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Cited by 12Reproductive Health and ContraceptionGlobal Maternal and Child HealthDemographic Trends and Gender Preferences

Women's participation in childbearing decision-making and its effects on short-interval births in Rohingya refugee camps of Bangladesh

Open access
Khan, Md Nuruzzaman, Khanam, Shimlin Jahan·2023·The Lancet Regional Health - Southeast Asia
DOI 10.1016/j.lansea.2023.100250PMC PMC10372892
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Abstract

Background: Women's involvement in family planning decision-making is significantly low among refugee women, potentially leading to an increased unintended and short interval pregnancies. This study aims to investigate the relationship between women's decision-making in childbearing and short-interval births among Rohingya refugee women in Bangladesh. Methods: Data from 719 women residing in three Rohingya refugee camps in Ukhiya, Cox's Bazar, Bangladesh, were analyzed. The outcome variable was birth spacing, categorized as short (<33 months between the two most recent births) or normal (≥33 months between the two most recent births). The primary explanatory variable was women's involvement in fertility decision-making with their partner, classified as never, sometimes, and always. Multivariate logistic regression analysis was conducted to assess the association between the outcome and explanatory variable while adjusting for potential covariates. Findings: 58% of births occurred within a short interval, while almost 48% of women reported no participation in fertility decision-making with their partner. Short interval birth was found to be increasing with decreasing women's participation in fertility decision-making with their partner. Women who sometimes or never made fertility decisions with their partner had 1.20 times (95% CI, 1.01-1.88) and 1.69 times (95% CI, 1.06-2.29) higher likelihood of short interval births, respectively, compared to women who always decided with their partner. Interpretation: Low women's participation in fertility decision-making with their partner among Rohingya refugees increases short interval births and adverse maternal and child health outcomes, including mortality. This highlights the need for counselling programs to educate and empower women, promoting joint fertility decision-making by couples. Funding: This research did not receive any specific funds.

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  • The Rohingya community has a profound gender imbalance, with the majority now comprised of reproductive aged women and children.

    “This unfortunate series of events has led to a profound gender imbalance within the Rohingya community, with the majority now comprised of reproductive aged women and children (Khan et al., 2021; Md Nuruzzaman Khan and Shimlin Jahan Khanam, 2023).”

    From Exploring the impact of preconception care and unintended pregnancy on access to antenatal healthcare services among Rohingya women: Insights from a cross-sectional survey (2024) · cites this paper as Md Nuruzzaman Khan and Shimlin Jahan Khanam, 2023

    The Discussion says that male fatalities caused by the Myanmar military left more females than males among Rohingya refugees, supporting the claimed gender imbalance. It does not say that reproductive-aged women and children now comprise the majority of the community. (LLM, conf=0.87)

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  • This lack of awareness contributed to high rates of maternal and child mortality and other adverse outcomes after arrival in Bangladesh.

    “Tragically, this lack of awareness contributed to high rates of maternal and child mortality, along with other adverse outcomes following their arrival in Bangladesh (Khan and Khanam, 2023).”

    From Exploring the impact of preconception care and unintended pregnancy on access to antenatal healthcare services among Rohingya women: Insights from a cross-sectional survey (2024) · cites this paper as Khan and Khanam, 2023

    The Introduction links limited awareness of family planning to unintended pregnancies and short-interval births, which it associates with adverse outcomes including maternal and neonatal mortality. The Discussion says these factors could contribute to higher mortality in the refugee camps, but its limitations state that the study cannot establish causation. The claim overstates that tentative link by saying lack of awareness contributed to high mortality rates after arrival in Bangladesh. (LLM, conf=0.86)

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  • Healthcare providers in refugee camps are primarily responsible for improvements in maternal and child health outcomes.

    “While there have been some improvements in maternal and child health outcomes, the credit for these advancements primarily belongs to the dedicated healthcare providers working in the refugee camps (Khan et al., 2021; Md Nuruzzaman Khan and Shimlin Jahan Khanam, 2023).”

    From Exploring the impact of preconception care and unintended pregnancy on access to antenatal healthcare services among Rohingya women: Insights from a cross-sectional survey (2024) · cites this paper as Md Nuruzzaman Khan and Shimlin Jahan Khanam, 2023

    The Introduction discusses adverse maternal and child health outcomes, and the Discussion describes family-planning programs in Rohingya refugee camps. Neither section reports improvements in those outcomes or attributes them primarily to healthcare providers (searched for improvements and provider contributions). (LLM, conf=0.74)

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Research works printed but not linked: 1

  1. [28]Rohingya refugee crisis in Cox's Bazar B. Health sector bulletin 3 2018 World Health Organization Geneva

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Authors
Khan, M. N., & Khanam, S. J.
Affiliations
Jatiya Kabi Kazi Nazrul Islam University (BD)
Corresponding author
Khan, Md Nuruzzaman
ORCID
Venue
The Lancet Regional Health - Southeast Asia
Publisher
Elsevier BV
Published
2023-08
Volume
15
Pages
100250
ISSN
2772-3682 (ISSN-L)
DOI
10.1016/j.lansea.2023.100250
PMC
PMC10372892
OpenAlex
W4384520771
Cited by
12
References
23
Citations by year
2026: 4 · 2025: 5 · 2024: 3
FWCI
3.07
Type
journal article
Language
en
Open access
Licence
Locations
  • The Lancet Regional Health - Southeast Asia (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
  • Social Sciences › Gender Studies › Demographic Trends and Gender Preferences
Keywords
birth spacing, Rohingya refugees, refugee women, family planning, couple decision-making, maternal and child health, refugee camps, Cox's Bazar

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