting several weeks to neighbouring nations, causing hundreds of deaths. We outline historical events preceding this complex emergency in health and human rights. The Rohingya people face a cycle of poor infant and child health, malnutrition, waterborne illness, and lack of obstetric care. In December, 2014, a UN resolution called for an end to the crisis. We discuss the Myanmar Government's ongoing treatment of Rohingya through the lens of international law, and the steps that the newly elected parliament must pursue for a durable solution.

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An assessment of antenatal care among Syrian refugees in Lebanon

Matthew Benage, P Gregg Greenough, Patrick Vinck … (2015)

Background After more than three years of violence in Syria, Lebanon hosts over one million Syrian refugees creating significant public health concerns. Antenatal care delivery to tens of thousands of pregnant Syrian refugee women is critical to preventing maternal and fetal mortality but is not well characterized given the multiple factors obtaining health data in a displaced population. This study describes antenatal care access, the scope of existing antenatal care, and antenatal and family planning behaviors and practice among pregnant Syrian refugees in various living conditions and multiple geographic areas of Lebanon. Methods A field-based survey was conducted between July and October 2013 in 14 main geographic sites of refugee concentration. The assessment evaluated antenatal services among a non-randomized sample of 420 self-identified pregnant Syrian refugee women that included demographics, gestational age, living accommodation, antenatal care coverage, antenatal care content, antenatal health behaviors, antenatal health literacy, and family planning perception and practices. Results In total, 420 pregnant Syrian refugees living in Lebanon completed the survey. Of these, 82.9% (348) received some antenatal care. Of those with at least one antenatal visit, 222 (63.8%) received care attended by a skilled professional three or more times, 111 (31.9%) 1–2 times, and 15 (4.3%) had never received skilled antenatal care. We assessed antenatal care content defined by blood pressure measurement, and urine and blood sample analyses. Of those who had received any antenatal care, only 31.2% received all three interventions, 18.2% received two out of three, 32.1% received one out of three, and 18.5% received no interventions. Only (41.2%) had an adequate diet of vitamins, minerals, and folic acid. Access, content and health behaviors varied by gestational age, type of accommodation and location in Lebanon. Conclusions Standards of antenatal care are not being met for pregnant Syrian refugee women in Lebanon. This descriptive analysis of relative frequencies suggests reproductive health providers should focus attention on increasing antenatal care visits, particularly to third trimester and late gestational age patients and to those in less secure sheltering arrangements. With this approach they can improve care content by providing early testing and interventions per accepted guidelines designed to improve pregnancy outcomes.

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Responding to the health needs of women from migrant and refugee backgrounds-Models of maternity and postpartum care in high-income countries: A systematic scoping review.

Helen Rogers, Lily Hogan, Dominiek Coates … (2020)

Pregnant women from migrant and refugee backgrounds living in high-income countries (HIC) are at increased risk of adverse perinatal outcomes compared with women born in the host country. Women from migrant and refugee background have perinatal healthcare needs that are recognised internationally as a public health priority. The aim of this study was to identify, appraise and synthesise available evidence on the effectiveness of models of care in pregnancy or first 12 months postpartum for women from migrant and refugee backgrounds living in HIC. Care models were mapped in terms of (a) effectiveness at improving service access, (b) effectiveness at improving maternal and infant health outcomes, (c) acceptability and appropriateness from the perspective of women and (d) acceptability and appropriateness from the perspective of service providers. Using systematic scoping review methodology, qualitative, quantitative, and mixed methods research published in English 2008-2019 were included. The databases MEDLINE, Embase, Emcare, PubMed, Scopus, CINAHL, PsycINFO, Web of Science, Google Scholar, Cochrane Database of Systematic Reviews and Joanna Briggs Institute were searched between 27 February 2019 and updated 27 December 2019. Qualitative and quantitative data were analysed narratively. Seventeen studies, involving 1,499 women and 203 service providers, were included. A diverse range of interventions were identified, including bilingual/bicultural workers, group antenatal care and specialised clinics. All identified interventions were acceptable to women, and improved access, however, few provided evidence of improved perinatal outcomes. Gaps identified for future research include the use of qualitative and quantitative approaches to ascertain the experiences of women, their families, service providers and impact on perinatal outcomes. Synthesis of the included studies indicates the key elements of acceptable and accessible models, which were as follows: culturally responsive care, continuity of care, effective communication, psychosocial and practical support, support to navigate systems, flexible and accessible services.

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Author and article information

Contributors

Lal B. Rawal:

ORCID: http://orcid.org/0000-0003-1106-0108

dr.lalrawal@gmail.com , L.rawal@cqu.edu.au

Journal

Journal ID (nlm-ta): Glob Health Res Policy

Journal ID (iso-abbrev): Glob Health Res Policy

Title: Global Health Research and Policy

Publisher: BioMed Central (London )

ISSN (Electronic): 2397-0642

Publication date (Electronic): 11 October 2021

Publication date PMC-release: 11 October 2021

Publication date Collection: 2021

Volume: 6

Electronic Location Identifier: 39

Affiliations

[1 ]GRID grid.1023.0, ISNI 0000 0001 2193 0854, School of Health Medical and Applied Sciences, Collage of Science and Sustainability, , Central Queensland University, Sydney Campus, ; Sydney, Australia

[2 ]GRID grid.1023.0, ISNI 0000 0001 2193 0854, Physical Activity Research Group, Appleton Institute, , Central Queensland University, ; Wayville, Australia

[3 ]GRID grid.1029.a, ISNI 0000 0000 9939 5719, Translational Health Research Institute, , Western Sydney University, ; Sydney, Australia

[4 ]GRID grid.1029.a, ISNI 0000 0000 9939 5719, School of Nursing and Midwifery, , Western Sydney University, ; Sydney, Australia

[5 ]GRID grid.1003.2, ISNI 0000 0000 9320 7537, The University of Queensland, ; Brisbane, Australia

[6 ]mPower Social Enterprises Ltd., Dhaka, Bangladesh

[7 ]GRID grid.477319.f, ISNI 0000 0004 1784 9596, Health Intervention and Technology Assessment Program (HITAP), ; Nonthaburi, Thailand

[8 ]GRID grid.414142.6, ISNI 0000 0004 0600 7174, Infectious Diseases Division, , icddr,b, ; Dhaka, Bangladesh

[9 ]GRID grid.414142.6, ISNI 0000 0004 0600 7174, Health Systems and Population Division, , icddr,b, ; Dhaka, Bangladesh

[10 ]GRID grid.1021.2, ISNI 0000 0001 0526 7079, School of Nursing and Midwifery, , Deakin University, ; Geelong, VIC Australia

[11 ]GRID grid.267362.4, ISNI 0000 0004 0432 5259, Centre for Quality and Patient Safety Research (QPS), , Alfred Health Partnership, ; Melbourne, VIC Australia

[12 ]GRID grid.1008.9, ISNI 0000 0001 2179 088X, Melbourne School of Population and Global Health, , University of Melbourne, ; Melbourne, VIC Australia

[13 ]GRID grid.1029.a, ISNI 0000 0000 9939 5719, School of Medicine, , Western Sydney University, ; Sydney, Australia

Author information

Lal B. Rawal http://orcid.org/0000-0003-1106-0108

Article

Publisher ID: 223

DOI: 10.1186/s41256-021-00223-1

PMC ID: 8507131

PubMed ID: 34635184

SO-VID: 3e529087-c1ad-43ce-99ae-764679bf0d3b

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 8 April 2021

Date accepted : 24 September 2021

Custom metadata

Keywords: rohingya refugees,bangladesh,family planning,hiv/aids,health services

Data availability:

Keywords: rohingya refugees, bangladesh, family planning, hiv/aids, health services