Reproductive health at conflict borders: a cross-sectional survey of human rights violations and perinatal outcomes at the Thai-Myanmar border

Abstract

Background Human rights violations (HRVs) are common in conflict and displacement contexts. Women are especially vulnerable to HRVs in these contexts, and perinatal health is acutely sensitive to related stressors and health care barriers. However, how HRVs affect immediate and long-term perinatal health in chronic displacement settings has not been closely investigated. Furthermore, it remains unclear whether and how HRVs in these contexts are tied directly to displacement circumstances or other marginalizing factors affecting local migrant and minority populations generally. Methods We investigated these questions using novel survey data from 577 women at the northern Thai-Myanmar border, where thousands of people have fled conflict in Shan State, Myanmar, for refuge in a range of precarious settings in Thailand, including unofficial refugee camps, villages, and worksites. We compared HRV exposures by ethnicity, country of birth, legal documentation, and residential setting. We then analyzed perinatal outcomes associated with HRV frequency, timing, and type. Results Birth in Myanmar, and ethnic minority and precarious legal status more broadly, predicted higher HRV prevalence. HRV frequency significantly predicted unmet antenatal care and lower birth weight, along with HRVs related to labor exploitation and violence or conflict. HRVs timed closer to pregnancies were more adversely associated with perinatal outcomes. Resource/property deprivation was the strongest predictor of pregnancy complications. Conclusions Human rights must be urgently attended to, through expanded HRV screenings and responsive care, and policy changes to further protect migrant workers, displaced persons, and others in precarious legal status situations.

Health problems and utilization of health services among Forcibly Displaced Myanmar Nationals in Bangladesh

“…Our study found that access to and utilization of basic health services including services for ANC, safe delivery, access to drugs and medication, neonatal and child health care were key challenges for the FDMNs living in Bangladesh. Previous studies conducted among the refugees Rawal et al glob health res policy (2021) 6:39 and migrants in Thailand [31] and countries of Southeast Asia [32] also highlighted similar problems. A study by Koning and colleagues reported that the Myanmar refugee mothers living in Thai-Myanmar border who experienced human right violations had significantly higher odds of unmet ANC need, suffered birth complications, low-birth of new-born babies and poor maternal and child health compared to those who did not experience human right violation [31].…”

“…Previous studies conducted among the refugees Rawal et al glob health res policy (2021) 6:39 and migrants in Thailand [31] and countries of Southeast Asia [32] also highlighted similar problems. A study by Koning and colleagues reported that the Myanmar refugee mothers living in Thai-Myanmar border who experienced human right violations had significantly higher odds of unmet ANC need, suffered birth complications, low-birth of new-born babies and poor maternal and child health compared to those who did not experience human right violation [31]. Similarly, the WHO Southeast Asia Regional Office (SEARO) (2018) reported that the refugees and migrants in the region suffer a range of reproductive and maternal health related problems [32].…”

Design and implementation of an intensive panel survey with refugees and other migrants in need of protection in Costa Rica

“…The extent to which intensive panel data collection can work among other populations originating from and residing in different locations therefore remains an open question. Nonetheless, a growing body of qualitative research and cross-sectional data on MNP across Latin America and in Europe, Jordan, southeast Asia, and sub-Saharan Africa provides new, contextually specific insights about the opportunities and needs for intensive panel data collection with MNP originating from and living in distinct political and cultural settings [ 27 , 70 – 72 ]. Third, in order to participate in our panel survey, participants needed to access a cellphone and the Internet.…”

PAs in Myanmar

“…Food shortages and forced labor have been reported 11. Displacement resulting in resource and property deprivation has increased pregnancy complications in Karen state, with 16% of women having preterm births 12…”