Social-ecological approaches to unmet need for family planning among Myanmar migrant women in Bangkok, Thailand

Abstract

Migration is considered one of the significant global issues of the early 21st century, as more and more people move today than ever before. During temporary migration, women experience poverty, unmet need for reproductive health care and limited access to family planning (FP) services which contributes to high rates of unintended pregnancy and unsafe abortion. The study's objectives were to identify the prevalence of unmet need for FP, its associated factors and predictors by using a socio-ecological model. This is a population based, cross-sectional descriptive study, primary data source with a sample of 360 Myanmar migrant women in Bangkok, collected by snow ball sampling method and face to face interview by using the structured questionnaires from 1st March to 30th April, 2018. For statistical analysis, descriptive statistics and logistic regression were used. The prevalence of unmet need for FP was 15.8% in which 11.9% for spacing and 3.9% for limiting. Participating women's mean age was 30 years (SD=5.8) and a few were unregistered (3.1%). Among the ethnic groups, half of respondents were Myanamr (52.8%) followed by Karen and Mon. Just over half of the participants (57.2%) were covered by health insurance. Approximately two-thirds of women (74.4%) reported that they cannot communicate well in Thai language. Predictors of unmet need for family planning included having more than 3 children (AOR=4.6; 95% CI=1.37-15.21), poor knowledge about FP (AOR=2.9; 95% CI=1.14-7.63), health insurance beneficiary (AOR=2.5; 95%CI=1.09-5.56), longer stay in Bangkok (AOR=3.4; 95% CI=1.62-7.06), satisfaction to facilities (AOR=4.5; 95% CI=2.15-9.47), long distance to access FP (AOR=2.1; 95% CI=1.02-4.25). FP services and information should be provided more specifically for Myanmar migrant population. Better knowledge transfer and health insurance coverage will likely benefit FP practices of this population group. Provision of community and workplace education, health care services and initiation of help-lines in Myanmar language may increase visibility of FP care services and bridge the gap between migrants and the public health system.