Background: Rohingya diaspora or Forcibly Displaced Myanmar Nationals (FDMNs), took shelter in the refugee camps of Cox’s Bazar, Bangladesh due to armed conflict in the Rakhine state of Myanmar. In such humanitarian crises, delivering sexual and reproductive health (SRH) services is critical for better health outcomes of this most-at-risk population where more than half are adolescent girls and women. This is a reflective paper on challenges and related mitigation strategies to conduct SRH research among FDMNs. The research on which this paper is based employed a concurrent mixed-method design combining a cross-sectional survey and qualitative interviews and group discussions with FDMNs to understand their SRH needs and demand-side barriers. Assessment of health facilities and qualitative interviews with healthcare providers and key stakeholders were carried out to assess facility readiness and supply-side barriers. Challenges and strategies: The researchers faced different challenges while conducting this study due to the unique characteristics of the FDMN population and the location of the refugee camps. The three key challenges researchers encountered include: sensitivity regarding SRH in the FDMNs, identifying appropriate sampling strategies, and community trust issues. The key approaches to overcome these challenges involved: actively engaging community members and gatekeepers in the data collection process to access respondents, identifying sensitive SRH issues through survey and exploring in-depth during qualitative interviews; and contextually modifying the sampling strategy. Conclusion: Contextual adaptation of research methods and involving community and local key stakeholders in data collection are the key lessons learnt from this study. Another important lesson was researchers’ identity and positionality as a member of the host country may create distrust and suspicion among the refugees. The multi-level complexities of humanitarian settings may introduce unforeseen challenges and interrupt research plans at different stages of research which require timely and contextual adaptations.

Safeguarding is rapidly rising up the international development agenda, yet literature on safeguarding in related research is limited. This paper shares processes and practice relating to safeguarding within an international research consortium (the ARISE hub, known as ARISE). ARISE aims to enhance accountability and improve the health and well-being of marginalised people living and working in informal urban spaces in low-income and middle-income countries (Bangladesh, India, Kenya and Sierra Leone). Our manuscript is divided into three key sections. We start by discussing the importance of safeguarding in global health research and consider how thinking about vulnerability as a relational concept (shaped by unequal power relations and structural violence) can help locate fluid and context specific safeguarding risks within broader social systems. We then discuss the different steps undertaken in ARISE to develop a shared approach to safeguarding: sharing institutional guidelines and practice; facilitating a participatory process to agree a working definition of safeguarding and joint understandings of vulnerabilities, risks and mitigation strategies and share experiences; developing action plans for safeguarding. This is followed by reflection on our key learnings including how safeguarding, ethics and health and safety concerns overlap; the challenges of referral and support for safeguarding concerns within frequently underserved informal urban spaces; and the importance of reflective practice and critical thinking about power, judgement and positionality and the ownership of the global narrative surrounding safeguarding. We finish by situating our learning within debates on decolonising science and argue for the importance of an iterative, ongoing learning journey that is critical, reflective and inclusive of vulnerable people.

Introduction Rohingya diaspora are one of the most vulnerable groups seeking refuge in camps of Cox’s Bazar, Bangladesh, arising an acute humanitarian crisis. More than half of the Rohingya refugees are women and adolescent girls requiring quality sexual and reproductive health (SRH) services. Minimum initial service package of SRH are being rendered in the refugee camps; however, WHO is aiming to provide integrated comprehensive SRH services to meet the unmet needs of this most vulnerable group. For sustainable and successful implementation of such comprehensive SRH service packages, a critical first step is to undertake a situation analysis and understand the current dimensions and capture the lessons learnt on their SRH-specific needs and implementation challenges. This situation analysis is pertinent in current humanitarian condition and will provide an overview of the needs, availability and delivery of SRH services for adolescent girls and women, barriers in accessing and providing those services in Rohingya refugee camps in Cox’s Bazar, Bangladesh, and similar humanitarian contexts. Methods and analysis A concurrent mixed-methods design will be used in this study. A community-based household survey coupled with facility assessments as well as qualitative in-depth interviews, key informant interviews and focus group discussions will be conducted with community people of Rohingya refugee camps and relevant stakeholders providing SRH services to Rohingya population in Cox’s Bazar, Bangladesh. Survey data will be analysed using univariate, bivariate and multivariable regression statistics. Descriptive analysis will be done for facility assessment and thematic analysis will be conducted with qualitative data. Ethics and dissemination Ethical approval from Institutional Review Board of BRAC James P Grant School of Public Health (2018-017-IR) has been obtained. Findings from this research will be disseminated through presentations in local, national and international conferences, workshops, peer-reviewed publications, policy briefs and interactive project report.

In this paper we aim to better understand the lived experiences of the slum dwellers in Dhaka, Bangladesh and the social, economic and health and well-being constraints resulting from the nationwide shutdown due to COVID-19 pandemic. We undertook rapid qualitative research telephone interviews (51, 44 women and 7 men) with slum dwellers. We analyse the data using intersectionality theory. Findings draw on direct experiences on the impact of the shutdown on vulnerable groups living in informal settlements in Dhaka city. Highlighting the tensions between the current shutdown to address the spread of COVID-19 and the immediate and urgent (food and other) needs of poor and vulnerable groups. Slums are overcrowded, steeped in deprivation, with residents using communal latrines, water sources, cooking spaces, with many slum dwellers unable to follow the recommended guidelines for preventing COVID-19. Most were living in panic and fear of getting infected. Stress and anxiety were reported as their precarious existence deepens with the continued containment measures and were particularly reported by women, who were also experiencing increasing levels of violence. Food relief distribution remains uneven and beset with irregularities. While health risks are a very real concern, their overriding insecurity is starvation. We frame our discussion within recommendations made on C-19 and intersectionality highlighting the importance of learning from qualitative testimonies with women and men within the context of informal settlements at this point in lockdown; the need to move beyond a deficit model and recognize and support resilience; and the importance of broadening bailout and stimulus packages to prioritize those most at risk and ensure multi-sectoral action approach to this pandemic in Bangladesh and elsewhere needs to be accompanied by a socially just model that recognizes the ways in which structural, patriarchal and social inequalities interplay to place the poorest most at risk to multiple threats.

Purpose: About half of the 16% adolescents in the world experience menstruation. Menstrual hygiene management (MHM) is a health concern and challenge especially in humanitarian situations as experienced by Myanmar Rohingya refugees living in Cox’s Bazar, Bangladesh. This study aims to assess knowledge, practice and influencing factors for MHM among Rohingya refugee adolescent girls of 14–18 years. Design/methodology/approach: The study used both quantitative (a cross-sectional survey with 340 adolescent girls through a structured questionnaire) and qualitative (7 in-depth interviews with adolescent girls and 2 focus group discussions with the mothers) approaches. Quantitative data, analyzed using STATA version 13.0, were supported by qualitative data, grouped into themes and presented as matrix. Findings: Around 51% adolescent girls learned about menstruation after menarche, at the mean age of 12 years, from their mothers and older sisters. About 75% used sanitary pads as absorbents which they got mostly as relief material or bought from local stores (83%); the rest used cloths and other materials (25%). About 57% of the respondents disposed of their absorbent by burying. Those who used reusable absorbents washed them with soap and water (40%) and mostly dried them indoors (17%). Factors influencing healthy MHM practice included the use of absorbent, privacy, disposal, washing and drying of clothes, physical activities, hygiene and pain management. Adolescents with secondary or higher education were four times more likely to have better MHM practice (odds ratio = 4.27; confidence interval = 1.19–15.31) than those with no formal schooling. Originality/value: This paper is based on a research undertaken as part of academic requirement.

While the prevalence of food insecurity among higher education students is consistently higher than the general population and some support is available, the extent to which programs developed to address food insecurity programs help students in higher education institutions remains unclear. This scoping review aimed to comprehensively synthesise the existing evidence on campus-based programs in addressing food insecurity in higher education institutions. A search was conducted on 5^th December 2023 in the electronic databases PubMed, Medline, Web of Science, and Scopus to identify food insecurity programs for students attending higher education institutions. Peer-reviewed articles written in English and published between 1 January 2003 and 5 December 2023 that met the inclusion criteria were included. There were no restrictions on study designs. Identified studies were screened in two stages and data were independently extracted. Thirty-three studies were included in this review, with most programs implemented in the United States. A wide range of programs were found, grouped into two categories: 1) food assistance and 2) support services and resources (i.e., food-related courses and health professional services). One-third of studies illustrated student engagement in the development and/or implementation process. Outcomes related to the programs included the prevalence of food insecurity status, diet and food-related outcomes, and student perceptions, awareness, and utilisation of the programs. While half of the included studies reported the prevalence of food insecurity, only five studies evaluated whether the program led to an improvement in food security status among students. Barriers to (n=30) and facilitators of programs (n=24) were identified by students and other stakeholders who were directly involved in the programs. Although this scoping review identified a wide range of campus-based programs to address food insecurity in higher education students, there is relatively limited evidence available on to what extent the programs improve food security levels. Identifying factors that hinder or facilitate campus-based programs from various stakeholders can help to inform researchers and policymakers in planning and developing food insecurity programs, particularly at the higher education level.