IFGH 2010: Access and Barriers to Health Services Experienced by the Hijra in Dhaka, Bangladesh

The hijra community are an ostracised male-to-female community within Bangladesh society. This study examined where the hijra access health services and highlighted the barriers they experience. It explored whether health organisations catered for hijra and what services they provided. It also looked at unmet health needs experienced by this community. This research took place in Dhaka, Bangladesh.

Ten hijra participants took part in in-depth interviews and five key-informant interviews were carried out with organisations that provided health services. Two focus groups took place with five junior hijra and five senior hijra who had undergone castration or urethral reconstruction. Heterogeneity sampling and conventional content analysis were used.

This community have access to very good STI/HIV health services, although this does not cover Hepatitis. They experience barriers in relation to general and transitioning health services, including geographical proximity, discrimination, financial constraints and community politics. These barriers were reflected in their choice of healthcare provider. This can result in receiving improper treatment or undergoing risky procedures.

Like other transgender communities, they experience discrimination which has a ripple effect on their access to healthcare. Their specific culture, hierarchy and community systems need to be taken into account by those who are working with them.

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