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Implementation of a community-based referral project to improve access to emergency obstetric and newborn care in Rohingya population during COVID-19 pandemic in Bangladesh
  1. Mrittika Barua1,
  2. Avijit Saha1,
  3. Srizan Chowdhury2,
  4. Sayantan Chowdhury3,
  5. Stenly Hely Sajow3,
  6. Malabika Sarker1
  1. 1 BRAC University James P Grant School of Public Health, Dhaka, Bangladesh
  2. 2 International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
  3. 3 United Nations Population Fund, Dhaka, Bangladesh
  1. Correspondence to Dr Mrittika Barua, BRAC University James P Grant School of Public Health, Dhaka 1213, Bangladesh; mrittika{at}


Introduction The delay in seeking emergency obstetric care leads to significant maternal morbidity and mortality and can worsen during pandemics, especially in humanitarian conflict settings with low uptake of obstetric services. To mitigate the challenges related to the second delay caused by lack of transport in the COVID-19 pandemic, the organisation United Nations Population Fund implements a community-based referral project called Referral Hub in the Rohingya refugee population in Bangladesh. The objective of the paper is to describe the implementation process of the Referral hub and present clients’ utilisation and perception of the service.

Methods Findings from part of a larger mixed-method study, the analysis of the standard operating protocol of the intervention, secondary data of routine utilisation of the 12 referral hubs between January and August 2020, 21 key informant interviews and a community survey among 100 pregnant women are presented in this paper.

Results The findings show an increasing trend in the referral hub utilisation and a strong recommendation of the service.

Conclusion Due to a robust referral mechanism by collaborating with the community and engaging accessible and free of cost transport service, the intervention has high potential to improve access to facility care in low-resource and humanitarian contexts, especially during pandemics.

  • Obstetrics
  • Reproductive Health
  • Sexual Health
  • COVID-19

Data availability statement

Data are available on reasonable request. Data will be available on reasonable request to the corresponding author.

This article is made freely available for personal use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

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Data availability statement

Data are available on reasonable request. Data will be available on reasonable request to the corresponding author.

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  • Contributors MB contributed to data collection, analysis and writing. AS contributed to data collection and data analysis. SrC contributed to data collection and qualitative data analysis, SaC (UNFPA) and SHS contributed to writing. MS contributed to study design, analysis and writing. MB is the guarantor of the study.

  • Funding The study has been funded by United Nations Population Fund.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.