Abstract
BackgroundIn Burma, severe human rights violations, civil conflict, and the persecution of ethnic and linguistic minority populations has resulted in the displacement of millions of people, many of whom now reside as internally displaced populations (IDPs) in Eastern Burma or in Thailand as refugees or undocumented migrants. Use of the intra-uterine device (IUD), a non-user dependent and highly reliable method of long acting reversible contraception, has the potential to make a significant impact on reproductive health in this protracted conflict setting.ObjectivesThis qualitative study aimed to understand Burmese women’s experiences with and perceptions of the IUD and identify avenues for improving contraceptive service delivery along the Thailand-Burma border.MethodsIn the summer of 2013, we conducted in-person in-depth open-ended interviews with 31 women who obtained IUDs from a clinic along the border. We conducted a content and thematic analysis of these data using both a priori (pre-determined) and emergent codes and inductive techniques.ResultsWomen’s experiences with the IUD are overwhelmingly positive and the experiences of friends and family impact use of the device. Financial considerations and access to reproductive health facilities also shape the use of the IUD in this region. The IUD is rare along the Thailand-Burma border and misinformation about this method of contraception is pervasive.ConclusionOur findings suggest that this modality of contraception is culturally acceptable and may be able to address structural barriers to reproductive health services along the Thailand-Burma border. Ensuring that information provided by health care providers and among peer groups is evidence-based, a full range of contraceptive methods is available, and adoption of an IUD is affordable are priorities for expanding access to reproductive health services in this setting.
Highlights
In Burma, severe human rights violations, civil conflict, and the persecution of ethnic and linguistic minority populations has resulted in the displacement of millions of people, many of whom reside as internally displaced populations (IDPs) in Eastern Burma or in Thailand as refugees or undocumented migrants
Twenty eight of our participants had received their intra-uterine device (IUD) at one of two health care organizations operating on the Thai side of the Thailand-Burma border; the other three participants received their IUDs in Burma
Women had used the IUD for two years; duration of use ranged from 6 months to 20 years
Summary
In Burma, severe human rights violations, civil conflict, and the persecution of ethnic and linguistic minority populations has resulted in the displacement of millions of people, many of whom reside as internally displaced populations (IDPs) in Eastern Burma or in Thailand as refugees or undocumented migrants. For more than half a century, Burmaa has been characterized by severe human rights violations, civil conflict, and persecution of ethnic and linguistic minorities. Combined with inequity in food distribution, healthcare services, and education the situation has led to the displacement of millions; this. This overall context has had profound consequences for reproductive health. One of the greatest markers of unmet contraceptive need in Eastern
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