Antenatal Care for Border Populations

The ethno-linguistic origins of the population living along the Thai-Burmese border are diverse; the largest ethnic group, on both sides of the north-western border, is Sgaw Karen. Shoklo Malaria Research Unit (SMRU) provides free antenatal clinics (ANC) to camp and migrant populations. The camp population are families who fled armed conflict in Burma and settled in camps inside Thailand. The migrant population is composed of individuals and their families who are in search of work, often moving back and forth along the border (Figure 1). Minimum accepted age for marriage among the Karen community is 16 years; and although approximately 20% of pregnant women are teenagers, pregnancies occurring in the early teens are exceptional. Environment and living conditions have hardly changed over the years [25 (link)]; both refugee and migrant worker populations are from similarly deprived socio-economic backgrounds, although the population living in camps receives food and free access to medical care.
SMRU clinics are staffed by local health-workers. First antenatal consultation includes an obstetric and medical history and a detailed clinical examination for all women. Active antenatal screening for malaria and anaemia at antenatal clinics has been routine since 1986, because in this area transmission of malaria is low and seasonal but deleterious to pregnant women [26 (link)]. Women are encouraged to deliver with trained midwives in SMRU clinics where their newborn is weighed and examined.