The largest camp for displaced persons in the world is in Cox’s Bazar, Bangladesh, housing nearly 1 million Rohingya people who fled violent persecution in the Rakhine State of Myanmar. Forced displacement negatively impacts a wide range of health outcomes; access to health facilities is crucial to mitigating these effects. Access to health facilities can be mitigated by distance, travel time, and cost. In this paper, we assess the obstacles Rohingya women face in accessing health facilities, and analyze how the obstacle of perceived distance correlates with demographic and health characteristics.

We conducted a community-based multi-stage stratified sample survey of 1,173 women aged 15-49 (one per household) living in four of the 33 camps in Cox’s Bazar. We used logistic multivariate regression to examine associations between perceived distance and demographic and health characteristics.

Among our sample, health facilities were key points of access to sexual and reproductive health (SRH) care and care in general: almost all respondents had been to a facility in the past year, and said a facility is where they would go if they needed care for a women’s health problem. Fifty-two percent reported it is (or sometimes is) a problem to pay for travel to a health facility, 71% report that waiting times at facilities are too long, and 32% report that their health facility is too far away. We found that residents of camps with fewer facilities per capita were more likely to report their facility was too far away (aOR = 5.16, 95% CI [3.66, 7.28]). Women who reported having difficulty walking (aOR = 2.10, 95% CI [1.49, 2.94]) or who reported experiencing chronic physical pain (aOR = 1.52, 95% CI [1.09, 2.11]) were more likely to report their facility is too far away.

Rohingya women face difficulties accessing health services, and their perception of distance to a health facility can impact their access. Since health facilities are overwhelmingly trusted sources of SRH care among Rohingya women, efforts to improve their access to facilities need to take place-based approaches to address obstacles specific to women’s camp residence and health characteristics.