Date of publication:

08/22/2025

Bangladesh

Do domestic laws and policies provide access to sexual and reproductive healthcare services for forcibly displaced and stateless persons? 

ANALYSIS

Assessment by population

Refugees
Asylum-seekers
Analysis

There are no domestic laws and policies that explicitly guarantee access to sexual and reproductive health care services for refugees and asylum-seekers in Bangladesh. The laws of Bangladesh do not explicitly provide any guarantee of asylum-seekers and refugees’ access to Sexual and Reproductive Health (SRH). The Government of Bangladesh has framed some policies for the citizens and different policies for Rohingya refugees to outline the strategy related to SRH. The National Population Policy, 2012 states about ensuring availability of family planning and reproductive health services to the citizens while raising awareness, disseminating information and prioritizing counselling.1 The policy focused on door-to-door services, delivery of specialized emergency services in case of mishaps or emergencies, awareness campaigns so that people accept the services frequently, supply quality family planning commodities and many more initiatives such as providing SRH services in all levels for easy availability and accessibility. One of the core strategies set by the policy is to encourage couples to accept family planning methods through informed choice and voluntarism.2 The policy also states about development of local level action plans for reproductive health services by determining the need of the community and incorporating representatives of disadvantaged women, local leaders, and stakeholders.3 The government introduced Bangladesh National Strategy for Maternal Health 2019-2030 that firmly acknowledges about implementing the full range of sexual-reproductive health care through a sector-wise approach, engagement, and collaboration for Bangladeshi women.4 This strategy also focuses on improvement of standards and procedures of service on SRH, promoting and creating awareness on SRH among citizens including adolescents. The government also incorporated Bangladesh Adolescent Reproductive Health Strategy, which is appliable to the citizens where it has stated to view Adolescent Reproductive Health (ARH) as a development issue and stated about embodying it in all national planning frameworks related to human development with a special focus on marginalized and high-risk adolescent groups.5

Rohingya women and girls represent over half of the refugee population in the refugee camps of Bangladesh and while the provision of Sexual Reproductive Health (SRH) care has improved since the beginning of the humanitarian response in Cox’s Bazar, access to these services remains a point of concern. Women refugees are extremely vulnerable to negative SRH outcomes due to limited knowledge on menstruation, menopause, sexually transmitted infections, and unwanted pregnancy. Moreover, since 2024, reports of challenges around the registration of some Rohingya refugee children for humanitarian assistance and protection unless the mother has agreed to health authority's request for long term family planning.6 Regarding this issue, UNHCR and other agencies working in the camps are conducting advocacy with government counterparts that such family planning policies and guidelines should emphasise the principle of universal human rights, voluntariness, non-discrimination, and transparency. 

 With training, Community Health Workers (CHWs), alongside health facilities and midwives, are attempting to enhance SRH awareness among Rohingya refugees. They provide culturally sensitive education on family planning, maternal health, and Sexually Transmitted Disease prevention, empowering individuals and improving community health. Over the years, the knowledge and awareness among women of reproductive age and adolescents have significantly increased through this approach. Through community surveillance and awareness initiatives, more women are now seeking antenatal check-ups and prioritizing facility-based deliveries. This shift has led to a notable increase in health facility deliveries, which has reached approximately 85%. Apart from this, community-based family planning commodities distribution is also ongoing, fostering access to Family planning items as well.  However, significant delays in seeking care especially during childbirth has contributed to the persistent high maternal and neonatal mortality reported in the camps, and issue that the health sector and the SRH working groups are actively addressing. While basic SRH information is available through community outreach and educational initiatives, there are opportunities to enhance both the reach and quality of this information. Factors such as language, cultural relevance, and access to resources in refugee settlements can affect the delivery and impact of SRH education. However, with ongoing support from humanitarian organizations and targeted, culturally sensitive approaches, there are further scopes to enhance SRH knowledge and empower the Rohingya community with more comprehensive and accessible information. 

Ensuring quality of both primary and secondary maternity services is also essential for an integrated SRH response. Despite the lack of specific legal guarantees, the Government of Bangladesh, in collaboration with the United Nations agencies and other humanitarian partners, provides sexual and reproductive health care services such as health promotion, preventative, curative, and secondary/tertiary referral services in the primary health centers with focus on the vulnerable groups including pregnant and post- natal women, newborns, the under-fives, including those with malnutrition and persons with disabilities. to refugees in the camps in Cox's Bazar. 

Notwithstanding all these efforts, it is important to note that, Bangladesh does not acknowledge "abortion" as a right; rather as an offense. The Penal Code of 1860, which applicable also to asylum-seekers and refugees in the country, uses the term "miscarriage" instead of "abortion" when addressing various types of pregnancy termination cases. For example, Section 312 of the Penal Code 1860 of Bangladesh states, “[w]hoever voluntarily causes a woman with child to miscarry, shall, if such miscarriage be not caused in good faith for the purpose of saving the life of the woman, be punished with imprisonment of either description for a term which may extend to three years, or with fine, or with both; and, if the woman be quick with child, shall be punished with imprisonment of either description for a term which may extend to seven years, and shall also be liable to fine.” On the other hand, Section 316 states, “[w]hoever does any act under such circumstances, that if he thereby caused death, he would be guilty of culpable homicide, and does by such act cause the death of a quick unborn child, shall be punished with imprisonment of either description for a term which may extend to ten years, and shall also be liable to fine.” These provisions of the Penal Code can be applicable to refugees as well. 

 According to data from 2018, a sizable percentage of pregnant Rohingya women were unable to obtain prenatal care (ANC) due to the service's unavailability or inaccessibility.7 Moreover, Essential ANC components including blood testing, urine testing, and tetanus vaccination are not readily available in many sexual and reproductive health institutions.8 Despite efforts by the government to provide the refugees with SRH services, numerous factors such as their vulnerability and transitions and lack of clarity on traditional beliefs and cultural models,9 the lack of skilled birth attendants, limited access to reproductive healthcare services, limited contraceptive options, lack of family planning knowledge, lack of awareness of HIV/STI prevention, increased risk of gender-based violence, and lack of knowledge about SRH, early and forced marriages, early childbearing, and gender-based violence in Rohingya refugee settings creates barriers in access to sexual and reproductive health care services.10