A descriptive study of Forcefully Displaced Myanmar Nationals (FDMN) presenting for care at public health sector hospitals in Bangladesh

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ABSTRACT

Background

In 2017 hundreds of thousands of ‘Rohingya’ fled to camps for Forcefully Displaced Myanmar Nationals (FDMN) in Cox’s Bazar, Bangladesh.

Objective

To describe the FDMNs presenting for care at public health facilities in Bangladesh so as to understand the health problems faced by the FDMNs and the burden on these public health facilities.

Methods

This study combined a retrospective review of existing hospital and clinic data with prospective surveillance in government health care centres.

Findings

The retrospective data showed a 26% increase in the number of consultations at the Kutupalong community clinic, the primary health facility closest to the camps, from 19,567 in 2015 to 26,309 in 2019. There was a corresponding 11% increase in admissions to health facilities in the area, from 80,991 in 2017 to 91,424 in 2019. Prospective surveillance of 9,421 FDMNs seeking health care from July 2018 to December 2019 showed that 29% had an infectious disease, 20% nutritional problems, 12% pregnancy-related conditions and 7% trauma or injury.

Conclusions

Great uncertainty remains regarding the return of FDMN to their home country of Myanmar. The current on-going protests following the military coup adds further insecurity to the status of the Rohingya. The presence of a large migrant population relative to a smaller host community burdens the limited facilities and resources of the public health sector. Continued support by the international public health community and civil society organizations is needed.

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Most cited references 15

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Risk factors for non-communicable diseases in Bangladesh: findings of the population-based cross-sectional national survey 2018

Baizid Khoorshid Riaz, Md Ziaul Islam, A N M Shamsul Islam … (2020)

Objectives To determine the national prevalence of risk factors of non-communicable diseases (NCD) in the adult population of Bangladesh. Design The study was a population-based national cross-sectional study. Setting This study used 496 primary sampling units (PSUs) developed by the Bangladesh Bureau of Statistics. The PSUs were equally allocated to each division and urban and rural stratum within each division. Participants The participants were adults aged 18 to 69 years, who were usual residents of the households for at least 6 months and stayed the night before the survey. Out of 9900 participants, 8185 (82.7%) completed STEP-1 and STEP-2, and 7208 took part in STEP-3. Primary and secondary outcome The prevalence of behavioural, physical and biochemical risk factors of NCD. Data were weighted to generate national estimates. Results Tobacco use was significantly (p<0.05) higher in the rural (45.2%) than the urban (38.8%) population. Inadequate fruit/vegetable intake was significantly (p<0.05) higher in the urban (92.1%) than in the rural (88.9%) population. The mean salt intake per day was higher in the rural (9.0 g) than urban (8.9 g) population. Among all, 3.0% had no, 70.9% had 1 to 2 and 26.2% had ≥3 NCD risk factors. The urban population was more likely to have insufficient physical activity (adjusted OR (AOR): 1.2, 95% CI: 1.2 to 1.2), obesity (AOR: 1.5, 95% CI: 1.5 to 1.5), hypertension (AOR: 1.3, 95% CI: 1.3 to 1.3), diabetes (AOR: 1.6, 95% CI: 1.6 to 1.6) and hyperglycaemia (AOR: 1.1, 95% CI: 1.1 to 1.1). Conclusions Considering the high prevalence of the behavioural, physical and biochemical risk factors, diverse population and high-risk group targeted interventions are essential to combat the rising burden of NCDs.

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Community clinics in Bangladesh: A unique example of public-private partnership

Baizid Khoorshid Riaz, Liaquat Ali, Sk. Ahmad … (2020)

Background Bangladesh has established more than 13,000 community clinics (CCs) to provide primary healthcare with a plan of each covering a population of around 6,000. The inception of CCs in the country has revolutionized the healthcare delivery to reach the doorstep of people. The provision of healthcare through CCs is truly participatory since the community people donate land for building infrastructure and also involve in management process. The study was conducted to assess pattern of public private partnership in healthcare delivery through participation of community people in establishment, management, monitoring and utilization of community clinics. Methods This quantitative study involving descriptive cross sectional design included 63 healthcare providers, 2,238 service-users and 3,285 community people as household members. Data were collected by face-to-face interview and reviewing records of CCs with the help of semi-structured questionnaire and checklist respectively. The public private partnership was assessed in this particular study by finding community participation in different activities of CCs. Data were analysed using descriptive statistics. Results Almost all (96.9%) CCs are located in easy-to-reach areas and have good infrastructure. Lands of all CCs are donated by the respective communities. The security of most of the CCs (93.7%) is maintained by community people. Cleanliness of the CCs is maintained by the cleaners or ayas who are appointed by local communities. Community Groups (CGs) of 88.9% and Community Support Groups (CSGs) of 96.8% CCs are found to be active. In most of the CCs (98.4%), monitoring is done by analysis of monthly reports. All CCs provide referral services for pregnant women. Health care delivery is found to be ‘good’ in more than three-fourths while health education service is ‘good’ in 96.7% of CCs. All CCs showed an increased trend in the utilization of services and conduction of normal child deliveries. Benefits of CCs as perceived by service users included free drugs (82.1%), free treatment (81.2%), easy access (76.3%), need-based health services (75.0%), and immunization services (68.6%). Almost all (99.0%) of the CC service users opined that CGs are involved in management of CC activities. Conclusion In resource-poor settings of developing countries, public private partnership in primary healthcare delivery through community clinics may play crucial role in sustainable development of community health by providing quality health care. The study recommends public-private partnership for strengthening CCs including establishment, maintenance, utilization, monitoring and supply of essential drugs and logistics.

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Violence and mortality in the Northern Rakhine State of Myanmar, 2017: results of a quantitative survey of surviving community leaders in Bangladesh

Parveen Parmar, Jennifer Leigh, Homer Venters … (2019)

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Author and article information

Journal

Journal ID (nlm-ta): Glob Health Action

Journal ID (iso-abbrev): Glob Health Action

Title: Global Health Action

Publisher: Taylor & Francis

ISSN (Print): 1654-9716

ISSN (Electronic): 1654-9880

Publication date (Electronic, pub): 8 September 2021

Publication date (Electronic, collection): 2021

Publication date PMC-release: 8 September 2021

Volume: 14

Issue: 1

Electronic Location Identifier: 1968124

Affiliations

[a ]Epidemiology and Community Medicine, Bangladesh Institute of Tropical and Infectious Diseases (BITID) Faujdarhat; , Chattogram, Bangladesh

[b ]Internal Medicine, Sadar Hospital; , Cox’s Bazar, Bangladesh

[c ]Civil Surgeon (Former); , Cox’s Bazar, Bangladesh

[d ]Upazila Health and Family Planning Officer (UHFPO); , Teknaf, Cox’s Bazar, Bangladesh

[e ]Upazila Health and Family Planning Officer (UHFPO); , Ukhiya, Cox’s Bazar, Bangladesh

[f ]Internal Medicine, Cox’s Bazar Medical College; , Cox’s Bazar, Bangladesh

[g ]Assistant Director, National Institute of Kidney Diseases; , Dhaka, Bangladesh

[h ]Research Centre, Universal Medical College; , Dhaka, Bangladesh

[i ]Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University; , Bangkok, Thailand

[j ]Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford; , Oxford, UK

[k ]Harvard T.H. Chan School of Public Health, Harvard University; , Boston, USA

[l ]The Open University; , Milton Keynes, UK

[m ]Child Health, Institute of Child Health and Human Development, National Institutes of Health, University of the Philippines; , Manila, Philippines

[n ]Director General of Health Services; , Dhaka, Bangladesh (Retired)

[o ]Dev Care Foundation; , Dhaka, Bangladesh

Author notes

CONTACT Lorenz von Seidlein Lorenz@ 123456tropmedres.ac Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University; , Salaya, Bangkok, Thailand

Author information

Jaqueline Deen https://orcid.org/0000-0001-8875-5026

Lorenz von Seidlein https://orcid.org/0000-0002-0282-6469

Article

Publisher ID: 1968124

DOI: 10.1080/16549716.2021.1968124

PMC ID: 8439211

PubMed ID: 34493163

SO-VID: c7ca0b28-3f04-4c95-b30b-59af6e4d0c2d

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

A descriptive study of Forcefully Displaced Myanmar Nationals (FDMN) presenting for care at public health sector hospitals in Bangladesh

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Annual Reviews Societal Impact of the Covid-19 Pandemic

Most cited references 15

Risk factors for non-communicable diseases in Bangladesh: findings of the population-based cross-sectional national survey 2018

Community clinics in Bangladesh: A unique example of public-private partnership

Violence and mortality in the Northern Rakhine State of Myanmar, 2017: results of a quantitative survey of surviving community leaders in Bangladesh

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