Background Access to family planning contributes up to a 44% reduction in maternal deaths. Since the majority of unplanned pregnancies and abortions occur in women who were either not using contraception or not using it consistently, greater access to contraception and more consistent use of contraception are crucial in the reduction of unplanned pregnancies and abortions. This study aims to determine which types of contraceptives are most often discontinued, the reasons for discontinuation, and the factors that influence contraceptive discontinuation for women in Myanmar. Methods This study is a secondary data analysis of calendar data from the 2015–16 Myanmar Demographic Health Survey. The dependent variable is discontinuation of contraception within 12 months among episodes of contraceptive use in the 5 years before the survey among women age 15–49. Multivariable logistic regression was used to identify the predictors of contraceptive discontinuation. Results The 12-month discontinuation rate for all contraceptive methods was 39%. The discontinuation rates for short-term methods were remarkably high (43% for pills and 42% for injectables), while the rate for long-term methods was very low (7% for intrauterine devices and 0.2% for implants). Discontinuation while still in need of contraception was high (55%) although 28% of those women switched to other modern methods. Multivariable logistic regression showed the factors associated with contraceptive discontinuation were a woman’s age, location (state/region), wealth, and number of births within the past 5 years. Conclusions The high rate of discontinuation while in need is very alarming given goals to reduce the unmet need for family planning in Myanmar. Family planning programs must ensure timely, informed method-switching by women who discontinue contraception, especially among women for whom discontinuation is the highest (age 45–49, middle and richest wealth quintile, regions where high discontinuation and multiparity); increase the availability of long-term contraceptive methods, and improve counseling that ensures clients’ informed and voluntary choice of family planning services.

ObjectivesHealth technology assessment (HTA) has been widely used to inform coverage decisions in high-income countries over the past few decades and has been getting increasing attention in middle-income countries as a tool for healthcare decision making in recent years. This study aims to use the case of the Maternal and Child Health Voucher Scheme (MCHVS) in Myanmar to understand how HTA can have a policy impact in a low or lower middle-income country.MethodsThe stages heuristic framework was used to describe the policy-making process. A document review was conducted and tacit knowledge of researchers involved was recorded.ResultsThe opportunity for a grant propelled maternal and child health to the policy agenda. An ex-ante HTA, which included a model-based health economic evaluation, informed the design of the scheme. The framework and key parameters from the ex-ante HTA were used for a mid-term review, which provided feedback to the policy implementation process. An ex-post HTA involved fielding a household survey to assess the impact of the scheme.ConclusionsHTA can be a useful method for informing resource allocation throughout the policy process in low and lower middle-income settings where no formal mechanism for making coverage decisions exists.