Summary: This paper introduces the TRANSFORM project, which aims to improve access to mental health services for people with serious and enduring mental disorders (SMDs – psychotic disorders and severe mood disorders, often with co-occurring substance misuse) living in urban slums in Dhaka (Bangladesh) and Ibadan (Nigeria). People living in slum communities have high rates of SMDs, limited access to mental health services and conditions of chronic hardship. Help is commonly sought from faith-based and traditional healers, but people with SMDs require medical treatment, support and follow-up. This multicentre, international mental health mixed-methods research project will (a) conduct community-based ethnographic assessment using participatory methods to explore community understandings of SMDs and help-seeking; (b) explore the role of traditional and faith-based healing for SMDs, from the perspectives of people with SMDs, caregivers, community members, healers, community health workers (CHWs) and health professionals; (c) co-design, with CHWs and healers, training packages for screening, early detection and referral to mental health services; and (d) implement and evaluate the training packages for clinical and cost-effectiveness in improving access to treatment for those with SMDs. TRANSFORM will develop and test a sustainable intervention that can be integrated into existing clinical care and inform priorities for healthcare providers and policy makers.

The livelihood sustainability of the Rohingya refugees relocated in Bhashan Char, Bangladesh, has been questioned by various international stakeholders due to the remoteness and perceived vulnerabilities of the island. The Bangladesh government, a few international organizations, and some non-government organizations are working on developing livelihood opportunities in there. But there is scarce study about the livelihood opportunities and challenges of the Rohingyas living there. This study explores the vulnerabilities and livelihood opportunities of Rohingyas in Bhashan Char so as to help increase their resilience. The vulnerabilities include natural, geographical, and climatic shocks and stresses (e.g., cyclone, floods, storm surge, sea-level rise, geographical position). However, there are ample opportunities for their livelihood development, despite some challenges which can be overcome with concerted efforts. The opportunities include intensification and extensification of livelihood activities, such as modern agriculture, fish farming, livestock rearing, small business, handicraft, fishing net mending, crab fattening, biofloc aquaculture, and fish cage culture, but turning these opportunities into reality requires sufficient investment and internationally positive attitude. Better shelter, better disaster preparedness, cultural practices, education, and skill development can increase their capacity to bounce back, absorb shocks, and make them more resilient. National and international humanitarian organizations should plan to enhance the resilience of the Rohingya communities living in Bhashan Char and the island itself so that they can sustain in the long run, even after their anticipated repatriation to Myanmar.

A range of formal and informal close-to-community (CTC) health service providers operate in an increasingly urbanized Bangladesh. Informal CTC health service providers play a key role in Bangladesh’s pluralistic health system, yet the reasons for their popularity and their interactions with formal providers and the community are poorly understood. This paper aims to understand the factors shaping poor urban and rural women’s choice of service provider for their sexual and reproductive health (SRH)-related problems and the interrelationships between these providers and communities. Building this evidence base is important, as the number and range of CTC providers continue to expand in both urban slums and rural communities in Bangladesh. This has implications for policy and future programme interventions addressing the poor women’s SRH needs. Data was generated through 24 in-depth interviews with menstrual regulation clients, 12 focus group discussions with married men and women in communities and 24 semi-structured interviews with formal and informal CTC SRH service providers. Data was collected between July and September 2013 from three urban slums and one rural site in Dhaka and Sylhet, Bangladesh. Atlas.ti software was used to manage data analysis and coding, and a thematic analysis was undertaken. Poor women living in urban slums and rural areas visit a diverse range of CTC providers for SRH-related problems. Key factors influencing their choice of provider include the following: availability, accessibility, expenses and perceived quality of care, the latter being shaped by notions of trust, respect and familiarity. Informal providers are usually the first point of contact even for those clients who subsequently access SRH services from formal providers. Despite existing informal interactions between both types of providers and a shared understanding that this can be beneficial for clients, there is no effective link or partnership between these providers for referral, coordination and communication regarding SRH services. Training informal CTC providers and developing strategies to enable better links and coordination between this community-embedded cadre and the formal health sector has the potential to reduce service cost and improve availability of quality SRH (and other) care at the community level.

Social Cohesion is an important issue for refugees and their host communities. Much attention on social cohesion in the literature has been focused on situations in the Middle East. This paper will bring attention to the Rohingya crisis in Bangladesh. With the influx of nearly one million Rohingya into Bangladesh in 2017, social cohesion between the Rohingya and their host communities has become more complex than ever. Although ensuring social cohesion is very important for Bangladesh, it has not been easy to implement under the present legislative framework of refugee management in Bangladesh. The sympathetic attitude of the host community toward the Rohingya has significantly declined during the past 4 years. In this context, qualitative research was undertaken to understand the challenges and dilemmas of social cohesion from both the host and Rohingya perspectives. Based on 50 key informant interviews, observations, and several informal group discussions, this paper argues that a negative perception among the neighboring host communities toward the Rohingya has increased, contributing to social tension. A pragmatic and sustainable approach has to be taken to ensure a cohesive and peaceful coexistence of the host communities and the Rohingya until dignified repatriation of the Rohingya is possible.

The international Islamic reform movement Tablighi Jamaat (TJ) began in India in the 1920s and has now spread over much of the world. Barbara Metcalf and others have raised the question of the impact of TJ practices in the area of gender relations. This article investigates this issue based on the author's fieldwork in Bangladesh. TJ teachings stress the importance of male authority within the family in a way that conflicts hardly at all with ‘traditional’ Bangladeshi patriarchal attitudes. However, the central practice of TJ, dawah (communicating the message of Islam) is carried out in ways that encourage positive and cooperative relations between husband and wife, and allow for female agency in a number of ways.