Adolescent reproductive health among Burmese refugees: A quantitative assessment

BACKGROUND Adolescents' access to reproductive health services in Burmese refugee camps along the Thai-Burma border is extremely limited, particularly for unmarried youth. 19.8% of pregnancies in Ban Mae Nai Soi refugee camp were to 10-19 year olds in 2005. 25.0% of school drop outs are due to unplanned pregnancies. Previous research suggests that conservative cultural and religious beliefs prevent unmarried youth from accessing reproductive health services at camp-based health clinics, particularly contraception. The goal of this research was to identify sexual and reproductive health practices among 10-24 year old Burmese refugees living in Ban Mae Naisoi camp as well as barriers youth face to accessing reproductive health services. METHODS A total of 746 young people aged 10-24 years were surveyed about their sexual and reproductive health behaviors. Half of the participants were selected as cases in an ongoing peer education pilot project. Controls were selected randomly after being matched for age, sex, ethnicity and geographical location. EpiInfo was used for data analysis. RESULTS We found a significant difference between contraceptive prevalence rates of married youth compared to unmarried youth: 57.0% of married youth use some form of contraception compared to only 32.0% of unmarried youth. 3.0% of sexually active youth report using condoms every time they have sex, while 35.6% report using condoms some of the time. There is no significant difference between condom usage rates of married youth compared to unmarried youth. However, there is a significant difference in where condoms are accessed. Married youth access condoms at health clinics inside camp, while unmarried youth either purchase condoms outside of camp or rely on older, married friends to access condoms for them. 13.6% of all sexually active youth report having at least one symptom of a sexually transmitted infection in the previous six months; however, only 26.3% of those youth sought treatment at a health clinic. CONCLUSIONS Public health policies need to be implemented to increase youth's access to reproductive health services, particularly contraception. Health clinics should become youth-friendly and condom distribution to unmarried youth should be condoned. Non-governmental organizations must work together with youth and community leaders to advocate for increased access to services.