From knowing our needs to enacting change: findings from community consultations with indigenous communities in Bangladesh

Abstract

IntroductionIndigenous peoples are among the most marginalized peoples in the world due to issues relating to well-being, political representation, and economic production. The research consortium Goals and Governance for Global Health (Go4Health) conducted a community consultation process among marginalized groups across the global South aimed at including their voices in the global discourse around health in the post-2015 development agenda. This paper presents findings from the consultations carried out among indigenous communities in Bangladesh.MethodsFor this qualitative study, our research team consulted the Tripura and Mro communities in Bandarban district living in the isolated Chittagong Hill Tracts region. Community members, leaders, and key informants working in health service delivery were interviewed. Data was analyzed using thematic analysis.FindingsOur findings show that remoteness shapes the daily lives of the communities, and their lack of access to natural resources and basic services prevents them from following health promotion messages. The communities feel that their needs are impossible to secure in a politically indifferent and sometimes hostile environment.ConclusionCommunities are keen to participate and work with duty bearers in creating the conditions that will lead to their improved quality of life. Clear policies that recognize the status of indigenous peoples are necessary in the Bangladeshi context to allow for the development of services and infrastructure.

Wide range of G6PD activities found among ethnic groups of the Chittagong Hill Tracts, Bangladesh

“…The CHT are densely forested, with limited accessibility and while the area covers approximately 10% of the country, it accounts for only 1% of the total population [28]. At least 12 major indigenous groups and a Bengali subpopulation are permanent residents of this region [29,30]. The CHT carry the highest burden of malaria within the country, incidence is seasonal with a major peak around June to August and a second smaller peak around February.…”

Prevalence and determinants of antibiotics self-medication among indigenous people of Bangladesh: a cross-sectional study

“…These ethnic groups have long maintained isolation from the general population, putting them at a disadvantage in obtaining healthcare facilities. As a consequence, their overall health status remains poorer compared with non-indigenous people 34–36. There is not sufficient information regarding antibiotics usage, including SMA, among this community of more than 2 million people.…”

Health shocks, care-seeking behaviour and coping strategies of extreme poor households in Bangladesh’s Chittagong Hill tracts

“…Extremely poor adivasi (ethnic minorities) communities in CHT1 for example have comparatively poor health outcomes and face challenges in accessing healthcare services because of dominant presence of informal providers (traditional healers), gender preference in accessing healthcare and decision making process (males get preference in seeking care), overriding cost, unitary service delivery mechanism (the current healthcare delivery system is predominantly based on the priorities and needs of plain land people), and inadequate knowledge and awareness [22] Over 2 million adivasi are Bangladeshi citizens. They are mostly involved in shifting agriculture which is also known as ( jhum ) in Chittagong Hill Tract (CHT) [23]. Their forest-based livelihood, language, cultural practice, religious faith and rituals are distinct from plain land Bengali’s [23, 24].…”

“…They are mostly involved in shifting agriculture which is also known as ( jhum ) in Chittagong Hill Tract (CHT) [23]. Their forest-based livelihood, language, cultural practice, religious faith and rituals are distinct from plain land Bengali’s [23, 24]. Since they largely reside in remote and peripheral area (mostly Chittagong Hill Tracts, CHT henceforth) where socioeconomic development tends to be lower and improving at a slower rate than in plain land, and the medical systems and health services remain problematic for the region’s development [24].…”

“…Since they largely reside in remote and peripheral area (mostly Chittagong Hill Tracts, CHT henceforth) where socioeconomic development tends to be lower and improving at a slower rate than in plain land, and the medical systems and health services remain problematic for the region’s development [24]. Consequently, the incidence of health shocks has been identified as central to adivasi groups’ livelihood resilience [23]. In the context of such poverty, livelihood interventions are promoted as a sustainable tool for poverty reduction and for improving the living conditions of disadvantaged groups.…”