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Access denied: Understanding the experiences of Burmese women who are unable to obtain a legal abortion in Thailand

 

Through in-depth interviews with women on the Thailand-Burma border, our two-year project aims to: 1) Document the experiences of Burmese women who are unable to obtain a safe and legal abortion through an existing referral system; 2) Evaluate the pregnancy outcomes of women who are denied an abortion three months and nine months after the denial; and 3) Assess the impact of misoprostol-related harm reduction materials distributed to a subset of women at the time of the denial. 

 

 

Assessing the availability, accessibility, and acceptability of emergency contraception in Tunisia

 

In 2001, Tunisia became the first country in the Arab world to register a dedicated emergency contraceptive pill (ECP). However, little research has been undertaken to systematically evaluate the service delivery and use patterns of ECPs in Tunisia. Our study aimed to fill this gap. Through this multi-methods study we assessed the availability, accessibility, and acceptability of EC in Tunisia and focused on the perspectives and experiences of pharmacists and both married and unmarried women. This project was undertaken in partnerships with the Tunisian Center for Public Health and Ibis Reproductive Health and was funded by the Society of Family Planning.

 

 

Conducting a reproductive health needs assessment in peri-Urban Yangon, Myanmar

 

Conflict in Myanmar has been ongoing for over fifty years and has led to massive population displacements, service disruptions, and shortages of trained health care workers. Reproductive health outcomes have subsequently suffered. Though the political landscape of the country has recently changed, many people fleeing volatile regions of the country have congregated in the slum settlements surrounding Yangon, Myanmar’s largest city. Little data exists on the health of women in this rapidly evolving area. This multi-methods needs assessment aims to understand the availability and accessibility of reproductive health services in the peri-urban Yangon region, explore women’s experiences and unmet needs, and identify mechanisms by which comprehensive service delivery can be improved. Informed by Separated by borders, United in Need, this project is being undertaken as a partnership between researchers at the University of Ottawa, the National YWCA of Myanmar, and CRHC.

 

Click here to read our first report on the findings.

 

 

Expanding access to long-acting reversible contraceptive methods on the Thailand-Burma border

 

The risk of unintended pregnancy and subsequent unsafe abortion among women in Eastern Burma and refugees and migrants in Thailand is considerable. Identifying avenues for reducing unplanned pregnancy within this especially vulnerable population has been widely recognized as a public health, service delivery, and research priority. The Mae Tao Clinic (MTC) in Mae Sot, Thailand operates one of the largest and most comprehensive health facilities along the Thailand-Burma border. This current project aims to understand better the factors that influence implant uptake in this setting, including health worker biases and patient misinformation.
 
This study is part of a larger MTC project that aims to understand and evaluate LARC use and distribution among patients who visit MTC. In 2011-2013, the same research team conducted a pilot study looking at barriers to IUD utilization among post-abortion care (PAC) clients as well as family planning clients. Since then, an interventional study was conducted to train healthcare workers and clinicians about IUD information and insertion; numbers for IUD usage among patients increased significantly after this study.

 

 

Expanding a referral system for safe, legal abortion care in Tak Province, Thailand

 

The ongoing civil conflict in Burma has significantly impacted reproductive health. Rates of unintended pregnancy and unsafe abortion among women in eastern Burma and refugees and migrants living in Thailand are considerable. Although abortion is legal in Thailand in many circumstances, women from Burma residing in Thailand are generally unable to access safe abortion care. Building from a successful pilot initiative that was launched in 2012, this project aims to establish and expand a referral system for safe, legal abortion care in two areas of Tak Province, Thailand. Further, this project will promote harm reductions strategies among both health care workers and women with unwanted pregnancies who do not qualify for safe, legal abortion care. This project is being led by Mae Tao Clinic in collaboration with CRHC, the Adolescent Reproductive Health Zone, and researchers at the University of Ottawa and is funded by the Safe Abortion Access Fund. Through rigorous monitoring and evaluation over the three year project period, this project aims to develop a model by which access to safe and legal abortion care can be expanded in legally restrictive settings.

 

Click here to read our first report on the findings.

Click here to read the executive summary in Burmese.

 

 

Improving young women's access to reproductive health education in Yangon, Myanmar

 

Building on the reproductive health needs assessment conducted by researchers at the University of Ottawa, the National YWCA of Myanmar and CRHC , this project aims to address misinformation surrounding sexual and reproductive health among young and unmarried women in peri-urban Yangon, Myanmar. Through a series of participatory peer education training sessions, this year-long project will aim to build confidence, increase knowledge of sexual and reproductive health issues, and address misinformation that hinders access to available services and care. Building on the priorities and experiences of our peer education participants, we will also develop a series of reproductive health education resources, including a comic book and a mobile app or website, tailored to the experiences and interests of young, unmarried women in peri-urban Yangon. This project is funded by an OceanPath Fellowship administered through the Coady Institute in Canada.

 

 

No exceptions: Documenting the abortion experiences of US Peace Corps Volunteers

 

Between 1979 and 2014, a US federal appropriations bill restricted the coverage of abortion for Peace Corps Volunteers. There were no exceptions to the coverage ban and abortion care was not covered under any circumstance. This large scale qualitative study aimed to document women’s experiences obtaining abortion care while in service under these restrictions and identify ways in which reproductive health services could be improved. This project was led by Dr. Angel Foster and was funded by a grant from the HRA Pharma Company’s Foundation.

 

Click here to read our first report on the findings.

 

 

Updating the medication abortion website

 

In 2003, Ibis Reproductive Health launched one of the first multi-lingual online resources dedicated to medication abortion. Available in Arabic, English, French, and Spanish, www.medicationabortion.com provides medically accurate and evidence-based information about three different medication abortion regimens to researchers, health service providers, and women considering the option of medication abortion for early pregnancy termination. In 2009, the website received nearly 500,000 visits from users in 208 countries and territories. CRHC is now collaborating with Ibis Reproductive Health to update the website and to introduce interactive, user friendly features to expand the reach of the resource. CRHC is also leading the effort to develop both Persian and Turkish translations and adaptations of the website.

Articles

 

  • November 2015. "We can lose our life for the abortion": exploring the dynamics shaping abortion care in peri-urban Yangon, Myanmar. Contraception. (Request article)

  • August 2015. "In rape cases we can use this pill": A multimethods assessment of emergency contraception knowledge, access, and needsd on the Thailand-Burma border. International Journal of Gynecology and Obstetrics. (Open access article)

  • February 2015. Assessing the experiences of intra-uterine device users in a long-term conflict setting: a qualitative study on the Thailand-Burma Border. Conflict and Health. (Open access article)

  • January 2015. No Exceptions: Documenting the Abortion Experiences of US Peace Corps Volunteers. The American Journal of Public Health. (Request article)

 

 

 

Reports

 

  • February 2015. Near the City but Hard to Reach: A Reproductive Health Needs Assessment in Peri-Urban Yangon, Myanmar (Full report)

  • January 2015. Establishing a safe abortion referral system for women from Burma residing in Chiang Mai, Thailand: Results from situation analysis research (Full report | Executive summary in Burmese)

  • May 2014. No Exceptions: Documenting the Abortion Experiences of US Peace Corps Volunteers (Full report | Executive summary)

  • 2012. Separated by Borders, United in Need: An assessment of reproductive health on the Thailand-Burma border* (Full report | Executive summary)

 

    * This report was authored by CRHC Principals and Consultants, and was a collaboration between Ibis Reproductive Health and the Global Health Access Program.

 

 

 

Other Resources

 

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