Online Program

Establishing a referral system for safe & legal abortion care: Evaluation of a pilot project on the Thailand/burma border

Tuesday, November 5, 2013 : 1:30 p.m. - 1:45 p.m.

Cari Sietstra, JD, Ibis Reproductive Health, Cambridge, MA
Meredith Walsh, MPH, RN, Graduate Entry Pathway, UMass Graduate School of Nursing, Worcester, MA
Margaret Hobstetter, JD, MPH, Ibis Reproductive Health, Cambridge, MA
Angel M. Foster, DPhil, MD, AM, Faculty of Health Sciences, University of Ottawa & Ibis Reproductive Health, Cambridge, MA
Introduction: In Thailand, abortion is legal when the pregnancy endangers the physical or mental health of the woman, in cases of rape or incest, or if the girl conceived at age 15 or younger. In practice, access is also restricted by providers' interpretations of the law and by the willingness of potential providers to perform abortions for any indication. Burmese refugees and migrants living in Thailand face additional obstacles in obtaining legal services. This pilot project connected Burmese women who were eligible for safe, legal abortion care with a local provider. Methods: In 2012, the project team helped establish a referral system between Mae Tao Clinic, a major healthcare provider for Burmese migrants, and Mae Sot Hospital, a local Thai hospital. Joint trainings that also included other community based organizations were held about Thai law, options counseling for unintended pregnancies, and the steps required for referral. We provide evaluation data from the first year of the project. Results: The pilot program resulted in nearly two dozen completed referrals for physical and mental health indications (8), rape and incest (13), and age (2). In reviewing and analyzing specific cases we reflect on the obstacles faced by both individuals and the overall referral system as well as successful and creative navigation strategies employed by stakeholders. Conclusion: The evaluation suggests implementation of a referral system for legal abortion care is feasible, even in protracted conflict and crisis settings. Expansion of the program to other areas of Thailand with large Burmese populations appears warranted.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Public health or related research

Learning Objectives:
Describe a pilot project dedicated to safe abortion referrals on the Thailand/Burma border List facilitators and barriers to the success of a referral project Identify avenues for expanding this pilot to other areas This abstract is submitted as part of a preformed panel entitled, "“This abstract is being submitted as part of a pre-arranged panel entitled “Reproductive health in conflict and post-conflict settings.”

Keyword(s): Abortion, Access and Services

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I hold the Echo Endowed Chair in Women's Health Research at the University of Ottawa where I am an Associate Professor in the Faculty of Health Sciecnes. I am also an Affiliated Scholar at Ibis Reproductive Health. I have been involved with this project since its inception and have been involved with all phases of the initiative.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.