Inequities in sexual and reproductive health services: a comparative study of refugee women from Myanmar in Bangladesh, Thailand, and Malaysia

Background: Refugee women and girls from Myanmar have been living in Bangladesh, Thailand, and Malaysia for an extended period. Numerous organizations have been delivering a range of sexual and reproductive health (SRH) services to them. However, these women encounter distinct challenges in accessing SRH services in these countries. Ensuring the availability of SRH services is fundamental to meeting their basic needs. Comparing and analyzing these similar situations can provide valuable insights on gaps in service provision and lessons learned.Objective: This study examines sociocultural information about refugees from Myanmar and their host populations and documents the availability of refugee SRH services in Bangladesh, Thailand, and Malaysia. The data was analyzed to identify gaps based on their cultural needs using Minimum Initial Service Package (MISP) objectives as a evaluation tool.Method: This research is a systematic documentary review. Articles, reports, and documents were searched through online databases such as Google Scholar, PubMed, humanitarian organization websites, and personal communications. A total of 69 pertinent articles were included in the study and the data was analyzed through qualitative matrices.Findings: This study documented the sexual and reproductive health and rights (SRHR) needs and availability of SRH services to female refugee population in three countries. Bangladesh provides comprehensive SRH services and partly fulfills all six MISP objectives. However, there were only limited services in one of the refugee camps, Bhasan Char. Thailand partially met five objectives for camp refugees and only one for urban refugees. Malaysia only fulfilled three out of six objectives. Bangladesh sets a positive example with integrated SRH and GBV services, disability inclusivity, and a focus on SRHR, while Malaysia and Thailand have no system of governance for SRH services. Malaysia was found to have the most refugee-unfriendly services with deficiencies in post-natal care and abortion services. Only limited HIV and STD services were offered in Thailand due to the cultural sensitivities of the refugee population. Conclusion: This study demonstrates a diversity of commitments and prominent gaps in SRH services and meeting SRHR needs in the three study countries. It is crucial for both humanitarian organizations and host countries to identify and meet SRHR needs of refugees using a rights-based approach and to routinely evaluate their work against an international standard such as the MISP.