Access to female contraceptives by Rohingya refugees, Bangladesh

Objective To determine the prevalence of the use of contraceptives among female Rohingya refugees in Bangladesh and its associated factors. Methods We conducted our cross-sectional survey at the Kutupalong refugee facility located in Cox's Bazar in November 2019. We used univariable and multivariable logistic regression models to determine the association between the use of contraceptives and our various predictor variables, including women's age, age at first marriage, education level and employment status. We also considered factors such as whether previous pregnancies were planned or unplanned, and the occurrence of non-consensual sex with husbands. Findings We found that 50.91% (251/493) of the survey participants used contraceptives, and that injection (169/251; 67.33%) and oral contraceptives (75/251; 29.88%) were the predominant modes. Of the women who did not use contraceptives, the main reasons were reported as disapproval by husbands (118/242; 48.76%), actively seeking a pregnancy (42/242; 17.36%) and religious beliefs (37/242; 15.29%). An increased likelihood of using contraceptives was found to be positively associated with women's employment outside their households (odds ratio, OR: 3.11; 95% confidence interval, CI: 1.69-6.11) and the presence of a health-care centre in the camp (OR: 3.92; 95% CI: 2.01-7.67). Women who reported an unplanned pregnancy during the previous 2 years were less likely to use contraceptives (OR: 0.02; 95% CI: 0.01-0.05). Conclusion To increase the acceptance and use of contraceptives, we recommend programmes targeted at women of reproductive age and their husbands, religious and community leaders, and providers of family planning and child and maternal health-care services.