Using Evidence to Improve Reproductive Health Quality along the Thailand-Burma Border

• Published in: Disasters Vol. 28; no. 3; pp. 255 - 268
• Main Authors: Sullivan, Tara M., Maung, Cynthia, Sophia, Naw
• Format: Journal Article
• Language: English
• Published: Oxford, UK and Boston, USA Blackwell Publishing Ltd 01-09-2004
• Subjects: Borders; Burma; capacity building; Continuity of Patient Care; Evaluation; Evidence-Based Medicine; Family planning; Female; Health Care Services; Health Knowledge, Attitudes, Practice; Health services; Humans; Illegal immigrants; internally displaced people; Labour migration; Management Audit; Maternal-Child Health Centers - standards; Migrants; Monitoring; monitoring and evaluation; Myanmar; Pregnancy; Professional-Patient Relations; Quality; Quality Assurance, Health Care - methods; Quality Indicators, Health Care; quality of care; Refugees; Reproductive health; Reproductive Health Services - standards; Sexual Reproduction; Thailand; Transients and Migrants; Thailand; Myanmar
• ISSN: 0361-3666; 1467-7717
• DOI: 10.1111/j.0361-3666.2004.00257.x

The Mae Tao Clinic, located on the Thailand‐Burma border, has provided health services for illegal migrant workers in Thailand and internally displaced people from Burma since 1989. In 2001, the clinic launched a project with the primary aim of improving reproductive health services and the secondary aim of building clinic capacity in monitoring and evaluation (M&E). This paper first presents the project's methods and key results. The team used observation of antenatal care and family‐planning sessions and client exit interviews at baseline and follow‐up, approximately 13 months apart, to assess performance on six elements of quality of care. Findings indicated that improving programme readiness contributed to some improvement in the quality of services, though inconsistencies in findings across the methods require further research. The paper then identifies lessons learned from introducing M&E in a resource‐constrained setting. One key lesson was that a participatory approach to M&E increased people's feelings of ownership of the project and motivated staff to collect and use data for programme decision‐making to improve quality.