Difficulties faced by older Rohingya (forcibly displaced Myanmar nationals) adults in accessing medical services amid the COVID-19 pandemic in Bangladesh

Sabuj Kanti Mistry; Arm Mehrab Ali; Uday Narayan Yadav; Md Nazmul Huda; Saruna Ghimire; Amy Bestman; Md Belal Hossain; Sompa Reza; Rubina Qasim; Mark F Harris

doi:10.1136/bmjgh-2021-007051

Difficulties faced by older Rohingya (forcibly displaced Myanmar nationals) adults in accessing medical services amid the COVID-19 pandemic in Bangladesh

BMJ Glob Health. 2021 Dec;6(12):e007051. doi: 10.1136/bmjgh-2021-007051.

Authors

Sabuj Kanti Mistry^{1

2

3

4}, Arm Mehrab Ali^{5

6}, Uday Narayan Yadav^{2

7}, Md Nazmul Huda^{8

9}, Saruna Ghimire¹⁰, Amy Bestman¹¹, Md Belal Hossain^{3

12}, Sompa Reza¹³, Rubina Qasim¹⁴, Mark F Harris²

Affiliations

¹ ARCED Foundation, Dhaka, Bangladesh smitra411@gmail.com.
² Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia.
³ BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh.
⁴ Department of Public Health, Daffodil International University, Dhaka, Bangladesh.
⁵ ARCED Foundation, Dhaka, Bangladesh.
⁶ Global Research and Data Support, Innovations for Poverty Action, New Haven, Connecticut, USA.
⁷ National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia.
⁸ School of Health Sciences, Western Sydney University, Campbeltown, New South Wales, Australia.
⁹ The School of Liberal Arts and Social Sciences, Independent University, Dhaka, Bangladesh.
¹⁰ Department of Sociology and Gerontology and Scripps Gerontology Center, Miami University, Oxford, Ohio, USA.
¹¹ The George Institute for Global Health, Sydney, New South Wales, Australia.
¹² School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada.
¹³ Institute of Nutrition and Food Science, University of Dhaka, Dhaka, Bangladesh.
¹⁴ Dow Institute of Nursing and Midwifery, Dow University of Health Sciences, Karachi, Pakistan.

Abstract

Background: COVID-19 has seriously disrupted health services in many countries including Bangladesh. This research aimed to explore whether Rohingya (forcefully displaced Myanmar nationals) older adults in Bangladesh faced difficulties accessing medicines and routine medical care services amid this pandemic.

Methods: This cross-sectional study was conducted among 416 Rohingya older adults aged 60 years and above residing in Rohingya refugee camps situated in the Cox's Bazar district of Bangladesh and was conducted in October 2020. A purposive sampling technique was followed, and participants' perceived difficulties in accessing medicines and routine medical care were noted through face-to-face interviews. Binary logistic regression models determined the association between outcome and explanatory variables.

Results: Overall, one-third of the participants reported difficulties in accessing medicines and routine medical care. Significant factors associated with facing difficulties accessing medicine included feelings of loneliness (adjusted OR (AOR) 3.54, 95% CI 1.93 to 6.48), perceptions that older adults were at the highest risk of COVID-19 (AOR 3.35, 95% CI 1.61 to 6.97) and required additional care during COVID-19 (AOR 6.89, 95% CI 3.62 to 13.13). Also, the notable factors associated with difficulties in receiving routine medical care included living more than 30 min walking distance from the health centre (AOR 3.57, 95% CI 1.95 to 6.56), feelings of loneliness (AOR 2.20, 95% CI 1.25 to 3.87), perception that older adults were at the highest risk of COVID-19 (AOR 2.85, 95% CI 1.36 to 5.99) and perception that they required additional care during the pandemic (AOR 4.55, 95% CI 2.48 to 8.35).

Conclusion: Many Rohingya older adults faced difficulties in accessing medicines and routine medical care during this pandemic. This call for policy-makers and relevant stakeholders to re-assess emergency preparedness plans including strategies to provide continuing care.

Keywords: COVID-19; cross-sectional survey; epidemiology; health services research; public health.

MeSH terms

Aged
Bangladesh / epidemiology
COVID-19*
Cross-Sectional Studies
Humans
Myanmar / epidemiology
Pandemics
SARS-CoV-2