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. 2024 Dec 31;17(1):2328893.
doi: 10.1080/16549716.2024.2328893. Epub 2024 Nov 8.

Community engagement to develop a dialogue-drama on adolescent pregnancy in a marginalised migrant population on the Thailand-Myanmar border: an ethnographic approach to participatory action research

Saw San Soe  1 , Saw Thwe Paw  1 , Mu Lwel Tha Dah  1 , Day Mu Dah, Thae Thae Naing, K Mwee Hser, Solomon Naw  1 , Htet Khaing Lu, Kanjana Winyoorat, Primprapaporn Thongdee, Saw Win Tun  1 , Poe Poe  1 , Rose McGready  1 , Poe Christ, Htee K Poung, Win Win Cho, Hser Nay Wah, Htoo Hser  1 , Saw Phee Do  1 , Paw Bway Shee, Bulakorn Tinoi, Prapatsorn Misa, May Myo Thwin, Ladda Kajeechiwa  1
Affiliations

Community engagement to develop a dialogue-drama on adolescent pregnancy in a marginalised migrant population on the Thailand-Myanmar border: an ethnographic approach to participatory action research

Saw San Soe et al. Glob Health Action. .

Abstract

Background: Communities in which adolescent pregnancy and safe abortion care are taboo may benefit from culturally appropriate information, education, and communication.

Objective: This ethnographic and participatory action research (PAR) elicited community members' perceptions to adolescent pregnancy: which then informed dialogue-drama development in Burmese and Karen language for undocumented migrants on the Thailand-Myanmar border.

Methods: PAR was conducted in Karen and Burmese language. Interviews and discussions elicited perceptions of community members about adolescent pregnancy. These were analysed for themes and using the fishbone technique, to determine the objectives for the drama. After developing the structure and content of the drama it was piloted, revised, and performed in communities. Responses and impact of the drama were recorded. The team reflected on the drama as a method for health messaging.

Results: In 2022, themes of responsibility, communication, and experiences of adolescent pregnancy emerged from 10 interviews and 6 discussions with community members. The fishbone technique established three dramatic objectives, woven into a teenage love story with an unplanned pregnancy, to raise community awareness of i) adolescent pregnancy, ii) contraception, and iii) choice in unexpected pregnancy. Post-drama feedback from 11 migrant communities (1,238 participants) was positive although some community members voiced concerns. Given the logistical challenges of conducting the drama in person, a film will be created for wider dissemination.

Conclusions: Participatory action research resulted in a culturally-nuanced performance, with communities requesting further performances and awareness on adolescent pregnancy and safe abortion care. Video is likely to be a more sustainable option.

Keywords: Burmese; Karen; Participatory action research; adolescence; pregnancy.

Plain language summary

Main findings: A participatory-action approach involving community members and adolescents resulted in a dialogue-drama which raised awareness of adolescent pregnancy, contraception, and choice in the event of an unplanned pregnancy.Added knowledge: The dialogue-drama was a useful tool, augmenting discussion of traditionally taboo issues including adolescent pregnancy and unsafe abortion.Global health impact for policy and action: The community driven dialogue-drama was well received and recommended by the community to address other health issues and hence this ethnographic method is potentially useful for similar global health settings.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Study flow chart.
Figure 2.
Figure 2.
Fishbone in (a) Burmese and (b) English.
Figure 3.
Figure 3.
Sites of the drama performance in Tak Province, Thailand with proportional representation of participants by site and disaggregated by sex.
See this image and copyright information in PMC

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