Barriers to Cardiovascular and Diabetes Care Among Elderly Rohingya Refugees in Bangladesh: A Qualitative Study of Healthcare Provider Perspectives.

BACKGROUND/OBJECTIVES: Non-communicable diseases (NCDs), including cardiovascular disease and diabetes, present an increasing challenge in humanitarian settings. While healthcare services in refugee camps have traditionally prioritised acute and communicable diseases, the long-term management of chronic conditions remains difficult, particularly among older adults. This study explored healthcare providers' perspectives on barriers to cardiovascular disease and diabetes care among elderly Rohingya refugees living in Cox's Bazar, Bangladesh. METHODS: A qualitative study was conducted using semi-structured interviews with six physicians working in Rohingya refugee camps in Cox's Bazar, Bangladesh. Participants were recruited through purposive and snowball sampling. Interviews were audio-recorded, transcribed verbatim, and analysed using inductive thematic analysis. RESULTS: Three overarching categories of barriers were identified: service delivery barriers, physical and environmental barriers, and socio-cultural barriers. Healthcare providers described limited diagnostic capacity, restricted medication availability, fragmented continuity of care, transport difficulties, challenging camp terrain, language barriers, low health literacy, and reliance on informal healthcare providers as key challenges affecting long-term management of cardiovascular disease and diabetes. These interconnected barriers were perceived to reduce healthcare access and continuity of care for elderly Rohingya refugees. CONCLUSIONS: The findings suggest that humanitarian healthcare systems should strengthen long-term management of non-communicable diseases among ageing refugee populations. Improving diagnostic capacity, ensuring reliable access to essential medicines, enhancing continuity of care, and supporting culturally appropriate health education and outreach services may improve chronic disease management in humanitarian settings. Further research exploring the perspectives of elderly Rohingya refugees is needed to complement healthcare provider perspectives.