Browsing by Author "Farnaz, Nadia"

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Challenges and strategies in conducting sexual and reproductive health research among Rohingya refugees in Cox’s Bazar, Bangladesh
(BMC, 12/14/2020) Ahmed, Rushdia; Aktar, Bachera; Farnaz, Nadia; Ray, Pushpita; Awal, Abdul; Hassan, Raafat; Bin Shafique, Sharid; Hasan, Md Tanvir; Quayyum, Zahidul; Jafarovna, Mohira Babaeva; Kobeissi, Loulou Hassan; El Tahir, Khalid; Chawla, Balwinder Singh; Rashid, Sabina Faiz
Background: Rohingya diaspora or Forcibly Displaced Myanmar Nationals (FDMNs), took shelter in the refugee camps of Cox’s Bazar, Bangladesh due to armed conflict in the Rakhine state of Myanmar. In such humanitarian crises, delivering sexual and reproductive health (SRH) services is critical for better health outcomes of this most-at-risk population where more than half are adolescent girls and women. This is a reflective paper on challenges and related mitigation strategies to conduct SRH research among FDMNs. The research on which this paper is based employed a concurrent mixedmethod design combining a cross-sectional survey and qualitative interviews and group discussions with FDMNs to understand their SRH needs and demand-side barriers. Assessment of health facilities and qualitative interviews with healthcare providers and key stakeholders were carried out to assess facility readiness and supply-side barriers. Challenges and strategies: The researchers faced different challenges while conducting this study due to the unique characteristics of the FDMN population and the location of the refugee camps. The three key challenges researchers encountered include: sensitivity regarding SRH in the FDMNs, identifying appropriate sampling strategies, and community trust issues. The key approaches to overcome these challenges involved: actively engaging community members and gatekeepers in the data collection process to access respondents, identifying sensitive SRH issues through survey and exploring in-depth during qualitative interviews; and contextually modifying the sampling strategy. Conclusion: Contextual adaptation of research methods and involving community and local key stakeholders in data collection are the key lessons learnt from this study. Another important lesson was researchers’ identity and positionality as a member of the host country may create distrust and suspicion among the refugees. The multi-level complexities of humanitarian settings may introduce unforeseen challenges and interrupt research plans at different stages of research which require timely and contextual adaptations.
Ethics and methods for collecting sensitive data: Examining sexual and reproductive health needs of and services for Rohingya refugees at Cox’s Bazar, Bangladesh
(The International Journal of Information, Diversity, & Inclusion, 7/13/2020) Aktar, Bachera; Ahmed, Rushdia; Hassan, Raafat; Farnaz, Nadia; Ray, Pushpita; Awal, Abdul; Bin Shafique, Sharid; Hasan, Md Tanvir; Quayyum, Zahidul; Rashid, Sabina Faiz
During humanitarian emergencies, such as the forced displacement of the Rohingya diaspora, women and adolescent girls become highly vulnerable to sexual and reproductive health (SRH) issues and abuse. Although sensitive in nature, community-driven information is essential for designing and delivering effective community-centric SRH services. This article provides an overview of the theoretical framework and methodologies used to investigate SRH needs, barriers, and challenges in service-delivery and utilization in the Rohingya refugee camps in Cox’s Bazar, Bangladesh. It also offers insights on important methodological and ethical factors to consider while conducting research in a similar context.A concurrent mixed-method study was undertaken in ten randomly selected Rohingya refugee camps between July and November2018. The design consisted of a cross-sectional household survey of 403 Rohingya adolescent girls and women, along with an assessment of 29 healthcare facilities. The team also completed in-depth interviews with nine adolescent girls, 10 women, nine formal andnine informal healthcare providers, key informant interviews with seven key stakeholders and seven influential community members. Lastly, three focus group discussions were undertaken with a group of 18 Rohingya men. Our theoretical framework drew from the socio-ecological models developed by Karl Blanchet and colleagues(2017) insofar as they considered a multiplicity of related contextual and cross-cutting factors.Building good rapport with community gatekeepers was key in accessing and sustaining the relationship with the various respondents. The data collected through such context-specific research approaches is critical in designing community-centric service-delivery mechanisms, and culturally and gender-sensitiveSRH interventions in humanitarian crises.
How to prevent and address safeguarding concerns in global health research programmes: Practice, process and positionality in marginalised spaces
(BMJ Journals, 5/13/2020) Aktar, Bachera; Alam, Wafa; Ali, Samiha; Awal, Abdul; Bayoh, Margaret; Chumo, Ivy; Contay, Yirah; Conteh, Abu; Dean, Laura; Dobson, Skye; Edstrom, Jerker; Elsey, Helen; Farnaz, Nadia; Garimella, Surekha; Gray, Linsay; Gupte, Jaideep; Hawkins, Kate; Hollihead, Beth; Josyula, Kunhi Lakshmi; Kabaria, Caroline; Karuga, Robinson; Kimani, Joseph; Leyland, Alastair H; te Lintelo, Dolf; Mansaray, Bintu; MacCarthy, Joseph; MacGregor, Hayley; Mberu, Blessing; Muturi, Nelly; Okoth, Linet; Otiso, Lilian; Ozano, Kim; Parray, Ateeb; Phillips-Howard, Penny; Rao, Vinodkumar; Rashid, Sabina; Raven, Joanna; Refell, Francis; Saidu, Samuel; Sobhan, Shafinaz; Saligram, Prasanna Subramanya; Sesay, Samira; Theobald, Sally; Tolhurst, Rachel; Tubb, Phil; Waldman, Linda; Wariutu, Jane; Whittaker, Lana; Wurie, Haja
Safeguarding is rapidly rising up the international development agenda, yet literature on safeguarding in related research is limited. This paper shares processes and practice relating to safeguarding within an international research consortium (the ARISE hub, known as ARISE). ARISE aims to enhance accountability and improve the health and well-being of marginalised people living and working in informal urban spaces in low-income and middle-income countries (Bangladesh, India, Kenya and Sierra Leone). Our manuscript is divided into three key sections. We start by discussing the importance of safeguarding in global health research and consider how thinking about vulnerability as a relational concept (shaped by unequal power relations and structural violence) can help locate fluid and context specific safeguarding risks within broader social systems. We then discuss the different steps undertaken in ARISE to develop a shared approach to safeguarding: sharing institutional guidelines and practice; facilitating a participatory process to agree a working definition of safeguarding and joint understandings of vulnerabilities, risks and mitigation strategies and share experiences; developing action plans for safeguarding. This is followed by reflection on our key learnings including how safeguarding, ethics and health and safety concerns overlap; the challenges of referral and support for safeguarding concerns within frequently underserved informal urban spaces; and the importance of reflective practice and critical thinking about power, judgement and positionality and the ownership of the global narrative surrounding safeguarding. We finish by situating our learning within debates on decolonising science and argue for the importance of an iterative, ongoing learning journey that is critical, reflective and inclusive of vulnerable people.
Knowledge and practice regarding menstrual hygiene management among the Rohingya refugee adolescent girls in Cox’s Bazar, Bangladesh: A mixed method study
(Emerald Publishing, 5/15/2021) Rakhshanda, Shagoofa; Ahmed, Sahlil; Saidu, Samuel; Nderitu, Christine; Thapa, Basanta; Awal, Abdul; Farnaz, Nadia; Rahman, Atiya; Aktar, Bachera; Faruque, A.S.G.
Purpose About half of the 16% adolescents in the world experience menstruation. Menstrual hygiene management (MHM) is a health concern and challenge especially in humanitarian situations as experienced by Myanmar Rohingya refugees living in Cox’s Bazar, Bangladesh. This study aims to assess knowledge, practice and influencing factors for MHM among Rohingya refugee adolescent girls of 14–18 years. Design/methodology/approach The study used both quantitative (a cross-sectional survey with 340 adolescent girls through a structured questionnaire) and qualitative (7 in-depth interviews with adolescent girls and 2 focus group discussions with the mothers) approaches. Quantitative data, analyzed using STATA version 13.0, were supported by qualitative data, grouped into themes and presented as matrix. Findings Around 51% adolescent girls learned about menstruation after menarche, at the mean age of 12 years, from their mothers and older sisters. About 75% used sanitary pads as absorbents which they got mostly as relief material or bought from local stores (83%); the rest used cloths and other materials (25%). About 57% of the respondents disposed of their absorbent by burying. Those who used reusable absorbents washed them with soap and water (40%) and mostly dried them indoors (17%). Factors influencing healthy MHM practice included the use of absorbent, privacy, disposal, washing and drying of clothes, physical activities, hygiene and pain management. Adolescents with secondary or higher education were four times more likely to have better MHM practice (odds ratio = 4.27; confidence interval = 1.19–15.31) than those with no formal schooling.
Situation analysis for delivering integrated comprehensive sexual and reproductive health services in humanitarian crisis condition for Rohingya refugees in Cox’s Bazar, Bangladesh: Protocol for a mixed-method study
(BMJ, 7/3/2019) Ahmed, Rushdia; Farnaz, Nadia; Aktar, Bachera; Hassan, Raafat; Shafique, Sharid Bin; Ray, Pushpita; Awal, Abdul; Rahman, Atiya; Urbaniak, Veronique; Kobeissi, Loulou Hassan; Rosie, Jeffries; Say, Lale; Hasan, Md Tanvir; Quayyum, Zahidul; Rashid, Sabina Faiz
Introduction Rohingya diaspora are one of the most vulnerable groups seeking refuge in camps of Cox’s Bazar, Bangladesh, arising an acute humanitarian crisis. More than half of the Rohingya refugees are women and adolescent girls requiring quality sexual and reproductive health (SRH) services. Minimum initial service package of SRH are being rendered in the refugee camps; however, WHO is aiming to provide integrated comprehensive SRH services to meet the unmet needs of this most vulnerable group. For sustainable and successful implementation of such comprehensive SRH service packages, a critical first step is to undertake a situation analysis and understand the current dimensions and capture the lessons learnt on their SRH-specific needs and implementation challenges. This situation analysis is pertinent in current humanitarian condition and will provide an overview of the needs, availability and delivery of SRH services for adolescent girls and women, barriers in accessing and providing those services in Rohingya refugee camps in Cox’s Bazar, Bangladesh, and similar humanitarian contexts. Methods and analysis A concurrent mixed-methods design will be used in this study. A community-based household survey coupled with facility assessments as well as qualitative in-depth interviews, key informant interviews and focus group discussions will be conducted with community people of Rohingya refugee camps and relevant stakeholders providing SRH services to Rohingya population in Cox’s Bazar, Bangladesh. Survey data will be analysed using univariate, bivariate and multivariable regression statistics. Descriptive analysis will be done for facility assessment and thematic analysis will be conducted with qualitative data. Ethics and dissemination Ethical approval from Institutional Review Board of BRAC James P Grant School of Public Health (2018-017-IR) has been obtained. Findings from this research will be disseminated through presentations in local, national and international conferences, workshops, peer-reviewed publications, policy briefs and interactive project report.