Project profile — Addressing Gaps in Refugee Access to Health



Overview 

CA-3-P010742001
$20,500,000
BRAC
2022-03-24 - 2027-06-30
Operational
Global Affairs Canada
OGM Indo-Pacific

Country / region 

• Bangladesh (100.00%)

Sector 

• Health, General: Medical services (12191) (10.00%)
• Basic Health: Basic health care (12220) (50.00%)
• Health: COVID-19 control (12264) (10.00%)
• Noncommunicable diseases: Promotion of mental health and well-being (12340) (10.00%)
• Population policy and administrative management:
Population policy and administrative management (13010) (10.00%)
Reproductive health care (13020) (10.00%)

Policy marker 

• Gender equality (significant objective)
• Environmental sustainability (cross-cutting) (significant objective)
• Participatory development and good governance (not targeted)
• Trade development (not targeted)
• Biodiversity (not targeted)
• Climate change mitigation (not targeted)
• Climate Change Adaptation (not targeted)
• Urban issues (not targeted)
• Desertification (not targeted)
• Children's issues (significant objective)
• Youth Issues (significant objective)
• Disaster Risk Reduction(DRR) (not targeted)
• Indigenous Issues (not targeted)
• Disability (significant objective)
• Nutrition (significant objective)
• ICT as a tool for development (not targeted)

Description 

The project aims to improve the health status of the Rohingya refugees in Cox’s Bazar to reduce vulnerabilities in the refugee camps and increase the utilization of comprehensive healthcare services by targeted refugees. Health services in the Rohingya refugee camps are inadequate in addressing the health-related needs of the over 900,000 refugees. Only 17% of the 200 health facilities in the camps have 24/7 access, and only three health facilities have surgical facilities. Women and adolescent girls’ access to sexual and reproductive health services have also been affected by the COVID-19 lockdowns and reallocation of health care resources. These sexual and reproductive health gaps can result in avoidable maternal and infant mortality and long-term gynaecological health problems. There is a low level of understanding and awareness of sexual and reproductive health exacerbated by stigmatisation around family planning, contraception and menstrual hygiene management. This cultural issue limits women and girls’ access to items and information that would support their health and hygiene. This project also addresses men’s control on women’s mobility and health issues, particularly decisions about childbearing, pregnancy-related health care, abortion, family planning issues, and women requiring men’s permission to visit health centres. Access to these is even more difficult for women and adolescent girls with disabilities and in women-headed households. Project activities include: (1) supporting and capacity strengthening of up to 13 BRAC health care facilities for delivering comprehensive, environment-friendly primary healthcare services particularly to women and girls with special focus on sexual and reproductive health and rights (SRHR), disabilities, mental health and gender-based violence (GBV), as well as offering COVID-19 screening capacity; (2) training up to 100 health service providers on modern methods of family planning and adolescent reproductive health and up to 44 doctors on clinical management of rape; (3) improving the health status of approximately 218,000 refugees in camps in Cox’s Bazar with a particular focus on women, adolescent girls, children, persons with disabilities and survivors of sexual and GBV; (4) providing nutritional assessment for children under five years and pregnant and lactating women. Counseling, follow up and referral of acute malnutrition cases from the BRAC health facilities to adjacent dedicated nutrition centers; (5) delivering essential health and nutrition messages to the Rohingya refugees with special focus on SRHR, GBV, malnutrition and COVID 19 prevention especially for women and girls; (6) sensitizing community members, such as local leaders, religious leaders parents and adolescents on gender equality and inclusion issues and increasing the utilization of SRHR, GBV and nutrition services; (7) engaging men in SRHR services through group sessions and individual counseling to sensitise men about their role in SRHR and use of family planning methods and motivate them to play a supportive role during pregnancy and child rearing so that women can understand and practice their SRH rights; and (8) training project staff, community health workers and volunteers on delivering gender responsive and inclusive services and on gender responsive data management and reporting. The activities are implemented in collaboration with local authorities, civil society organizations and communities to work towards the institutionalization of approaches.

Expected results 

The expected outcomes for this project include: (1) increased access to health and nutrition services, especially on SRHR, disabilities, mental health, and GBV among Rohingya refugees, particularly marginalized women and girls, in environmentally sustainable health facilities in the Cox’s Bazar refugee camps; and (2) increased gender equality and decision-making among women and girls to improve health seeking behavior and practices in the Rohingya community in Cox’s Bazar camps .

Results achieved 

Results achieved as of March 2024 include: (1) provided 501,925 people with health and reproductive health services, such as modern contraception methods. Also trained and informed them on ways to end sexual and gender-based violence, including child, early, and forced marriage; (2) operationalized 11 primary healthcare facilities and provided gender-sensitive comprehensive primary health and nutrition services; (3) installed disability-friendly toilet facilities and ramps and gender-segregated toilets; (4) established adolescent corners in 3 Primary Healthcare Centres (PHCs) and provided counselling for managing complications during adolescence; (5) provided 6 health facilities with running water supplies and improved access to clean water. Also installed 22 water filters in 11 PHC facilities for safe drinking water for the patients and attendees through the project; (6) coached and trained 37 community health workers to provide intensive healthcare services at the community level; (7) provided primary healthcare services with a particular focus on sexual and reproductive health and rights, disabilities, mental health, and gender-based violence to 48,224 Rohingya refugees, particularly women and girls; and (8) 33.75% of the 134 women surveyed (ages 15 to 49) reported being capable of making informed decisions regarding health and nutrition, family planning, sexual relations, contraceptive use, and reproductive health care.

Budget and spending 


Original budget $0
Planned disbursement $0
Transactions
Country percentages by sector
Type of finance Aid grant excluding debt reorganisation
Collaboration type Bilateral
Type of aid Project-type interventions