In 2018, KIT Royal Tropical Institute conducted two assignments to improve health services for refugees and host communities in Cox’s Bazar, Bangladesh.

Supporting an over-stretched health system in Cox’s Bazar

Since violence erupted in Rakhine State, Myanmar, in August 2017, over 900,000 Rohingya have fled from Myanmar to Bangladesh. These refugees live in makeshift settlements in the Cox’s Bazar district, where cramped living conditions present significant public health risks. The sheer magnitude of refugee numbers puts massive pressure on all health services.

In 2018, KIT carried out two assignments to support our international partners working to meet the humanitarian needs of refugees and host communities in Cox’s Bazar.

Improving health sector coordination with the World Health Organisation

In the first assignment, the World Health Organisation (WHO) commissioned KIT to conduct a review of health service delivery for the Rohingya refugees. The project aimed to assist key health and humanitarian actors to coordinate and develop a health sector plan for 2019 and beyond.

Applying mixed methods, the project evaluated the health services provided to the Rohingya refugees in Cox’s Bazar. The project gave special attention to sexual and reproductive health—including newborn care—child health, communicable and non-communicable diseases, and mental health services. Despite major progress in accessibility and coverage of the health services for a large numbers of refugees, the evaluation revealed that there was a lack of horizontal and vertical coordination of the provided services. This included the potential risk for misdiagnosis due to the lack of adherence to technical protocols by service providers.

Evaluating mental health concerns with Sida

KIT conducted the second project on behalf of Sida. It focused on better understanding the mental health and psychosocial support needs of Rohingya refugees and supporting communities. It also evaluated the actors currently providing mental health support in the region. Data on mental health problems amongst Rohingya refugees is scarce, but recent estimates suggest a high prevalence of mental health concerns. These include common complaints like depression, anxiety, and symptoms associated with post-traumatic stress disorders.

Using a community-based, participatory approach, KIT conducted research and produced a report which confirmed a high prevalence of mental health concerns amongst the refugees and surrounding communities. The report is now being used to inform health sector partners of current gaps, challenges and best practices in mental health and psychosocial support. Its ultimate aim is to promote integrated, effective and culturally appropriate mental health services to the Rohingya.