Inequality in receiving maternal health care among Rohingya women living in Cox's Bazar refugee camps and its associated factors

科克斯巴扎尔难民营中罗兴亚妇女获得孕产妇保健服务的不平等及其相关因素

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Abstract

BACKGROUND: This study explores receiving maternal health care (MHC) and associated factors among the Rohingya refugee women living in the camps in Cox's Bazar, Bangladesh, amidst a backdrop of severe challenges, including high maternal mortality rates and limited healthcare access. METHODS: A cross-sectional study was conducted among 415 refugee women in Camp-4, located in the Kutupalong Mega area in Cox's Bazar. Data were collected using a structured, pretested, and facilitator-administered questionnaire. RESULTS: Of the Rohingya refugee women, 297 (71.57%) had at least four antenatal care (ANC) visits, 247 (59.5%) gave birth to the last baby in a place with an adequate facility, and 288 (69.4%) reported that the skilled birth attendants (SBAs) were present during the previous delivery. Moreover, 331 (79.8%) received postnatal care (PNC), while 314 (28.7%) had a PNC visit with a doctor or healthcare provider. Above all, half of them (51%) received adequate maternal health care (MHC), such as medical facilities during delivery, postnatal visit, etc. Bivariate analysis shows that the status is highly significant in all aspects of the Rohingya refugee women's receiving ANC, pregnancy, and PNC through exposure to maternal health information and services. Nagelkerke R(2) value shows that the Rohingya women's exposure to maternal health information and services appeared as stronger predictors than socioeconomic variables for receiving MHC. The result of multivariate logistic regression depicts that younger age among refugee women (AOR = 0.93, 95% CI: 0.88-0.98), having greater land ownership in Myanmar (AOR = 1.07, 95% CI: 1.01-1.13), receiving consultation with a skilled health care provider about maternal, sexual, and reproductive health (MSRH) (AOR = 5.22, 95% CI: 2.18-12.), participating in an awareness program about MSRH (AOR = 1.98, 95% CI: 1.08-3.61), and understanding MSRH messages (AOR = 5.31, 95% CI: 2.63-10.69) had a significantly higher association with receiving MHC. CONCLUSION: Maternal health information and services have a significant influence on receiving maternal health care. Accordingly, this study highlights the importance of strengthening maternal health interventions, as it is challenging to alter their socioeconomic status within existing settings.

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