Publication: Improved pregnancy outcome in refugees and migrants despite low literacy on the Thai-Burmese border: results of three cross-sectional surveys
Accepted Date
2011-06-17
Issued Date
2011-06-17
Copyright Date
2011
Resource Type
Language
eng
ISSN
1471-2393 (electronic)
Rights
Mahidol University
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BioMed Central
Bibliographic Citation
Carrara VI, Hogan C, De Pree C, Nosten F, McGready R. Improved pregnancy outcome in refugees and migrants despite low literacy on the Thai-Burmese border: results of three cross-sectional surveys. BMC Pregnancy Childbirth. 2011 Jun 17;11:45.
Suggested Citation
Carrara, Verena I., Hogan, Celia, De Pree, Cecilia, Nosten, Francois, McGready, Rose Improved pregnancy outcome in refugees and migrants despite low literacy on the Thai-Burmese border: results of three cross-sectional surveys. Carrara VI, Hogan C, De Pree C, Nosten F, McGready R. Improved pregnancy outcome in refugees and migrants despite low literacy on the Thai-Burmese border: results of three cross-sectional surveys. BMC Pregnancy Childbirth. 2011 Jun 17;11:45.. doi:10.1186/1471-2393-11-45 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/683
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Title
Improved pregnancy outcome in refugees and migrants despite low literacy on the Thai-Burmese border: results of three cross-sectional surveys
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Abstract
BACKGROUND: Maternal and infant health has been associated with maternal
education level, which is highly associated with literacy. We aimed at estimating
literacy rates among reproductive age women attending antenatal clinics in camps
for refugees and in migrant clinics in Tak province, north-western Thailand, to
determine whether illiteracy had an impact on birth outcomes.
METHODS: Three reading assessments were conducted using an identical method each
time, in 1995-97, 2003 and 2008. Midwives chose at random one of four pre-set
sentences. Each woman was asked to read aloud and scoring was based on a
"pass/fail" system. Pregnancy outcomes were compared with maternal literacy rate.
RESULTS: Overall, 47% (1149/2424) of women were able to read. A significant
improvement was observed among migrant (34% in 2003 vs. 46% in 2008, p = 0.01),
but not refugee (47% in 1995-97, 49% in 2003, and 51% in 2008) women. Literate
women were significantly more likely to be of non-Karen ethnicity, primigravidae,
non-smokers, to remain free from malaria during pregnancy and to deliver in a
health clinic. Significant improvements in pregnancy outcome (reductions in
premature births, low birth weight newborns and neonatal death) between 1995-97
and 2003 were unrelated to literacy.
CONCLUSIONS: Significant reductions in poor pregnancy outcome over time have not
been driven by changes in literacy rates, which have remained low. Access to
early diagnosis and treatment of malaria in this population, and delivery with
skilled birth attendants, despite ongoing low literacy, appears to have played a
significant role.