Transcript Zinia Sultana,UNHCR: Knowledge, Attitudes and Behaviours of Rohingya Refugees and Status of Family Planning Services in UNHCR’s Operation in Cox’s Bazar, Bangladesh

Knowledge, Attitudes and Behaviours of Rohingya
Refugees and Status of Family Planning Services in
UNHCR’s
Operation in Cox’s Bazar, Bangladesh
Title
Dr. Zinia Sultana
Reproductive Health Consultant, UNHCR
General information
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The official two refugee camps are
situated in Cox’s Bazar district of
Bangladesh.
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Total 30,369 Rohingya refugees are
residing in KTP and NYP camp.
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They are receiving basic services from
UNHCR and its partners.
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A local NGO (RTMI) provides RH services
to the refugees with the support from
UNHCR and UNFPA. They receive FP
commodities from Government FP
department for refugees.
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Challenges encountered in provision of FP services in
the camps
We learnt:
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Community is resistant towards contraceptive uptake.
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General feeling of hopeless situation.
But we identified:
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Inadequate support from Government.
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Lack of staff to provide the service.
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Frequent rupture of stock for FP commodities.
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Lack of awareness and information on FP among refugees.
Interventions to overcome the situation
• Advocacy with Government for integration of the programme
with national FP services.
• Engage more staff and community volunteers for the
programme in camps.
• Various FP promotion activities in the community.
FP Promotion Activities
Awareness session with women at community
Couple counseling
Awareness session with women at SFC
Discussion with community and
religious leaders
Counseling mother on FP at delivery unit
The FP booklet published by Islamic
Foundation, Bangladesh
How effective were the interventions???
Key Findings from Baseline Study
Quantitative method:
• CPR for any method is 37.7% and 36.9% for
modern method among WRA. (19% in 2009
according to HIS report)
• CPR for any method among ever married
women is 44%.
• Most preferred methods are injectable
(57.6%) and OCP (32.9%) among women
who are currently using any FP method .
Photo: HH survey at NYP camp
Key Findings from Baseline Study
Quantitative method:
Graph 1: Awareness of Family Planning Methods Among
Women of Reproductive Age
• Ever used FP method is 61.7%
among WRA.
•
2.4% of women have an unmet
need for FP services.
• Future intend to use FP
methods in next 12 months is
6%.
90.0%
Women Who are Aware of Method
• Knowledge of ECP and
traditional FP methods is very
limited.
100.0%
86.6%
81.5%
80.0%
64.9%
70.0%
60.0%
50.0%
46.2%
42.0%
40.0%
30.0%
20.0%
10.0%
18.5%
5.1%
2.8%
0.6% 0.6%
0.0%
Family Planning Method
*Percentages may add up to greater than 100% as respondent may give more than 1 response.
Key Findings from Baseline Study
Qualitative method:
• The decision about using FP is generally
made by the couple.
• Refugees are satisfied with current FP
services.
• Commodities are free and easily accessible
for married couples.
• Unmarried adolescents are excluded from
the service.
Photo: FGD with adolescent boys, KTP camp
Key Findings from Baseline Study
Qualitative findings
• Refugees are aware about advantages of
using FP methods.
• There is a well functioning referral system
to the government FP clinics for long term
and permanent methods.
• Resistance from the community has been
reduced in recent years.
• Elderly people still have some
misconception and myths related to FP.
Photo: FGD with adult women, KTP camp
Some thoughts on study findings
• Unrealistic unmet need?
To get the real unmet need, we may include the women who reported
a) about the their plan for next pregnancy as ‘When Allah wants’
b) undecided about next pregnancy
c) as currently pregnant or in postpartum and this current pregnancy or last
pregnancy was unwanted.
• Male sterilization under reported?
• Information on sexual activity under reported?
Acknowledgement
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Nadine Cornier, UNHCR Geneva
Herve Isambert, UNHCR Bangkok
Mihoko Tanabe, WRC
Stacy De Jesus,CDC
UNHCR, Cox’s Bazar
UNHCR, implementing partners in Cox’s Bazar
Research team and data entry staff
Community Volunteers
Refugee religious and community leaders
Women, men, adolescent boys and girls participated in the study