In 2010, following its approval by the Ministry of Health, the medical abortion combination pack Medabon (containing mifepristone and misoprostol) was made available at pharmacies and in a restricted number of health facilities in Cambodia. The qualitative study presented in this paper was conducted in 2012 as a follow-up to longer-term ethnographical research related to reproductive health and fertility regulation between 2008 and 2012. Observations were carried out at several clinic and pharmacy sites and in-depth interviews were conducted with a purposive sample of 20 women who attended two MSI Cambodia centres and 10 women identified through social networks; six men (women's male partners); eight health care providers at the two MSI centres and four pill sellers at private or informal pharmacies (who also provided health care services in private clinics). Although the level of training among the drug sellers and providers varied, their knowledge about medical abortion regimens, correct usage and common side effects was good. Overall, women were satisfied with the services provided. Medical abortion was not always a women-only process in this study as some male partners were also involved in the care process. The study illustrates positive steps forward being taken in making abortion safe and preventing and reducing unsafe abortion practices in Cambodia.

BackgroundThe frequency of bloodborne pathogen healthcare-associated infections is thought to be high in developing Southeast Asian Countries. The underlying social-cultural logics contributing to the risks of transmission are rarely studied. This report provides some insights on the social and cultural factors that shape hygiene practices in Cambodian health care settings.MethodsWe conducted qualitative surveys in various public and private health facilities in Phnom Penh, the capital city and in provinces. We observed and interviewed 319 participants, health care workers and patients, regarding hygiene practices and social relationships amongst the health care staff and with patients. We also examined the local perceptions of hygiene, their impact on the relationships between the health care staff and patients, and perceptions of transmission risks. Data collection stem from face to face semi-structured and open-ended interviews and focus group discussions with various health care staffs (i.e. cleaners, nurses, midwives and medical doctors) and with patients who attended the study health facilities.ResultsOverall responses and observations indicated that hygiene practices were burdened by the lack of adequate materials and equipements. In addition, many other factors were identified to influence and distort hygiene practices which include (1) informal and formal social rapports in hospitals, (2) major infection control roles played by the cleaners in absence of professional acknowledgment. Moreover, hygiene practices are commonly seen as an unessential matter to be devoted to low-ranking staff.ConclusionOur anthropological findings illustrate the importance of comprehensive understanding of hygiene practices; they need to be considered when designing interventions to improve infection control practices in a Cambodian medical setting.

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In Southeast Asia, many young rural female migrants supplement their income by working as beer promoters. This study examined how young, female beer promoters working in Vientiane Capital, Lao PDR, navigate intimate relations and sexual encounters and how their experiences create sexual vulnerabilities. A total of 30 female beer promoters aged 18-24 years old were recruited using snowball sampling. Repeated face-to-face in-depth interviews were undertaken and thematic analysis conducted to identify common themes. Most participants had their first coital experience pre-migration but living in the city introduced them to a larger pool of potential partners. Unprotected sexual intercourse was common, with young women usually deferring to their male partners preference for non-condom use. Working as beer promoters, the sexualised environment of the bar room promoted male ideals of femininity and exposed the young women to sexual harassment. While the young women used various strategies to assert their autonomy, and challenge unequal gender norms, the prevailing male hegemony acted to subvert female sexual agency. Leveraging young urban migrants' desire to complete education, live independently and postpone motherhood may provide opportunities to examine and challenge gender norms and harmful practices.