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“I came by the bicycle so we can avoid the police”: factors shaping reproductive health decision-making on the Thailand-Burma border

2.1 Study Sites

Our data collection took place between June and August of 2013 in two cities located along the
Thailand-Burma border: Mae Sot, Thailand, and Mae La, Thailand. Located only 5 km from the
Burmese border, Mae Sot includes a large population of individuals who fled Burma during the civil
strife as well as people who have crossed the border in search of economic opportunities and served
as our primary base throughout the project. Mae Sot is home to the Mae Tao Clinic, an independent
facility that provides comprehensive care to cross-border, migrant, and refugee populations and
serves a catchment area of more than 200,000 people. Our second study site was the Mae La refu-
gee camp, one of the largest unofficial refugee camps located along the border with over 40,000 in-
habitants (AMI, 2012), otherwise known as “persons of concern” or as displaced populations
(UNHCR, 2005).

2.2 Recruitment and Data Collection
We used a multi-modal, multi-lingual recruitment strategy to identify participants. Because the study
was designed to explore women’s experiences with and perceptions of the IUD, women were eligi-
ble to participate in the study if they were over 18 years of age, had used an IUD for at least six
months, and were living along the Thailand-Burma border as a refugee, migrant, or cross-border in-
dividual. Women also needed to be sufficiently fluent in English, Burmese, or Karen in order to par-
ticipate. Women who were interested in speaking with us first contacted our local Study Coordinator
(Saw Nanda Hsue) who provided additional information about the study, confirmed eligibility, and
scheduled the interview at a mutually convenient time and location. A local member of our team
helped advertise the study in the Mae La refugee camp through her networks which helped recruit
the majority of our participants for this study.
We obtained informed consent before commencing and audio-recording each interview. Using an
interview guide developed specifically for this study, Jillian Gedeon conducted the interviews with
the aid of an interpreter when necessary. We asked women to share with us information about their
sexual and reproductive health history, experiences with the IUD, and thoughts on the ways that ser-
vices along the border could be improved. Due to the sensitivity of the research topics, participants
were given the option of having either a male or a female interpreter. Interviews in Mae Sot
were conducted in a private room at Mae Tao Clinic and interviews in Mae La refugee camp took
place either in a private room courtesy of a local organization or in the woman’s house, per her pref-
erence. Women were repeatedly assured that participation and their responses to our questions would
have no impact on the health services they received. All participants received the Thai Baht equiva-
lent of USD10 as a thank you for participating, as well as refreshments during the interview itself.
The Health Sciences and Sciences Research Ethics Board at the University of Ottawa approved this
study (File #H02-13-08), as did the research committee at Mae Tao Clinic, Mae Sot, Thailand.

2.3 Data Management and Analysis
Our analytic plan was iterative, meaning that we reviewed data as they were collected to reflect
on categories of content, adapt the interview guide, and identify thematic saturation. Jillian Gedeon
also made detailed field notes before and after the interview and formally memoed throughout the
project in order to reflect on emerging themes and the ways in which her positionality influenced the
process. We transcribed and translated the interviews and used ATLAS.ti to manage our data (Friese,
2014). Using a sequenced approach to coding and interpretation, we conducted content and thematic
analyses of the data through employing both a priori (pre-determined) codes and categories based on
our study questions and the interview guide as well as inductive techniques to identify emergent
themes (Gibbs, 2008). Regular study team meetings guided our interpretation.
In the results section we begin with a brief description of our participants. We then turn to the fin-
dings related to women’s perceptions of the factors that impact reproductive health decision-making

80 International Journal of Population Studies | 2016, Volume 2, Issue 1