Top

International Journal for Equity in Health

Published in:

Open Access 01-12-2015 | Research

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

Authors: Sameera Hussain, Ana Lorena Ruano, Atiya Rahman, Sabina Faiz Rashid, Peter S. Hill

Published in: International Journal for Equity in Health | Issue 1/2015

Abstract

Introduction

Indigenous 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.

Methods

For 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.

Findings

Our 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.

Conclusion

Communities 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.

WHO Commission on Social Determinants of Health. Closing the Gap in a Generation.

Barsh RL. Indigenous peoples and the UN commission on human rights: a case of the immovable object and the irresistible force. Hum Rights Q. 1996;18(4):782–813.CrossRef

Stavenhagen R. How strong Are the rights of indigenous peoples? J Hum Rights. 2011;10(3):414–21.CrossRef

UN DESA. State of the World’s Indigenous Peoples [Internet]. United Nations Publications; 2009 [cited 2015 Jun 15]. Available from: http://www.un.org/esa/socdev/unpfii/documents/SOWIP/en/SOWIP_web.pdf.

Chakma P, Dhana BM. Bangladesh. In: The Indigenous World 2015 [Internet]. [cited 2015 Jun 15]. Available from: http://www.iwgia.org/iwgia_files_publications_files/0716_THE_INDIGENOUS_ORLD_2015_eb.pdf.

Amnesty International. Pushed to the edge: indigenous rights denied in Bangladesh’s Chittagong Hill Tracts [Internet]. 2013 Jun [cited 2015 Oct 1]. Available from: http://www.amnesty.org.uk/sites/default/files/pushed_to_edge.pdf.

Roy D. Country Technical Note on Indigenous Peoples’ Issues: People’s Republic of Bangladesh [Internet]. 2012 Nov [cited 2015 Sep 30]. Available from: http://www.ifad.org/english/indigenous/pub/documents/tnotes/bangladesh.pdf.

Uddin N. Politics of Cultural Difference: Identity and Marginality in the Chittagong Hill Tracts of Bangladesh. South Asian Surv. 2010;17(2):283–94.CrossRef

Ahmed K. Defining indigenous in Bangladesh: international law in domestic context. Int J Minor Group Rights. 2010;17(1):47–73.CrossRef

10.

Tuhin MAA. Health Discourse in Chittagong Hill Tracts in Bangladesh [dissertation on the Internet]. [Tromso (Norway)]: UiT The Arctic University of Norway; 2015 [cited 2015 Oct 6]. Available from: http://munin.uit.no/handle/10037/7775.

11.

Barkat A, Halim S, Poddar A, Zaman B, Osman A, Khan S, et al. Socio-economic baseline survey of Chittagong Hill Tracts [Internet]. 2009 [cited 2015 Oct 6]. Available from: http://www.hdrc-bd.com/admin_panel/images/notice/1387703212.03.%20socio-economic%20baseline%20survey%20of%20chittagong%20hill%20tracts.pdf.

12.

CHTDF. Annual Report 2014: promotion of development and confidence building in the Chittagong Hill Tracts [Internet]. [cited 2015 Sep 30]. Available from: http://www.hdrc-bd.com/admin_panel/images/notice/1387703310.01.%20study%20on%20perception%20of%20illness%20and%20health%20seeking%20behavior%20among%20five%20ethnic%20groups.pdf.

13.

Rahman SA, Kielmann T, McPake B, Normand C. Healthcare-seeking behaviour among the tribal people of Bangladesh: Can the current health system really meet their needs? J Health Popul Nutr. 2012;30(3):353–65.

14.

Ahmed FH, Habib SE, Rahman MM, Uddin J, Rahman MA. Perception of illness and health seeking behavior among five ethnic groups [Internet]. 2010 [cited 2015 Oct 1]. Available from: http://www.hdrcbd.com/admin_panel/images/notice/1387703310.01.%20study%20on%20perception%20of%20illness%20and%20health%20seeking%20behavior%20among%20five%20ethnic%20groups.pdf.

15.

Bangladesh’s Persecuted Indigenous People [Internet]. Human Rights Watch. [cited 2015 Oct 25]. Available from: https://www.hrw.org/news/2015/05/18/bangladeshs-persecuted-indigenous-people

16.

The World Bank. Bangladesh | Data [Internet]. [cited 2015 Oct 6]. Available from: http://data.worldbank.org/country/bangladesh

17.

Bangladesh Bureau of Statistics [Internet]. [cited 2015 Oct 6]. Available from: http://www.bbs.gov.bd.

18.

The World Factbook [Internet]. [cited 2015 Sep 30]. Available from: https://www.cia.gov/library/publications/theworld-factbook/geos/bg.html

19.

Jamil DI, Panday PK. The elusive peace accord in the Chittagong Hill Tracts of Bangladesh and the plight of the indigenous people. Commonw Comp Polit. 2008;46(4):464–89.CrossRef

20.

Uddin A. Dynamics of Strategies for Survival of the Indigenous People in Southeastern Bangladesh. Ethnopolitics. 2015 Apr 27;0(0):1–20.

21.

Yasmin L. The Tyranny of the Majority in Bangladesh: The Case of the Chittagong Hill Tracts. Nationalism Ethn Polit. 2014 Jan 1;20(1):116–32.

22.

Chowdhury K. Politics of identities and resources in Chittagong Hill Tracts, Bangladesh: ethnonationalism and/or indigenous identity. Asian J Soc Sci. 2008;36(1):57–78.CrossRef

23.

Karim L. Pushed to the margins: adivasi peoples in Bangladesh and the case of kalpana chakma. Contemp South Asia. 1998;7(3):301–16.CrossRef

24.

Islam SS. The insurgency movement in the Chittagong Hill Tracts of bangladesh: internal and external dimensions. J Third World Stud. 2003;20(2):137–60.

25.

BRAC. Bandarban Fact Sheet [Internet]. [cited 2015 Oct 22]. Available from: https://www.brac.net/sites/default/files/Bandarban.pdf.

26.

Bandarban HDSS, Bangladesh [Internet]. INDEPTH Network: better health information for better health policy. 2011 [cited 2015 Oct 1]. Available from: http://www.indepth-network.org/Profiles/Bandarban%20HDSS.pdf.

27.

Dowlah C. Jumma insurgency in Chittagong Hills Tracts: how serious is the threat to Bangladesh’s national integration and what can be done? Small Wars Insur. 2013;24(5):773–94.CrossRef

28.

UNDP. Governance of CHT [Internet]. [cited 2015 Oct 8]. Available from: http://www.chtdf.org/index.php/cht-issues/cht-institutions.

29.

Ahmed SM, TG E s, Standing H, Mahmud S. Harnessing pluralism for better health in Bangladesh. Lancet. 2013;382(9906):1746–55.CrossRefPubMed

30.

UNDP. CHT Situation [Internet]. [cited 2015 Oct 6]. Available from: http://www.chtdf.org/index.php/cht-issues/cht-situation.

31.

Brolan CE, Hussain S, Friedman EA, Ruano AL, Mulumba M, Rusike I, et al. Community participation in formulating the post-2015 health and development goal agenda: reflections of a multi-country research collaboration. Int J Equity Health. 2014;13(1):66.PubMedCentralCrossRefPubMed

32.

Sandelowski M. Combining qualitative and quantitative sampling, data collection, and analysis techniques in mixed-method studies. Res Nurs Health. 2000;23(3):246–55.CrossRefPubMed

33.

Crowe M, Inder M, Porter R. Conducting qualitative research in mental health: thematic and content analyses. Aust N Z J Psychiatry. 2015;49(7):616–23.CrossRefPubMed

34.

Graneheim U, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105–12.CrossRefPubMed

35.

Fereday J, Muir-Cochrane E. Demonstrating rigor using thematic analysis: a hybrid approach of inductive and deductive coding and theme development. Int J Qual Methods. 2008;5(1):80–92.

36.

Uddin E. Ethnic disparity in family socioeconomic status in Bangladesh: implication for family welfare policy practice. Glob Soc Welf. 2014;2(1):29–38.CrossRef

37.

Uddin MA. Displacement and destruction of ethnic people in Bangladesh. Canadian Social Science. 2010;4(6):16–24.

38.

Ruano AL, Dahlblom K, Hurtig A-K, San Sebastián M. ‘If no one else stands up, you have to’: a story of community participation and water in rural Guatemala. Glob Health Action. 2011;4(6412).

39.

Misbahuzzaman K, Smith-Hall C. Role of forest income in rural household livelihoods: the case of village common forest communities in the Chittagong Hill Tracts. Bangladesh Small-Scale For. 2015;14(3):315–30.CrossRef

40.

Hernández AR, Hurtig A-K, Dahlblom K, Sebastián MS. Integrating views on support for mid-level health worker performance: a concept mapping study with regional health system actors in rural Guatemala. Int J Equity Health. 2015;14(1):91.PubMedCentralCrossRefPubMed

41.

Panday PK, Jamil I. Conflict in the Chittagong Hill Tracts of bangladesh: an unimplemented accord and continued violence. Asian Surv. 2009;49(6):1052–70.CrossRef

Title: From knowing our needs to enacting change: findings from community consultations with indigenous communities in Bangladesh
Authors: Sameera Hussain
Ana Lorena Ruano
Atiya Rahman
Sabina Faiz Rashid
Peter S. Hill
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: International Journal for Equity in Health / Issue 1/2015
Electronic ISSN: 1475-9276
DOI: https://doi.org/10.1186/s12939-015-0264-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Introduction

Methods

Findings

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Findings

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2015

Analysis of the equity of emergency medical services: a cross-sectional survey in Chongqing city

The relationship between socioeconomic status/income and prevalence of diabetes and associated conditions: A cross-sectional population-based study in Saskatchewan, Canada

Integrating views on support for mid-level health worker performance: a concept mapping study with regional health system actors in rural Guatemala

Development and validation of the Australian Aboriginal racial identity and self-esteem survey for 8–12 year old children (IRISE_C)

Perceived affordability of health insurance and medical financial burdens five years in to Massachusetts health reform

Older Brazilian women’s experience of psychological domestic violence: a social phenomenological study