BackgroundThe Rohingya people of Myanmar have been subject to government-sponsored discrimination, detention, violence, and torture, causing several waves of a mass exodus to Bangladesh. Since August 2017, when the latest wave of migration began, there has been a rapid expansion of refugee camps in Cox’s Bazar, Bangladesh, with camps now accommodating approximately 335,000 new refugees. In this rapidly changing scenario, assessing the needs of the Rohingya and the host communities in Cox’s Bazar is critical for prioritizing resource allocation. We conducted a rapid needs assessment survey in both the Rohingya and host communities in Cox’s Bazar to highlight the most pressing needs in the community. MethodsWe conducted a randomized survey of 402 recently-arrived Rohingya households and 400 households in the local host community, from March 15 to March 18, 2018. The survey collected information on household demographics, mortality, education of all members, income, and livelihoods, access to food and water, vaccination, and access and utilization of healthcare. We calculated descriptive statistics and appropriate standard errors for survey responses on these topics.FindingsThe sampled Rohingya households were younger than the host community households. Two-thirds of the reported deaths in the Rohingya households in the last 12 months were among male household members, with a low overall mean age at death (38.7 years). The majority (76·0%) of Rohingya household members, above the age of 15, reported having had no education, and 52·6% of Rohingya children were not attending school. Nearly all (93·5%) Rohingya households reported a decrease in income over the last 12 months, with 79.9% reporting no current income. Mean reported income in the host community was not significantly different between 2018 and the previous two years. We found high levels of reported food insecurity among the Rohingya, which was also reflected in their prioritization of food over all else if provided additional cash assistance, and in their borrowing money to procure food. The majority (61·7%) of Rohingya children, under two, had received zero doses of injectable vaccines in Myanmar, and of them, 24·8% had also not received any injectable vaccines in Bangladesh. For oral vaccines, 57·5% of children, under two, had received zero doses in Myanmar, of whom 29·6% had also not received any oral doses in Bangladesh. In comparison, children in the host community had much higher rates of vaccination. Some Rohingya households reported challenges in accessing healthcare (14·2%), with the majority reporting distance to a healthcare facility as the main cause. In the host community, 32·5% of all surveyed households reported issues accessing healthcare, with wide variation (0 to 57·6%) among locations.InterpretationThe results of this rapid needs assessment offer important insights into the most pressing challenges facing the Rohingya while providing contextual information about the neighboring Bangladeshi communities hosting them. The Rohingya population is greatly impoverished, with very low levels of education. While growing evidence globally demonstrates the prudence in formally integrating refugees into the labor force, doing so in Bangladesh will entail strategic investment in imparting skills and education to the host and migrant populations, with a particular focus on women. Resources should also be allocated to address pressing needs such as food shortages and vaccination gaps.FundingThis study was supported by BRAC and the FXB Center for Health and Human Rights, Harvard TH Chan School of Public Health.

This article is based on the Skills Training for Advancing Resources (STAR) project for the youth initiative of the Bangladesh Rural Advancement Committee (BRAC) in Bangladesh. The objective was to explore the consequences of social and economic inclusion of this project for the persons with disability (PWDs) and transgender (TG) youth people. The research focused on how inclusive programmatic interventions created multidimensional impacts among the “marginalized” and “excluded” PWD and TG youths at the grassroots level. This study adopted a qualitative approach where in‐depth case interviews and observation were applied for data collection. PWD and TG graduates, master craft persons (MCPs), employers, and program staff members were the participants in this study. Results found that PWD and TG youths faced vulnerabilities and social stigma in their lives and livelihood trajectories due to their physical inability and low level of social dignity. The STAR project has a certain level of contribution to the livelihoods of PWD and TG people, where these helped them to gain their social, cultural, and economic capital. Findings would be an important guideline for policymakers, NGO managers, and human rights workers.

Forced displacement is a major driver of mental disorders among refugees worldwide. Poor mental health of adult refugees, particularly mothers, is also considered a risk factor for the psychological well-being and development of their children. In this study, we experimentally examine the extent to which a multifaceted psychosocial program improves the mental well-being of refugee mothers, and facilitates growth and development among children under the age of two. In partnership with BRAC, we ran a cluster randomized controlled trial on 3,500 Rohingya mother-child dyads in refugee camps in Bangladesh. Participants were given weekly psychosocial support for a year that includes psychoeducation and parenting support for mothers and play activities for both mothers and children. The intervention was largely successful and led to: (i) reductions in the psychological trauma and depression severity of mothers and children, (ii) improvements in communication, gross-motor, problem-solving, and social skills of children, and (iii) reductions in stunting, underweight, and wasting among children in the treatment group. The intervention also caused the mental health of children to be more aligned with the mental health of their mothers, implying policies targeting the mental well-being of displaced mothers can be an important stepping stone to developing psychological resilience among their children, which can help them grow into well-rounded, healthy adults.