Use of prenatal care services

• Adequate: initiated during the first trimester and 6 ANC visits or more

• Inadequate: initiated after first trimester and fewer than 6 ANC visits

• 75% of UMW in CA and NY received prenatal care in the first trimester vs. 57% of UMW in FL

• 35% of UMW in FL had fewer than 6 prenatal visits vs. CA (13%) and NY (12%)

• UMW in CA and FL entered ANC approximately 2 weeks later than those in NY

• UMWs had higher likelihood of inadequate use of ANC than U.S.-born citizens in CA, NY, FL but odds ratio was greater in FL (3.5) compared to CA (1.9) and NY (1.6)

To measure effect of health subsidy on uptake of contraception among refugees, who were assigned to 2 NGOs:

• One NGO provided 90% subsidies for health care (subsidized care)

• One NGO only encouraged refugees to use public and private health care resources (nonsubsidized care)

• Knowledge, attitudes, and practices regarding FP

• Approval of FP by women, friends, and spouses

• Has ever heard of FP (nonsubsidized vs. subsidized): 44.9% vs. 88.9%

• Currently using any contraceptive method (nonsubsidized vs. subsidized): 24.9% vs. 54.5%

• Approval of FP (nonsubsidized vs. subsidized):

  • Women: 49.5% vs. 85.8%

  • Friends: 47.7% vs. 85.5%

  • Spouses: 44.6% vs. 88.6%

To reduce maternal mortality among Afghan refugees in the Hangu district of Pakistan

• Established EmOCs staffed with female Pakistani doctors, nurse-midwives, and dayas from among the refugee population. EmOC staff are available or on-call 24/7

• Educated on danger signs during pregnancy and the importance of skilled attendance

• Facilitation of referral forms to EmOC

• Decreased maternal mortality ratio and maternal deaths during birth

• Increased utilization of services (EmOC): births, complications, referrals, cesarean deliveries

• Case fatality rate

• Coverage

• Knowledge of danger signs among the target population

• Maternal mortality ratio per 100,000 (before vs. after): 291 vs. 102

• Percentage of refugee births in an EmOC facility (1996 vs. 2007): 4.8% vs. 67.2%

• Cesarean delivery fatality among refugees: 0.2% vs. United Nations target of less than 1%

• Prenatal coverage (3+ PNC visits) from 2000 to 2006: 49% vs. 90%

• HS: (Lebanese women vs. Syrian refugees)

  • Percentage of women who sought but did not obtain contraception (54.11% vs. 43.6%)

  • Percentage of women that attended ANC visits (63.18% vs. 70.26%)

  • Median number of ANC visits (7 vs. 4)

• CS (Lebanese vs. Syrian refugees):

  • Percentage of women that attended ANC visits (87.5% vs. 98.6%)

  • Median of ANC visits (4 vs. 4)

To document experiences of women who accessed SARP:

• Trained counselors in Thailand and Burma in pregnancy options counseling, skill-building exercises, and logistics of SARP

• SARP offered referrals for care and financial coverage

• Successful referrals

• Denial of services to referred women

• Experiences and satisfaction of women with the SARP

• 52/81 successful referrals (64%)

• 17/81 referrals that were denied service (21%)

• Satisfactory experience with SARP services:

  • Comprehensive RH services

  • Women described SARP counselors as understanding, open, friendly and nonjudgmental

  • Women reported a sense of empowerment and commitment to advocating for SARP

Location: Northern Thailand

Design: In-depth qualitative interviews (n=16)

Secondary analysis of program records (N=918)

To provide early MA in low-resource and legally restricted setting

Trained social workers and counselors (network providers) on counseling and provision of early MA

• Provided access to a free supply of misoprostol for early MA

• Made network providers available for questions, concerns, and follow-up within 4 weeks of initial dose

• Percentage of successful complete MA

• Experiences of self-managed abortions

• 96% of women had successful complete MA

• Qualitative results:

  • Positive experiences regarding safety, tolerable side effects, and the absence of complications

  • Satisfaction with the counseling services provided

  • Women’s concerns about the legal risks for themselves and the network providers for involvement in MA

To increase literacy skills, knowledge of RH, and use of RHS available in the camps

• Literacy sessions with reproductive health content: safe motherhood, FP, STI, HIV/AIDS, and GBV

• Literacy sessions were conducted by previously trained teachers. Sessions had a medium duration of 2 hours, twice a week for a duration of between 6 months and 5 months

• Increased knowledge and use of contraception, as well as discussion about contraception use with partners

• Increased knowledge of STIs

• Antenatal care, including immunization

• Knowledge of PNC

Difference between before vs. after of having ever spoken to their partners or family members about (before vs. after)^e:

• RH: 18% (69% vs. 87%)

• Condoms: 20% (65% vs. 85%)

• STIs: 31% (54% vs. 85%)

• HIV: 18% (66% vs. 84%)

To train refugees engaged in sex work to become peer educators to meet the RH needs of refugees performing sex work

• Trained 2 cohorts of peer educators on human rights, sex work, SRH, life skills, community outreach and advocacy

• Peer educators designed and implemented community outreach activities (distributing condoms, capacity-building sessions, peer counseling and support sessions)

• Self-reported increased knowledge on SRH, legal topics related to sex work and GBV

• Increased willingness to share the knowledge with their peers

• Peer educators reported an increase in knowledge (e.g., safe sex and FP)

• Peer educators reported perceiving themselves as ambassadors for female refugees engaged in sex work

To improve RH of refugee women, refugee providers created RHG, which was integrated into local health system

• Trained health care facilitators to conduct outreach/education activities with women, men, and youth^a and provide information and advice on RH, and distribute condoms and spermicides^a

• Created drama groups and youth-oriented activities to engage larger audiences and spread RH messages^a

• Attitudes on PNC

• Knowledge regarding:

  • Reason to attend PNC

  • Danger signs in pregnancy

  • Actions if danger signs present

• Utilization of services by parous women

Population: Female refugees (aged 15–49 years) from Sierra Leone and Liberia living in 48 refugee camps

To increase FA uptake and decrease NTD incidence among migrant and refugee women

• Workshops with health workers on NTDs and dosing of FA

• Community outreach through posters, pamphlets, and workshops with different stakeholders (e.g., local HCWs, men, NGOs, and field managers)

• Uptake of FA among migrant and refugee women

• Increased knowledge about FA among HCWs

• Negative difference in FA uptake before and after the intervention (1.3% vs. 0.65%; P=.465)

• Percentage of HCWs that knew that NTDs could be prevented by taking FA before conception (16% before vs. 72% after; P<.001)