Project overview | ptl | live

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As part of our Play to Learn (PtL) research, NYU Global TIES for Children - in partnership with icddr,b - is conducting a longitudinal prenatal and early years cohorts study which follows caregivers and their young children from the Rohingya refugee and host communities in Cox’s Bazar, Bangladesh. The study starts in the prenatal period and continues through the first years of life. It aims to investigate, longitudinally, the potential lifespan health and developmental implications of being conceived, gestated, born, and raised in contexts of war and displacement.

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Rohingya, a stateless, ethnic minority from the state of Rhakine in Myanmar, have fled to Bangladesh and other countries in several waves over many decades, “escaping genocide, crimes against humanity, and ethnic cleansing”. The most recent and largest wave was in 2017, where over 700,000 Rohingya sought refuge in neighboring Bangladesh. Now, an estimated 954,000 Rohingya are residing in crowded settlements on the southeastern coast of Bangladesh in Cox’s Bazar district. Nearly half of this population, just over 450,000, are children under the age of 18. Individuals are clustered in several contiguous administrative “camps”, with the largest cluster now hosting close to 600,000 people, making it by far the largest refugee settlement in the world. With current estimates indicating that the average duration of displacement is over 20 years and our increasing understanding of the intergenerational transmission of trauma and its life-course implications for health and wellbeing, refugee camps today are being reimagined as spaces where children and caregivers can receive health, education, psychosocial, and other services to buffer from the impacts of trauma, and prepare them for the best possible future. Until 2018 there had been virtually no research, especially on early childhood development (ECD), in the context of the Rohingya living in Cox’s Bazar. This has slowly started to change in the years since. Contexts of conflict, emergency, and crisis, such as the dire circumstances of the Rohingya, constitute some of the most challenging settings for human development in the world. Developmental trajectories and the powerful protective factors that may improve them in these conditions have never been studied at large scale, leaving a huge gap in the science and practice of human development. The dearth of comprehensive ECD services in Cox’s Bazar and the challenging circumstances in the camps mean that hundreds of thousands of children are at risk of not reaching their full developmental potential. In order to provide the necessary and appropriate services and support to ensure healthy development of these children, it is critical to investigate how ECD unfolds and how to design programs and interventions for this population.

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Context

CONTEXT

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STUDY GOALS

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This study aims to identify powerful sources of risk and resilience in this very particular culture and context to inform programs and interventions designed to support healthy child development for the Rohingya population. Our guiding research questions include:

1. How does being conceived, gestated, born, and raised in contexts of war and displacement affect developmental trajectories of children in and around the Cox’s Bazar camps?
2. How are experiences of war and displacement, and the resulting trauma and stressful life experiences, transmitted to the next generation? And what are the consequences for lifelong health and development?
3. What are the specific risk and protective factors at multiple levels (neurobiological, psychological, physical, social) and among multiple generations that influence human development in contexts of war and displacement?

Study goals

Principles

We aim always to ensure fast-paced knowledge generation and remain responsive to the needs of service providers and the populations they serve. We do this by ensuring breadth and depth of the data and maintaining openness and flexibility to iterate and pivot in response to findings from the study and our community engagement activities.Breadth and depth of data: A broad interdisciplinary and multi-method strategy, drawing on methods and approaches from, for example, developmental science, public health, and anthropology, allows us to gain a comprehensive picture of the bioecological systems, enabling a deeper understanding of the dynamic nature of human development in this context. Openness and flexibility to iterate and pivot: While pursuing the primary research questions, we also allow the data to generate hypotheses and research questions as we go. This is critical to conducting research in this context, as 95% of research on child development has focused on just 5% of the world’s children. A willingness to flexibly adapt research designs as we learn from quantitative and qualitative data allows for research that is more responsive to the context and the study population and facilitates a fast-paced process of advancing our knowledge base. Continuous community engagement: At the heart of it all we emphasize regular and ongoing community engagement (through focus group discussions, key informant interviews, and participatory workshops) to continuously ensure the relevance of our research and validity of our findings. We believe these underlying principles will generate faster, more relevant, and actionable findings and could form the blueprint for the rapid advancement of a global developmental science.

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Longitudinal prenatal and birth cohort studies allow for uniquely powerful investigations into life-course developmental trajectories and the protective processes that can inform how to maximize developmental potential. Landmark multi-decade studies in high- and low- and middle income countries alike have yielded remarkable insights into early predictors of later health and functioning, and the sources of risk and resilience, and have had wide ranging influence on policy and practice. Despite the historic scientific contributions of longitudinal birth cohort studies of human development, large gaps remain in this literature. Relatively few large-scale and long-term longitudinal studies have begun in the prenatal period, a particularly vulnerable developmental time regarding stress exposure. Longitudinal studies have shown prenatal exposure (through severe stress in the pregnant mother) and early experiences of adversity can have life-long implications for health and wellbeing. These effects have been directly measured in physical and mental health outcomes, and have been shown to be reflected in alterations in a number of neurobiological systems. Importantly, recent studies have found that trauma and trauma related mental health can be transmitted prenatally to the next generation with potential lifelong consequences for physical and mental health, highlighting the absence of and need for longitudinal investigations of human development in humanitarian contexts. In addition, there have been strikingly few longitudinal studies of early childhood development that draw from methods and measures used across a diverse range of disciplines, from epidemiology to anthropology, combining survey research with in-depth semi-structured interviews, neurobiological markers, direct assessments of children’s development, anthropometrics, observations of children interacting with their caregivers and environment, and community engagement and participatory approaches. Combining these methods allows for triangulation of data and verification of our findings, providing a thorough and valid picture of participants and their communities.

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RATIONALE

PRINCIPLES

STUDY GOALS

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As part of our Play to Learn (PtL) research, NYU Global TIES for Children is conducting a longitudinal prenatal and early years cohorts study which follows Rohingya caregivers and their young children from the prenatal period, to birth, and through their first years of life. This study aims to investigate, longitudinally, the potential lifespan developmental implications of being conceived, gestated, born, and raised in contexts of war and displacement. Three topics that are as of yet vastly understudied, especially in humanitarian contexts, will receive particular attention: the role of fathers in their children’s upbringing and development; early marriage and childbearing; and the role of play in building resilience in early childhood in this sociopolitical context.

As part of our Play to Learn (PtL) research, NYU Global TIES for Children - in partnership with icddr,b - is conducting a longitudinal prenatal and early years cohorts study which follows caregivers and their young children from the Rohingya refugee and host communities in Cox’s Bazar, Bangladesh. The study starts in the prenatal period and continues through the first years of life. It aims to investigate, longitudinally, the potential lifespan health and developmental implications of being conceived, gestated, born, and raised in contexts of war and displacement.

RATIONALE

PRINCIPLES

STUDY GOALS

CONTEXT

As part of our Play to Learn (PtL) research, NYU Global TIES for Children - in partnership with icddr,b - is conducting a longitudinal prenatal and early years cohorts study which follows caregivers and their young children from the Rohingya refugee and host communities in Cox’s Bazar, Bangladesh. The study starts in the prenatal period and continues through the first years of life. It aims to investigate, longitudinally, the potential lifespan health and developmental implications of being conceived, gestated, born, and raised in contexts of war and displacement.

RATIONALE

PRINCIPLES

STUDY GOALS

CONTEXT

RATIONALE

PRINCIPLES

STUDY GOALS

CONTEXT

As part of our Play to Learn (PtL) research, NYU Global TIES for Children - in partnership with icddr,b - is conducting a longitudinal prenatal and early years cohorts study which follows caregivers and their young children from the Rohingya refugee and host communities in Cox’s Bazar, Bangladesh. The study starts in the prenatal period and continues through the first years of life. It aims to investigate, longitudinally, the potential lifespan health and developmental implications of being conceived, gestated, born, and raised in contexts of war and displacement.