Yu Par Khin1, Nobutoshi Nawa2, Takeo Fujiwara1, Pamela J Surkan3. 1. Department of Global Health Promotion, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan. 2. Department of Medical Education Research and Development, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan. Electronic address: nawa.ioe@tmd.ac.jp. 3. Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, Maryland 21205, USA.
Abstract
OBJECTIVES: Despite relatively poor health outcomes of migrants in Japan, little is known about their access to reproductive healthcare. We conducted qualitative research to explore perceived barriers to access, with a specific focus on contraceptive services, and their consequences among Myanmar migrants in Japan. STUDY DESIGN: From January to April 2020, we conducted 17 in-depth interviews with Myanmar migrant women and four key informant interviews with Myanmar interpreters working in health services in Tokyo, Saitama, and Chiba prefectures. We transcribed interviews and coded them in ATLAS.ti primarily using a deductive approach based on the five components of Levesque and colleagues' conceptual framework of healthcare access. We also used inductive coding to allow for other themes outside of the framework to emerge. RESULTS: Among the 17 women, almost half stated that they were using periodic abstinence based on the presumed fertility window or the withdrawal method. Furthermore, slightly over half of the women had a history of unintended pregnancy. Language barriers, limited health information sources, cultural and health beliefs and financial factors played important roles in access to contraceptives among Myanmar migrant women. Women described how these barriers resulted in feeling lack of control over family planning and unintended pregnancies. CONCLUSIONS: Findings suggested that Myanmar migrants in Japan are faced with limited contraceptive access. Language barriers, limited information sources, health beliefs, and cultural and financial factors affected access. IMPLICATIONS: Results suggest that to increase public awareness and contraceptives access of Myanmar women in Japan non-profit support programs would benefit from the help of existing social networks of Myanmar migrants, interpreters, and Japanese doctors and researchers in reproductive health.
OBJECTIVES: Despite relatively poor health outcomes of migrants in Japan, little is known about their access to reproductive healthcare. We conducted qualitative research to explore perceived barriers to access, with a specific focus on contraceptive services, and their consequences among Myanmar migrants in Japan. STUDY DESIGN: From January to April 2020, we conducted 17 in-depth interviews with Myanmar migrant women and four key informant interviews with Myanmar interpreters working in health services in Tokyo, Saitama, and Chiba prefectures. We transcribed interviews and coded them in ATLAS.ti primarily using a deductive approach based on the five components of Levesque and colleagues' conceptual framework of healthcare access. We also used inductive coding to allow for other themes outside of the framework to emerge. RESULTS: Among the 17 women, almost half stated that they were using periodic abstinence based on the presumed fertility window or the withdrawal method. Furthermore, slightly over half of the women had a history of unintended pregnancy. Language barriers, limited health information sources, cultural and health beliefs and financial factors played important roles in access to contraceptives among Myanmar migrant women. Women described how these barriers resulted in feeling lack of control over family planning and unintended pregnancies. CONCLUSIONS: Findings suggested that Myanmar migrants in Japan are faced with limited contraceptive access. Language barriers, limited information sources, health beliefs, and cultural and financial factors affected access. IMPLICATIONS: Results suggest that to increase public awareness and contraceptives access of Myanmar women in Japan non-profit support programs would benefit from the help of existing social networks of Myanmar migrants, interpreters, and Japanese doctors and researchers in reproductive health.