Social cohesion, trust, and utilisation of maternal health services among refugee and host community women in Bangladesh and Kenya

Abstract

The global refugee crisis places significant pressure on host communities, particularly in low- and middle-income countries. Social cohesion and trust between refugee and host communities are critical for maternal health service utilisation. This study explores the relationship between host–refugee trust, social cohesion, and maternal health service use in Bangladesh and Kenya, focusing on facility-based delivery, antenatal care visits, and postnatal care attendance. To do so, a cross-sectional survey was administered among 649 refugee/displaced women and 371 host community women in the two locations. The results show high trust levels in both groups, while social cohesion is greater among refugee/displaced women. A higher social cohesion score is significantly associated with increased odds of attending four or more PNC appointments (adjusted odds ratio: 1.03; 95 per cent confidence interval: 1.01–1.05). Strengthening social cohesion may enhance maternal health service utilisation, especially postnatal care, in refugee-hosting settings, underlining the need for interventions fostering community bonds.