Data Sheet 1_Strengthening Migrant Access to Reproductive Healthcare in Thailand: observation of fixed and outreach service-based models of antenatal care for Karen and Myanmar migrants in Thailand, 2021–2024.pdf

First ANC contact at <12 weeks was the lowest-performing indicator overall (<30% of women). In contrast, syphilis screening, blood pressure monitoring, and fetal heartbeat measurement achieved >97.5% among all women. Homebirth without a skilled birth attendant was 2-fold higher in the outreach group (11.6% outreach, 5.3% fixed).

Within 100 days of birth, 58.6% of women (1,945 of 3,318) opted for contraception; of these, the majority chose an implant (1,305 of 1,945, 67.1%), mostly (860 of 1,305, 65.9%) within 7 days postpartum. Completion of the 4-component delivery package (≥2 tetanus vaccinations, skilled birth attendance, health insurance and contraception within 100 days of birth) was achieved by 48.6% of women in total, with a greater proportional increase (year one to three) in the outreach group, including for health insurance.

There were three maternal deaths (giving a maternal mortality ratio of 91 [95%CI: 31–267] per 100,000 live births [3 of 3,290]) and the maternal near-miss rate was 33 per 1,000 live births (95% CI: 28–40; 110 of 3,290), primarily due to postpartum hemorrhage.</p>Conclusion<p>In total, five of seven quality indicators of care defined by the WHO framework for a positive pregnancy experience improved, with the outreach model of care nearly meeting the standards achieved by the fixed model.

While the outreach model performed well, its sustainability remains a significant concern.</p>