Contraceptive Practice and Reproductive Health among Naga ... Contraceptive Practice and Reproductive

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  • Contraceptive Practice and

    Reproductive Health among Naga

    Married Women in Hard-to-reach Area of

    Lahe Township, Myanmar

    Aung Kyaw Khant, Aung Aung, Poe Poe Aung, Kyaw Swar Aye,

    Ohnmar Myint, Zayar Myatthu, Ye Lin Soe,

    Nyan Lin Htet & Ye Lin Aung 1

  • Introduction

    • Globally, 63 percent of married women were using some form

    of contraception worldwide in 2017 which is projected to grow

    by 20 million by 2030, from 758 million in 2015 to 778 million

    in 2030.

    • Myanmar is slowly but steadily moving towards the goal of

    healthy family planning and increasing contraceptive

    prevalence rate.

    2

  • Introduction(2)

    • Despite the high proportion of people who know different

    types of contraception, uptake of contraception is still low in

    Myanmar

    • Specific method uptake is generally very superficial in Myanmar

    especially hard-to-reach area

    3

  • 4

     Infant mortality rate= 86/1000 live births

     Under five mortality rate= 100/1000 live births

     IMR= 60/1000 live births

     U5MR= 62/1000 live births

     IMR= 70/1000 live births

     U5MR= 72/1000 live births

    Introduction (3) • Economically and socio-demographically limited

    region. • Per-capita income, health status and literacy rate is

    far lower as compared to other states and regions of the country.

    Lahe Township Sagaing region Myanmar

    Lahe Township

  • Objective

    • To determine knowledge and practice of contraceptive uptake

    and reproductive health among Naga Married Women in Lahe

    Township in Naga Self Administrated Zone, Sagaing Region

    5

  • Methodology

    • Study Design Mixed methods study using

    quantitative and qualitative interviews

    • Study Population and area currently married women, age

    between 15 to 49 years

    • Study Period From April to June, 2019

    • Sampling method Stratified random sampling

    6 Figure 1. Map of Sagaing Region Figure 2 Map of Lahe township

  • Methodology

    7

    Methods Ward/village Number of participants

    Female Male

    1. Focus Group Discussions

    (FGD)

    Myoma ward 10

    Tar Lan ward 10

    Lone Khin village 6

    2. In-depth Interviews

    (IDI)

    Ma Kyan village 1

    Lone Khin 3

    3. Key Informant Interview

    (KII)

    Ma Kyan village 2

    Lone Khin 1

    No(1) Toe Chea ward 3 2

    Table 1. Distribution of participants in qualitative data collection

  • Methodology

    Data analysis

    • For quantitative data

    • For qualitative data

    8

    FGD with rural women

    IDI with a mother

  • 9

    Ethical consideration

    • Ethical clearance- DSMRC, IRB

    • Informed consent

  • Results

    10

    Rural area, 78%

    Urban quarters,

    22%

    Figure 3. Urban and rural Distribution of the study

    N= 302

  • 11

    11.7%

    54.4%

    27.9%

    18%

    1.7%

    36.6% 33.2%

    14.9%

    7.5% 6.1%

    0.0%

    10.0%

    20.0%

    30.0%

    40.0%

    50.0%

    60.0%

    Under 20 years

    21 yrs- 30 yrs 31yrs- 40 yrs 41yrs- 50yrs 51yrs- 60yrs 61 yrs and above

    P e

    rc e

    n t

    Married women Husband

    Figure 4. Distribution of age group of the study population

    • Common age of marriage was 20 (range 14-39)

    • Mean numbers of family member in a household was 29 (range 2-21).

    N= 302

  • 12

    0.0%

    10.0%

    20.0%

    30.0%

    40.0%

    50.0%

    60.0%

    Illiterate Read and write

    Primary/ Basic school

    Middle school

    High school

    54.0%

    5.3%

    23.3%

    12.0%

    3.3%

    53.3%

    9.1%

    14.5% 11.6% 9.8%

    P er

    ce n

    t

    Married women

    Husband

    N= 302

    Figure 5. Distribution of educational status of the study population

  • 13

    0.0%

    10.0%

    20.0%

    30.0%

    40.0%

    50.0%

    60.0%

    70.0%

    80.0%

    Dependent Government staff

    Employee Self-employ Farming

    30.8%

    2.1% 1.4%

    54.7%

    11.1%

    1.8% 5.3%

    8.1%

    71.3%

    13.7%

    P er

    ce n

    t

    Married women Husband

    Figure 6. Distribution of occupation of the study population

    N= 302

  • 14

    [VALUE]%

    [VALUE]%

    [VALUE]% [VALUE]% [VALUE]% [VALUE]% [VALUE]% [VALUE]% [VALUE]% [VALUE]% 0

    20

    40

    60

    80

    100

    120

    P er

    ce n

    ta ge

    N= 225

    Figure 7. Types of Modern Contraceptive methods known by this study population (n=225)

    Knowledge of modern contraceptive methods

    • 78.7% knew modern contraceptive methods very well

    • 21.3% does not know

  • 15

    Figure 8. Types of modern contraceptive methods currently use by this study population (n=117)

    Practice of modern contraceptive methods

    74%

    21%

    4% 2%

    Injection

    OC pills

    Implant method

    Female Sterilization

    41%

    59%

    Yes No

  • 16

    Figure 8. Types of modern contraceptive methods currently used by study population

    Practice of modern contraceptive methods

    74%

    21%

    4% 2%

    Injection

    OC pills

    Implant method

    Female Sterilization

    41%

    59%

    Yes No

    N= 117 N= 302

  • Table 2. Association between educational status, place of delivery (n=277)

    Educational status Delivery at

    Home

    N (%)

    Delivery at

    Health center

    N (%)

    95% CI

    P value

    Illiterate 119 (84.4) 22 (15.6) 1.05-1.63 0.012

    Primary education 70 (88.6) 9 (11.4)

    Middle school &

    above

    24 (66.7) 12 (33.3)

    17

  • Table 3. Association between educational status and delivery person (n=277)

    Educational status Delivered by

    Relatives/ husband

    N (%)

    Delivered by Skilled

    birth Attendance

    N (%)

    95% CI

    P

    value

    Illiterate 70 (49.3) 72 (50.7) 1.0-1.57

  • Table 4. Univariate analysis in sociodemographic characteristics and contraceptive practice

    Contraceptive Practice 95% CI

    P value

    No Frequency (%)

    Yes Frequency (%)

    Educational status (n=277)

    Illiterate 98 (64.5) 54 (35.5) 1.1768- 2.2712

    0.003

    Primary education 51 (61.5) 32 (38.5)

    Middle school & above 15 (35.7) 27 (64.3)

    Occupation (n=243)

    Dependent 37 (41.1) 53 (58.9) 0.20911- 0.59233

    0.0001

    Employee/ Self-employ 121 (68.5) 61 (33.5) 19

  • Table 5. Univariate analysis in sociodemographic characteristics and contraceptive practice

    Contraceptive Practice 95% CI

    P value

    No

    Frequency (%)

    Yes

    Frequency (%)

    Residence (n=272)

    Rural 140 (64.2) 78 (35.8) 0.23035-

    0.71758

    0.001

    Urban 27 (42.2) 37 (57.8)

    Family member (n=281)

    2-7 numbers 72 (54.1) 61 (45.9) 0.37747-

    1.04642

    0.073

    8-21 numbers 77 (65.3) 41 (34.8) 20

  • 21

    “အချ ို့အနေေဲ့ သားဆက်ခခား ေည်းန ွေကို ေားမလည်သူန ွေရှိသလို

    အချ ို့ကလည်း သားသမီးများ ဲ့အ ွေက် မ ်နိုင် ာန ွေရှိပါ ယ”်

    (a woman 20 years old, Ma Kyan village)

    Reasons for not taking contraceptive • Affordability & accessibility • Lack of access • Family size • Traditional belief

    “ စ်ချ ို့ဆိုရင် ကနလးမရချင်ဘူး … ဆိုင်မှာ ဝယ်ရမှာ ပိုကဆ်ံမရှိကကဘူး… စ်ချ ို့ကကန ာလ့ဲ နဆးရုံကုိ သွေားရမှာ ရှက ်ယ် ဲ့… အဲလိုေဲ့ ကနလးရရင်လဲ ယူလိုက်ကက ာပဲ…” ( FGD group from Lahe )

    သားနကကာခြ ်ရင် ကျေ်းမာနရး ထိခိုက်မှာစိုး ယ်. ကျွေ်န ာ ်ို့ ဆီက မိေ်းမန ွေက အလုပ်ကကမ်း လုပ်နေရ ာ ခြစ် ဲ့အ ွေက် အလုပ်မလုပ်နိုင်မှာစိုး ာပါ…” (30 years old, Male, Ma Kyan village)

  • 22

    ကနလးနမွေးရင် ကိယု့်အိမ်မှာ ကုိယ့်ဘ