Abstract
BackgroundAccess 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.MethodsA 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.ResultsThe 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%).ConclusionsOverall, 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.
Highlights
The increasing number of displaced populations has become one of the major human rights and health problems worldwide [1]
Since 1948, Bangladesh has hosted a majority of Rohingya refugees and Forcibly Displaced Myanmar Nationals (FDMNs) who entered Bangladesh in three major influxes in 1978, 1992 and 2016–2017 [11, 12]
The majority of the FDMNs in makeshift settlements (76.9%) as well as the FDMNs living in the host communities (57.1%) said that the non-governmental organizations (NGOs) clinics were the most accessible places for seeking health care services (Table 1)
Summary
The increasing number of displaced populations has become one of the major human rights and health problems worldwide [1]. Displaced people generally face human rights and health-related issues such as lack of access to basic healthcare, education, and employment opportunities as well as limited freedom of movement. They live in precarious situations characterized by the denial or loss of nationality, exclusion and discrimination, and oppression [2,3,4]. The increasing deterioration of security in some countries of the Asia and Pacific regions has resulted in increased internal and cross border displacements These regions currently host over eight million displaced people including 3.5 million refugees, 2.7 million internally displaced persons (IDPs) and 1.6 million stateless people who are predominantly refugees from Afghanistan and Myanmar [1]. This study presents health problems and utilization of health services among Forcibly Displaced Myanmar Nationals (FDMNs) living in the southern part of Bangladesh
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