Determinants of institutional maternity services utilization in Myanmar

Abstract

Background Maternal mortality is a persistent public health problem worldwide. The maternal mortality ratio of Myanmar was 250 deaths per 100,000 live births in 2017 which was the second-highest among ASEAN member countries in that year. Myanmar’s infant mortality rate was twice the average of ASEAN member countries in 2020. This study examined factors influencing institutional maternity service utilization and identified the need for improved maternal health outcomes. Methods A cross-sectional study design was used to examine the experience of 3,642 women from the 2015–16 Myanmar Demographic and Health Survey by adapting Andersen’s Behavioral Model. Both descriptive and inferential statistics were applied. Adjusted odds ratios and 95% confidence interval were reported in the logistic regression results. Results The findings illustrate that the proportion of women who delivered their last child in a health/clinical care facility was 39.7%. Women live in rural areas, states/regions with a high levels of poverty, poor households, experience with financial burden and the husband’s occupation in agriculture or unskilled labor were negatively associated with institutional delivery. While a greater number of ANC visits and level of the couple’s education had a positive association with institutional delivery. Conclusion The determinants of institutional delivery utilization in this study related to the institutional facilities environment imply an improvement of the institutional availability and accessibility in rural areas, and different states/regions, particularly Chin, Kayah and Kachin States- the poorest states in Myanmar. The poverty reduction strategies are urgently implemented because problems on health care costs and household economic status played important roles in institutional delivery utilization. The ANC visits indicated a significant increase in institutional delivery. The government needs to motivate vulnerable population groups to seek ANC and institutional delivery. Moreover, education is crucial in increasing health knowledge, skills, and capabilities. Thus, improving access to quality, formal, and informal education is necessary.

Dietary Habits and Associated Factors of Pregnant Women Attending Antenatal Clinics at Township Hospitals in Naypyidaw Territory, Myanmar

“…In the current study, majority of the pregnant women were under 35 years old (80.8%), which corresponds with what was reported in the secondary data analysis of the Myanmar demographic and health survey as more than half of the pregnant women were 25 to 34 years of age (10). Almost all were Burmese in Ethnicity (97.8%) and Buddhist in religion (95.8%) which was not surprising because the study took place in a Burmese-dominated area.…”

Institutional delivery and postnatal care utilisation among reproductive-aged women who had completed four or more antenatal care visits in Myanmar: a secondary analysis of 2015–2016 Demographic and Health Survey

“…We categorised women’s age into five groups: ‘15–19 years’, ‘20–24 years’, ‘25–29 years’, ‘30–34 years’ and ‘35 years and above’ 31 ; education into four groups: ‘no formal education’, ‘primary education’, ‘secondary education’ and ‘more than secondary education’ 32 ; and employment status into ‘currently employed’ and ‘currently unemployed’. 33 For women’s involvement in decision-making, we calculated a score based on three questions: ‘if the woman participates in decisions regarding her own healthcare’, ‘if the woman participates in decisions regarding large household purchases’, and ‘if the woman participates in decisions regarding visits to family or relatives’.…”

Pemilihan Fasilitas Kesehatan Tempat Bersalin Di Era Jkn: Analisa Data Susenas 2019

“…Pendidikan rendah cenderung akan membuat orang berada pada taraf ekonomi yang rendah pula. Strategi pengentasan kemiskinan harus segera dilaksanakan karena masalah biaya perawatan kesehatan dan status ekonomi rumah tangga memainkan peran penting dalam pemanfaatan fasilits kesehatan yang memadai (Lwin & Punpuing, 2022).Wanita atau keluarga dengan tingkat ekonomi tinggi 4,732 kali lebih mungkin menggunakan fasilitas kesehatan untuk persalinan daripada wanita atau keluarga dengan tingkat ekonomi rendah.…”

“…Hal senada disampaikan oleh Pulok, dkk yang menyatakan adanya inequitas akses menjadi tantangan di Bangladesh dalam satu dekade terakhir (Pulok et al, 2020). Kelengkapan dalam pemeriksaan kehamilan (ANC) juga menjadi faktor penting dalam pemilihan fasilitas tempat bersalin (Lwin & Punpuing, 2022).…”

“…Bantuan kepada masyarakat tidak mampu sangat penting untuk menunjang kehidupan kesehatan mereka. Hal ini karena biaya perawatan kesehatan dan status ekonomi rumah tangga memainkan peran penting dalam pemanfaatan fasilitas kesehatan (Lwin & Punpuing, 2022). Penelitian yang dilakukan oleh Were et al, 2017 menyimpulkan bahwa ada kaitan antara pemanfaatan layanan kesehatan dengan kepemilikan jaminan kesehatan khusunya bagi ibu hamil dan bersalin.…”