Experience of the hijra community in accessing formal healthcare in Dhaka city: an exploratory qualitative study

Abstract

Introduction: The Hijra community experience social exclusion in Bangladesh. One of the key aspects of life is health. It is the right of the general population of a country to access formal healthcare services at the public and private healthcare facilities. The people of the Hijra community face numerous discriminatory challenges in accessing health services at the hospitals and other community clinics due to gender disparity even after they are legally recognized by the government at the ‘Third Gender’. Objective: To understand the experiences of the Hijra community members in accessing formal healthcare services. Method: An exploratory qualitative method comprising of 26 In Depth Interviews (IDIs) and 5 Key Informant Interviews (KIIs) were conducted among the Hijra persons residing in different locations of Dhaka city. The data were analyzed by using coding strategies and thematic analysis. Finding: The study findings revealed that the Hijra people commonly experience cold, fever, allergy, non-communicable diseases (NCDs), sexually transmitted infections (STIs) and insomnia. However, seeking formal healthcare for the mentioned health issues is a challenging experience for them due to lack of service provision for the third genders in the hospital premises, negligence and refusal to provide services by the care providers, verbal and physical harassment by the service providers and surrounding people. Conclusion: The study shows the need to sensitize the society and incorporate Hijra identity (third gender) within the administrative service provision of the formal healthcare facilities alongside the ‘male’ and ‘female’ gender categories. It also recommends improving the knowledge and attitude of the care providers towards the Hijra community by familiarizing them with their biological and cultural aspects to avoid further discrimination and humiliation when seeking for formal healthcare in future.