GLOBAL – RAISE/IAWG Literature Review
26 May 2026
Dear Colleagues,
This week’s RAISE/IAWG literature review begins with a retrospective study examining stillbirth rates and causes among refugee and migrant populations on the Thailand-Myanmar border over nearly four decades. The second article presents a scoping review of how woman-centred care principles are incorporated into national intrapartum care policies and guidelines in conflict-affected and fragile states in the Greater Horn of Africa. The final article applies the theory of planned behavior to examine refugee women’s intention to switch from short-acting to long-acting reversible contraceptives in Ethiopian refugee camps.
Please find this week’s articles below. If you have trouble accessing any of them, please feel free to contact RAISE/IAWG at: raise@cumc.columbia.edu.
Reduction of stillbirth rate in refugee and migrant populations living on the Thailand Myanmar border: A retrospective study 1986–2023.
by Prins, T. J., van der Schaaf, G., Min, A. M., Gilder, M. E., Tun, N. W., Theint, M. M. M., Wiladphaingern, J., Moo, E., Moore, K. A., Stekelenburg, J., Angkurawaranon, C., Rijken, M. J., van Vugt, M., Nosten, F., & McGready, R. (2026). Reduction of stillbirth rate in refugee and migrant populations living on the Thailand Myanmar border: A retrospective study 1986–2023.
PLOS Global Public Health, 6(5), e0005983.
Abstract
Understanding the local causes of stillbirth is essential to providing safe care in pregnancy and birth. This study describes the rate and causes of stillbirth and identifies factors associated with stillbirth in the migrant and refugee population residing in border regions between Thailand and Myanmar. A retrospective review of medical records of all singleton pregnancies delivered or followed at antenatal clinics of the Shoklo Malaria Research Unit from 1986 to 2023, with a known outcome of pregnancy and estimated gestational age of 28 weeks and more. Multivariable logistic regression was performed to compare the factors between livebirths and stillbirths. During the 37 year period there were 65,101 singleton births including 721 stillbirths. The stillbirth rate decreased to a third of the initial rate from 26 per 1000 in 1986 to 1990 to 8 per 1000 in 2020 to 2023. In 1986, 80% of births took place at home with the proportion declining significantly over time settling to 10 to 15% from 2012. Out of 721 stillbirths, 574 (79.5%) were classifiable. 26.0% of those were designated as intrapartum and 74.0% as antepartum stillbirth. Causal classification was possible for 67.7% of stillbirths, with the top 3 causes being antepartum haemorrhage 26.0%, congenital abnormality 12.9%, and maternal infection 12.3%. It is possible to decrease the stillbirth rate in refugee and migrant populations despite intermittent conflict. Improving access to health clinics and skilled attendance at birth has the potential to reduce preventable stillbirths.
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Woman-centred care in conflict-affected and fragile states: a scoping review of policy integration and implementation gaps in the greater horn of Africa.
by Ahmed, S. A. E., Dawson, A., Masuda, C., & Mahimbo, A. (2026).
Reproductive Health, 23, 95. https://doi.org/10.1371/journal.pgph.0005983
Abstract
Background: Woman-centred care (WCC) is a respectful approach and a key component of quality care that prioritises a woman’s dignity, autonomy, and preferences during pregnancy, birth, and postpartum. Health policies and guidance documents underpinned by such principles are essential to shaping high-quality healthcare that prevents adverse outcomes, saves lives, and makes pregnancy and childbirth positive experiences, regardless of humanitarian settings. We sought to identify how WCC is incorporated into national intrapartum care policies, plans, and service guidelines in conflict-affected and fragile states in the Greater Horn of Africa.
Methods: We systematically searched for policy, plans and guidance documents focusing on maternal health and intrapartum care in Sudan, South Sudan, Ethiopia, Somalia and Eritrea published between 2000 and 2025. A directed qualitative content analysis approach was used to analyse 42 documents, organised into six core WCC principles.
Findings: Of the 42 documents reviewed, 17 national policies, 7 plans, and 18 technical guidelines, most were issued by government health ministries. Explicit reference to “woman-centred care” was rare, with related terms like patient-centred and respectful maternity care appearing more frequently after 2016. Three main patterns of WCC integration emerged: systematic, fragmented, and profession-specific. Ethiopia has incorporated a respectful maternity care framework into policy and training since 2016, with ongoing audits but limited accountability. Sudanese documents (2008 to 2027) support patient-centred care but lack clear guidance on implementation and monitoring. South Sudanese documents reference client-centred values in policy, though implementation guidance is inconsistent. In Somalia, WCC is addressed mainly in midwifery strategies, while broader plans seldom mention it, and monitoring frameworks are unclear.
Conclusion: National health policies and guidance documents in the Greater Horn of Africa increasingly acknowledge WCC principles, though explicit use of the term “woman-centred care” is rare. Accountability mechanisms, resource allocation, and monitoring frameworks for WCC are notably lacking, except partially in Ethiopia. Addressing implementation challenges such as accountability, resource allocation, and monitoring is critical for advancing WCC and improving maternal health outcomes in crisis contexts. Integrating WCC principles across the reproductive health continuum, including adolescent health and postnatal care, is necessary for comprehensive quality improvement.
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Intention to switch from short-acting to long-acting reversible contraceptives among refugee women in Ethiopia: application of the theory of planned behavior.
by Alamdo, A. G., Kotoh, A. M., Modey, E. J., & Enos, J. Y. (2025)
Contraception and Reproductive Medicine, 10, 69. https://doi.org/10.1186/s12978-026-02313-0.
Abstract
Background: The validity of the theory of planned behavior (TPB) in predicting health behavior intention has proven its applicability to various health behaviors, such as condom uptake, HIV prevention, and contraception use in resource-limited settings. However, the effectiveness of the TPB framework in understanding refugee women’s intention to switch from short-acting contraceptives (SAC) to long-acting and reversible contraceptives (LARC) remains unclear. This study examined how the TPB predicts refugee women’s intention to switch from SAC to LARC.
Methods: This study is a nested component of a larger retrospective cohort examining contraceptive use dynamics among women in Ethiopian refugee camps. Initially, 1,290 family planning records from selected health facilities in Ethiopian refugee camps were reviewed. Among SAC users, 238 women who were current users and familiar with LARC methods (implants and/or IUDs) participated in this study. Four constructs, based on the TPB variables, measured using a 7-point Likert scale, were analyzed to explore the relationship between attitude, subjective norms, and perceived behavioral control as predictors of the intention to switch from SAC to LARC. The Structural Equation Model (SEM) with the Stata SEM Builder and maximum likelihood estimation was used to evaluate how well the data fit the TPB model and identify the key predictors of the intention to switch from SAC to LARC.
Results: All specified relations between the three constructs and the intention to switch from SAC to LARC in TPB were exhibited as statistically significant. The TPB model accounted for 66.3% of the variation in the intention to switch from SAC to LARC. A positive attitude toward LARC use (β=0.16; P=.014), strong subjective norms (β=0.46; P=.001), and higher perceived behavioral controls (β=0.17; P=.001) had a positive influence on refugee women’s intention to switch from SAC to LARC.
Conclusion: The TPB model demonstrated a good fit for examining refugee women’s intention to switch from SAC to LARC, with the subjective norm being the strongest predictor.
SOURCE: RAISE INITIATIVE: https://doi.org/10.1186/s40834-025-00403-1