The United Nations Refugee Agency states that over a million displaced Rohingya refugees have fled war-torn Myanmar to escape genocidal violence following decades of persecution and human rights abuses. The Rohingya people, a mostly Muslim minority ethnic group in Myanmar, have historically been denied citizenship and basic human rights, severely restricting their access to education and health services. Currently, more than 880,000 Rohingya refugees, half of which are children, are residing in overcrowded refugee camps within Cox’s Bazar in Bangladesh.
While overpopulation and other humanitarian issues remain a concern within these camps, health agencies in Bangladesh in collaboration with development partners such as the United Nations Population Fund (UNFPA) are working on family planning and reproductive health care services, in hope of reducing unplanned pregnancies, unsafe abortions and their associated complications.
“The protracted situation in these camps along with the poor living conditions has a substantial impact on women’s health,” says Dr Mofi Islam, a Senior Lecturer for the Department of Public Health at La Trobe University. “Women’s sexual and reproductive health are not receiving enough attention, as the basic services such as food and shelter are often seen as of greater importance.”
Around 150 national and international non-governmental organisations and their partners are supporting the Ministry of Health and Family Welfare of Bangladesh by providing refugees with access to health and family planning services. While this emergency response ensures basic healthcare in the refugee camps in Bangladesh, Dr Islam questions the overall impact this initiative has on contraceptive use among the refugee women.
“Little is known about the prevalence surrounding the use of contraception among female Rohingya refugees in these environments,” says Dr Islam. “That’s why our study looks at what information is available regarding contraception and the barriers that prevented its use within the community.”
Dr Islam collaborated with Md Nuruzzaman Khan of Jatiya Kabi Kazi Nazrul Islam University and Md Mashiur Rahman and Md Mostafizur Rahman of the University of Rajshahi to survey close to 500 Rohingya women in camps about their contraception use. They found that around half of the women were using contraceptives at the time of the survey.
The most common reasons for not using contraceptives was disapproval by the women’s husbands or in-laws, followed by desiring pregnancy and religious beliefs. Their research was in part funded by a La Trobe Asia research grant and they have published their findings recently in the Bulletin of the World Health Organization.
“Husband’s disapproval and religious beliefs are the leading causes behind why female Rohingya refugees do not use contraception,” says Dr Islam. “The Rohingya population is traditionally conservative and they consider children as God's gift, so any improvement in their attitudes will need time.”
As Dr Islam’s study only focussed on women of reproductive age, the academic recommends that future research should include men and senior Rohingya refugees, as the findings of this study suggest that husbands and in-laws play a major role in deciding a woman’s access to and use of contraceptives. Yet, until more research is conducted, Dr Islam explains that some initiatives may help educate Rohingya women on the benefits of contraceptive use.
“I think the ongoing programmes involving outreach family planning workers should continue. They also need to involve Rohingya volunteers or Rohingya outreach workers.”
