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Health care providers’ perspectives on financial incentives’ influence on the uptake of long-acting reversible contraception methods and on the quality of care of family planning services: A Qualitative in-depth interview study with Bangladeshi health care providers providing service provision to Rohingya clients in Cox’s Bazar, Bangladesh
Dalarna University, School of Health and Welfare.
2021 (English)Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
Abstract [en]

Background: In August 2017, over 700,000 Rohingya refugees fled to Bangladesh, following eruptions of ethnic violence. Currently, Cox’s Bazar in Bangladesh hosts the world’s largest refugee camp, which hosts more than 870,000 Rohingya refugees. The imprest fund, a small financial incentive, was implemented in June 2020 and distributed to Bangladeshi health care providers involved in providing long-acting contraception (LARC) procedures to Rohingya clients. Thus far, no research had been done on how the imprest fund affected the quality of care, or influenced the uptake of LARCs. This study was conducted to bridge this research gap.Aim: To explore health care providers’ perspectives on whether financial incentives influenced the uptake of long-acting reversible contraception (LARC) methods and Quality of Care (QoC), what barriers and facilitators exist to LARCs, and how future uptake of LARCs can be increased in Cox’s Bazar.Methodology: Qualitative in-depth interview with 10 health care providers, 2 doctors and 8paramedics in the humanitarian setting of Cox’s Bazar, Bangladesh. The data collection was carried out between March and April 2021. The data was analysed using an inductive qualitative content analysis approach.Results: The results of this study demonstrate that patriarchal structures, religious norms and neighbours influence the uptake of LARCs, highlight perspectives on Quality of Care (not impacted, only slightly improved), and argue that financial compensation, awareness raising, inclusion and trust are key to increase uptake of LARCs.Conclusion: This study argues that the implementation of the imprest fund has not impacted, or slightly improved, the quality of care. This study concludes that future SRH programming should include financial compensation or voucher assistance for Rohingya women, include husbands, local leaders and religious actors, and integrate GBV into SRH services provision. However, due to the vulnerabilities of Rohingya clients, there is a risk that financial incentives could compromise reproductive and contraceptive methods choice. Therefore, more research needs to be done in the future on how to mitigate this risk.

Place, publisher, year, edition, pages
2021.
Keywords [en]
Rohingya refugee crisis, Cox’s Bazar, Bangladesh, sexual and reproductive health (SRH) services, family planning, long-acting reversible contraception (LARC), financial incentives, imprest fund, quality of care, health care providers
National Category
Health Sciences
Identifiers
URN: urn:nbn:se:du-37687OAI: oai:DiVA.org:du-37687DiVA, id: diva2:1578935
Subject / course
Sexual Reproductive Perinatal Health
Available from: 2021-07-07 Created: 2021-07-07 Last updated: 2022-03-07

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CiteExportLink to record
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Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • chicago-author-date
  • chicago-note-bibliography
  • Other style
More styles
Language
  • de-DE
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  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
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  • asciidoc
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