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ACAPS Thematic Report: Rohingya Response, Health behaviours & COVID-19 - 3 April 2020

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The 855,000 Rohingya Refugees currently residing in 34 makeshift camps in Cox’s Bazar, Bangladesh are highly vulnerable to COVID-19. Lessons learned from previous epidemic responses, such as the response to Ebola across affected African countries, highlight the critical role perceptions have on health seeking behaviour, trust in humanitarian responders and the willingness of affected communities to comply with public health measures.

Among the Rohingya refugees in Bangladesh, distrust and lack of confidence in the medical system of the response is widespread. The implications of this on the effectiveness of any COVID-19 response cannot be overstated or ignored. The perception that the Rohingya have of the health system in the camps is their reality and is highly informed by their culture, history, and their understanding of sickness and health. Their decisions about how to behave in an outbreak will be shaped entirely by that reality and this is the reality that is already shaping their uptake of preventative measures. Therefore, if the perceptions and opinions of Rohingya on healthcare are not taken properly into account and if community awareness and engagement are not prioritized as a key pillar of the COVID-19 response, lessons indicate that the capacity of response actors to control the outbreak will be severely hindered. Rohingya must be engaged and informed throughout all stages of the programming cycle to build trust. At a time when humanitarian staff are facing access challenges and reduced activities in the camps, proactively engaging Rohingya will also help to ensure overall programme continuity while building the trust and engagement desperately needed to implement effective COVID-19 control measures.

The purpose of this thematic report on health behaviours is to support humanitarian responders in understanding the current perceptions of healthcare, the impact of these perceptions on health seeking behaviour and the direct implications these perceptions and behaviours have on the ability to respond to, and control, a COVID-19 outbreak in the Rohingya refugee camps.