Family planning practices of women working in the Cambodian garment industry: a qualitative study

Abstract

Background Women working in Cambodian garment factories have unmet needs for contraception and safe abortion services, because of their background and living conditions. This study describes their experiences regarding abortion and contraception as part of a larger project to develop an intervention to support comprehensive post-abortion care.Methods We conducted semi-structured interviews with women seeking abortion services at private health facilities. In addition, we interviewed the private providers of abortion and contraception services surrounding garment factories. Interviews lasted up to 60 minutes and were conducted in Khmer and later translated into English. A thematic analysis was undertaken, with medical abortion experiences coded according to the Cambodia comprehensive abortion care protocol.Results We interviewed 16 women and 13 providers between August and November 2018. Most women were married and had at least one child. Among factory workers the major reported reasons for abortion were birth spacing and financial constraints. Family, friends, or co-workers were the major information resources regarding abortion and contraception, and their positive or negative experiences strongly influenced women’s attitude towards both. Medical abortion pills were not always provided with adequate instructions. Half of the participants had a manual vacuum aspiration procedure performed after medical abortion. While women knew the side effects of medical abortion, many did not know the adverse warning signs and the signs of abortion completion. Only three women started post abortion family planning, as most of the women expressed fear and hesitation due to side effects and misconceptions related to with modern contraception. Fear of infertility was particularly reported among young women without children.Conclusion This research shows that in this setting not all women are receiving comprehensive abortion care and contraceptive counselling. Provision of accurate and adequate information about abortion methods and modern contraception was the dominant shortfall in abortion care. Future work needs to address this gap by developing appropriate and effective interventions and informative tools for women in the Cambodian garment industry.

Development of an Intervention to Support Reproductive Health of Garment Factory Workers in Cambodia

“…Further details regarding recruitment, data collection and analysis are reported elsewhere. (9) During the course of the project we organized several meetings to share and discuss behaviours observed in research that could feasibly be targeted and potential interventions resulting from the needs assessment activities, and then design, produce and re ne a pilot intervention. In order to address limitations in the provision of accessible contraceptive information and information materials for factory workers in general and speci cally at the time of seeking medical abortion we decided to make three 'edutainment' videos about family planning and one instructional video about how to take MA correctly.…”

“…(11) The videos were designed to target barriers to contraception use that were identi ed in the needs assessment, ethnographic and interviews studies. (9) The videos were released through MSIC's communication channels and their impact was evaluated by an independent digital media company (Havas Champagne media). ( 12…”

“…Findings from these interviews are reported elsewhere. (9) In brief, for health issues during worktime, workers were able to use the factory in rmary, and outside of work the option to use public or private providers. The main role of the in rmaries was to treat minor ailments.…”