Factors affecting Rohingya women's reproductive decision-making in refugee camps, Cox's Bazar, Bangladesh

Many conflict-affected women face violence, displacement, sexual violence, unwanted pregnancies, and limited reproductive health care. Rohingya have resided in Myanmar for generations; the government has denied them citizenship. Therefore, they fled to Bangladesh due to government and indigenous persecution. In August 2017, 7,45000 Rohingya migrants entered Cox's Bazar, the world's largest refugee camp with 9,14,998 residents. In a male-dominated Rohingya society, Rohingya women are less empowered and struggle with sexual and reproductive health issues and reproductive decision- making power. Rohingya men are seemingly controlling their wives’ reproductive health. This research aims to explore the factors that affect Rohingya women’s reproductive decision-making and participation in reproductive decisions in camps. A qualitative case study approach and purposive sampling were used to select 17 key informants (12 from Rohingya refugees and 5 from different stakeholders) drawn from the camps and organisations with the required knowledge and experiences. Thematic analysis was used to analyse the data and ATLAS.TI is used to code the subtheme. The findings of the study show that the cultural context, political reasons for the Rohingya community's larger family size, early marriage and child pregnancy, gender roles and stereotyping led the community to ignore women's empowerment. Secondly, the three key factors, which are education, lack of health services and religious conservativeness, are responsible for preventing Rohingya women’s active participation in reproductive decision- making. The study also identified the women’s perceived control behaviour for their reproductive health. However, Rohingya women are facing several challenges, which include Rohingya men’s less interest in knowing about contraceptive methods, more expectation of a son than a daughter, and their propensity to want more government food basket assistance. Moreover, husbands are less likely to take part in the programs held by the service providers to raise awareness for boys and men in camps. Therefore, this study concluded from a community development perspective that it highlights the significant influence of patriarchal norms on reproductive decision-making within the Rohingya community. The majority of women rely on the decisions of their husbands or senior male family members regarding childbirth, reflecting a broader pattern of gender inequality and limited autonomy in reproductive health. For sustainable change, community development efforts must focus not only on individual behaviours but also on transforming the underlying social structures that restrict women’s reproductive choices.

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