Connecting care: transforming health for Rohingya refugees in Cox’s Bazar

After several visits to a primary health care (PHC) facility in the Rohingya refugee camps in Cox’s Bazar, 38-year-old Jamnat Ara* still did not know what was wrong.

She experienced persistent fatigue, headaches, sleeplessness and sudden episodes of anger, making it difficult for her to care for her family and manage daily activities. Each symptom was treated separately, with no clear explanation of what connected them.

“I kept going back, but I didn’t understand what was happening to me,” she said. “I thought it was just tiredness from daily life, but it didn’t go away.”

Jamnat’s experience reflects a broader challenge in humanitarian settings: Physical symptoms and psychological distress often overlap, yet care is often delivered separately, limiting effective diagnosis and treatment. This means that people living with noncommunicable diseases (NCDs) – who are at greater risk of developing mental health conditions – too often experience delayed diagnosis and incomplete care, leading to poorer physical and mental health outcomes.

A shift towards integrated, person-centred care

In Cox’s Bazar, home to more than one million Rohingya refugees, the scale and complexity of health needs require coordinated services. Since the beginning of the crisis, Public Health Needs Assessments (PHNA) have consistently highlighted the magnitude of the challenge, with the latest PHNA (2025—2026) finding that around one in ten households has at least one member living with a mental health condition.

In response, the Government of Bangladesh, with technical leadership from WHO and support from the European Union Civil Protection and Humanitarian Aid Operations (ECHO), has been integrating mental health and NCD services through the revised Minimum Service Package, moving beyond fragmented treatment to more coordinated and comprehensive care.

^{Health workers in Cox’s Bazar receive training on the WHO Package of Essential NCD Interventions. (WHO Bangladesh)}

Between 2024 and 2025, WHO NCD and mental health staff intensified training and support to strengthen integrated service delivery. More than 150 newly recruited PHC providers were trained through the Mental Health Gap Action Programme (mhGAP), while another 150 frontline health workers received training on the WHO Package of Essential NCD Interventions.

These efforts were complemented by regular supportive supervision, clinical mentoring and case discussions between health workers and technical experts, reinforcing skills gained through training and strengthening the quality of care. Increasingly, efforts have focused on integrating services and promoting collaboration between NCD and mental health units to ensure that patients are routinely screened and managed for both conditions.

Frontline providers across the camps report earlier identification of complex conditions, stronger referral pathways and more consistent follow-up care.

^{Following the WHO-led trainings, supportive supervision at PHC centres has improved care for patients like Jamnat. (WHO/Terence Ngwabe Che)}

From fragmented visits to informed care

For Jamnat, the change became clear during a follow-up consultation last year. Instead of focusing on symptoms separately, health workers considered emotional wellbeing, stress and daily challenges alongside her physical health. This helped them understand how her symptoms were connected.

“Before, we often treated only what we saw immediately,” said Dr Abdul Kader, a medical officer who works at a PHC facility supported by the International Organization for Migration and WHO in Camp 9. “Now, we assess mental and physical health together. This helps us identify underlying conditions earlier and provide more comprehensive care.”

Jamnat received counselling, a clear explanation of her condition and a referral for continued support. “For the first time, I understood what was happening to me and I finally felt I could manage my condition,” she said.

Her experience reflects a broader shift: When care is comprehensive, patients are not only treated – they are understood.

Delivering impact under pressure

Despite camp-wide progress, high patient volumes, limited resources and gaps in medicines and psychosocial services continue to put pressure on the system. Continued investment in training, supervision and referral networks is essential to sustain progress, without creating parallel systems.

“Integrating mental health and NCD services is essential for delivering people-centred care in humanitarian settings,” said Dr Tran Minh, Head of the WHO Emergency Sub Office in Cox’s Bazar. “With support from the European Union, this approach has helped health workers in Cox's Bazar identify complex conditions earlier and provide more comprehensive and effective care. Sustaining and expanding these gains will require predictable funding and long-term investment to ensure integrated services reach those most in need.”

As displacement becomes more common and protracted worldwide, Cox’s Bazar offers important lessons. For Jamnat, it brought clarity after months of uncertainty. For health workers, it has changed how they assess and support patients. And across the broader response, it has provided more coordinated and comprehensive care for people with complex health needs – linking services and improving outcomes.

*Name has been changed to protect the individual’s identity

For more information about this publication, please contact Terence Ngwabe Che, External Communication Officer, Cox’s Bazar Sub-Office, WHO Bangladesh, at chet@who.int