title: Empirical lessons regarding contraception in a protracted refugee setting: A descriptive study from Maela camp on the Thai-Myanmar border 1996 - 2015.
abstract: Conflict settings and refugee camps can be chaotic places, with large and rapid population movements, exacerbated public health problems, and ad hoc health services. Reproductive health care that includes family planning is of heightened importance in such settings, however, funding and resources tend to be constrained and geared towards acute health services such as trauma management and infectious disease containment. Here we report on the complexities and challenges of providing family planning in a post-emergency refugee setting, using the example of the largest refugee camp on the Thai-Myanmar border, in existence now for over 30 years. Data from 2009 demonstrates an upward trend in uptake of all contraceptives, especially long acting reversible contraception (LARC) and permanent methods (e.g. sterilization) over time. Increased uptake occurred during periods of time when there were boosts in funding or when barriers to access were alleviated. For example a surgeon fluent in local languages is correlated with increased uptake of tubal ligation in females. These data indicate that funding directed toward contraceptives in this refugee setting led to increases in contraceptives use. However, contraceptive uptake estimates depend on the baseline population which is difficult to measure in this setting. As far as we are aware, this is the longest reported review of family planning services for a refugee camp setting to date. The lessons learned from this setting may be valuable given the current global refugee crisis.
authors.affiliation: The Planned Parenthood Association of Thailand, Bangkok, Thailand.
authors.forename: Somjet
authors.initials: S
authors.lastname: Srikanok
authors.affiliation: Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand.
authors.forename: Daniel M
authors.identifier: http://orcid.org/0000-0002-5352-7338
authors.initials: DM
authors.lastname: Parker
authors.affiliation: Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand.
authors.forename: Amber L
authors.initials: AL
authors.lastname: Parker
authors.affiliation: Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand.
authors.forename: Tracey
authors.initials: T
authors.lastname: Lee
authors.affiliation: Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand.
authors.forename: Aung Myat
authors.initials: AM
authors.lastname: Min
authors.affiliation: The Planned Parenthood Association of Thailand, Bangkok, Thailand.
authors.forename: Pranee
authors.initials: P
authors.lastname: Ontuwong
authors.affiliation: Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand.
authors.forename: Saw
authors.initials: S
authors.lastname: Oo Tan
authors.affiliation: The Planned Parenthood Association of Thailand, Bangkok, Thailand.
authors.forename: Supachai
authors.initials: S
authors.lastname: Sirinonthachai
authors.affiliation: Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand.|Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Old Road campus, Oxford, United Kingdom.
authors.forename: Rose
authors.initials: R
authors.lastname: McGready
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D003267:Contraception / Q000191:economics* / Q000379:methods / Q000706:statistics & numerical data; D003270:Contraceptive Agents / Q000008:administration & dosage / Q000191:economics; D005193:Family Planning Services / Q000191:economics* / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D002052:Myanmar / Q000453:epidemiology; D011247:Pregnancy; D012036:Refugees / Q000706:statistics & numerical data; D013785:Thailand / Q000453:epidemiology; D055815:Young Adult
chemical_list: D003270:Contraceptive Agents