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  • 1.
    Maung, Naw Teresa
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Factors associated with unmet need for family planning in currently married fecund women of 15-49 years in Myanmar: A study on Demographic and Health Survey (2015-2016) cross sectional data2017Självständigt arbete på avancerad nivå (magisterexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [en]

    Background: Unmet need for family planning points the gap between the women’sreproductive aims and their contraceptive practices. In the developing world, 225 millions ofwomen are having unmet need despite increase in contraceptive use. Maternal andreproductive health still regarded as an important public health concern in the developingcountries and in Myanmar. Though there were many studies performed in the specific statesand regions of Myanmar, the national wide studies related to reproductive health are stillvery few due to data availability.

    Aims: The study aims to assess the unmet need for family planning, to explore theassociation between unmet need and demographic and socioeconomic characteristics ofwomen, and to assess the major reasons for not using of contraceptive methods amongwomen with unmet need in Myanmar.

    Methods: The study used the cross-sectional data from national representativeDemographic and Health Survey (2015-2016) data of Myanmar. The total currently marriedfecund women of 15 to 49 years of age (n=5195) were used. The likelihood of associationbetween unmet need for family planning and predictor variables was examined by logisticregression models. The association was reported in odds ratio (OR) and 95% confidenceinterval with statistical significance level set at 0.05.

    Results: The unmet need for family planning was 18.35%, of which 5.91% for spacing and12.45% for limiting. The adjusted analysis showed unmet need was higher in 45-49 years agegroup (OR=3.47; 95% CI= 1.91-6.31), women with no education (OR=1.94; 95% CI =1.21-3.12), poorest wealth quantile (OR=1.53; 95% CI =1-2.34), and women who did not visit tohealth facility in the last 12 months (OR=1.89; 95% CI =1.3-2.73). The parity of womenshowed protected association to unmet need (OR=0.65; CI= 0.05-0.85). The fear of sideeffects and infrequent sexual activity was found to be major reasons for not using ofcontraceptive among married women.

    Conclusion: The study results showed that unmet need for family planning amongcurrently married women still need to be lowered. The fecund women of older age groups,poor and uneducated women should be prioritized to ensure access to family planningservices. Improving the quality of family planning services along with provision of healtheducation and counselling sessions are important. Unmet need among unmarried womenneed to be studied in the future.

  • 2.
    Maung, Naw Teresa
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    The effects of individual and community factors on childhood stunting in Myanmar: A Multilevel analysis using Demographic and Health Survey (2015-2016)2018Självständigt arbete på avancerad nivå (masterexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [en]

    Background: Childhood stunting is a well-known indicator to signifies the chronic malnutrition status that access the overall well-being of children. Stunting affects children’s development and when established, it typically becomes permanent. According to UNICEF framework of malnutrition, childhood stunting is interrelated with multiple factors ranging from the individual to the national level, indicating the importance of contextual effect on the childhood malnutrition. In Myanmar, chronic malnutrition is still a public health concern along with the significant burden. The aim of this study was to explore the burden of stunting among under five children in Myanmar and to assess the effect of induvial and community factors on childhood stunting.

    Methods: This study used the national representative Demographic and Health Survey of Myanmar (2015-2016). The sample of 4,183 children of 0 to 59 months with complete anthropometric measurement were included in the analysis. Multi-level logistic regression models with two levels were fit to the data due to the hierarchical structure of the data, with individuals at level one nested within communities (n=439) at level two. The main outcome of the study is stunting status of under 5 children defined by height-for-age Z score less than -2 standard deviations (SD).

    Results: The prevalence of stunting in Myanmar was 30% among which 22% of moderate and 8% of severe stunting. Moreover, residential and regional variations were observed, Chin state showed highest prevalence at 40%. The study observed 8% of the variation in childhood stunting was attributable to the differences across communities. Proportional change in variance (PCV) explained variation in stunting across the communities was explained by 3.4% of the variations were explained by child factors alone, 48.2 % by child, maternal and household factors and 58.6% by both individual level and community level factors included in the study. After adjusting individual and community factors, child age group 25-36 months (OR=8.9; 95% CI=6.63 -11.95), female sex (OR=0.78; 95% CI=0.67 -0.90), small size at birth (OR=2.59; 95% CI=2.00 -3.35), maternal height less than 150 cm (OR=2.05; 95% CI=1.76 -2.4), poorest household wealth quintile (OR=2.14; 95% CI=1.49 -3.07) and cluster elevation of more than 1500 meter (OR=2.00; 95% CI=1.21 -3.3) showed the strongest association with childhood stunting.

    Conclusion: The study provides evidence that over and above individual level factors and communities factors are important explanations for the variation of childhood stunting in Myanmar. The importance of the context where children live revealed that the nutrition policy and program implications need to focus on community attributes to attain the full potential in addressing childhood malnutrition. Moreover, the future interventions need to be focus in reducing social inequalities and addressing regional differences to ensure equal opportunities and accessibility by different social groups across the country.

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