Accessibility to healthcare services and treatment for people with noncommunicable diseases in Rohingya refugee camps in Bangladesh

Noncommunicable diseases (NCDs) are the leading cause of mortality and disability worldwide. Considering the ongoing health and humanitarian crisis and addressing NCD-related issues in Rohingya refugee camps has become a growing challenge. The purpose of this study is to assess the accessibility of healthcare services and treatment for people suffering from NCDs in Rohingya refugee camps in Bangladesh's Cox's Bazar. This cross-sectional study included people with NCDs, specifically those who had one or more of the following diagnoses: cardiovascular disease, diabetes, musculoskeletal disorders, or chronic obstructive pulmonary disease. Participants were chosen from 25 makeshift camps in the Cox's Bazar district, specifically Kutupalong and Balukhali. Between November 1 and December 30, 2023, data was collected through face-to-face interviews. The data were obtained from 430 respondents. 51.6% of the respondents were from the age group above 45 years old. 50.7% of the participants were male. Among the study group, musculoskeletal disorders were the most dominant NCD (65.8%), then diabetes (58.4%), COPD (32,3%), and CVD (14.9%), with 55.8% of the respondents reported more than one NCD. Health facilities inside the camp settlement (87.5%), and pharmacies (59.4%) were the most common type of the accessible healthcare settings. In our study, no such statistical significance was found among the socioeconomic status or camp locations for accessibility to healthcare services, or for outreach healthcare services. No such significant different results have been observed between employed and unemployed groups. Almost all the respondents' income was lower than the expenses. 79.4% of the participants reach to the health facilities on foot, while for majority of the respondents (83.7) travel more than 3 km to reach the facilities. Most respondents were less likely to get the required services. 94.2% of the respondents didn't receive all the required health services for their existing NCDs. Lack of imaging facilities (99.0%), lab test (75.0%) and lack of specialized doctors (43.1%) were the dominant factors for not getting accessing to desired healthcare. Unavailability of free medication and higher out-of-pocket expenses had also been mentioned to be the barriers for accessibility to healthcare. Stigma (20.2%), experiencing of unpleasant behaviors (17%) and mistrust of existing services are the major barriers to access to NCDs Healthcare. When desirable services were absent within their nearby area, 76.3% participants didn't travel far to access the healthcare services.