Objective

Breast-feeding in the first 6 months of life is critical for ensuring both child health and well-being. Despite efforts to improve breast-feeding practices, recent studies have reported that Myanmar continues to have low rates of exclusive breast-feeding.Design/Setting/SubjectsA community-based breast-feeding promotion programme using trained community members was implemented for 1 year in hard-to-reach townships of Myanmar. The present study assessed the breast-feeding practices using a cross-sectional survey of 610 mothers of children under 2 years old: specifically, breast-feeding within 24 h, exclusive breast-feeding up to 6 months and breast-feeding duration.

Results

Using Cox models for breast-feeding duration before 24 months, the hazard of breast-feeding cessation was lower in programme v. non-programme townships (hazard ratio (HR)=0·55; 95 % CI 0·32, 0·95). Mothers who worked as shop owners or ran a family business had lower hazard of breast-feeding cessation (HR=0·13, P<0·05) v. those who worked as supervisors, managers, self-employed and businesswomen. The hazard of breast-feeding cessation was higher in women in higher wealth quintiles v. those in the lowest quintile (lower quintile, HR=3·49, P<0·1; higher quintile, HR=3·50, P<0·1; highest quintile, HR=3·47, P<0·1).

Conclusions

The intervention did not affect exclusive breast-feeding practices or breast-feeding within the first 24 h. Potential reasons include existing high levels of early initiation of breast-feeding due to ongoing government-led maternal and child health activities, and social and traditional practices related to complementary feeding. Community-based breast-feeding programmes should continue to promote exclusive breast-feeding and develop strategies to support working mothers.

Myanmar has experienced slowly rising levels of contraceptive use in recent years. Between 2014 and 2016, Population Services International (PSI)/Myanmar implemented a multi-pronged intervention to increase contraceptive use by leveraging its social marketing clinics and providers, and providing additional community outreach. The aim of this study is to explore trends over time in contraceptive uptake and assess whether exposure to the PSI program was associated with women adopting a method. Baseline and end line data were collected using a repeated cross-sectional survey of married women of reproductive age in 2014 and 2016. We find that use of the implant and intrauterine device (IUD) has increased among contraceptive users over time, although there was no significant association for short-term methods. There was also an increase in all types of method use between time periods compared to non-users of contraception. Women who reported seeing a PSI contraception pamphlet had increased odds of having adopted an IUD or implant in the study period. This suggests that interventions that address both supply and demand side barriers to contraception can have an impact on contraceptive uptake, especially more effective long acting methods.

Background

Maternal and reproductive health remains a significant public health issue in Myanmar. Little data exists on women's health issues, including social and demographic influences. While past studies have demonstrated rural/urban health disparities, an increasingly important population resulting from urban growth in Myanmar is the internal migrant population, individuals moving within the country for better job or educational opportunities. Past studies suggest that women make up more than half of internal migrants, yet there is a dearth of information on this new wave of migration, particularly on women's reproductive health issues. The objective of this study is to assess the influence of women's migration in Myanmar on reproductive health outcomes, including delivering in a facility, using a skilled birth attendant, and using a modern method of family planning.

Methods

Data from a cross-sectional household survey using multistage cluster sampling design conducted between September to October 2014 was used to assess the accessibility and the use of maternal and child health products and services. A total of 1800 currently married women of reproductive age, including 348 from urban and 1452 from rural areas, were recruited to complete surveys. A set of multivariable regressions was performed to assess reproductive health outcomes and predictors.

Results

Across health indicators, female migrants had better health outcomes compared to non-migrants. Controlling for demographic characteristics, migrants were 1.60 times more likely to use a modern form of family planning compared to non-migrants (p < 0.01) and use antenatal care during pregnancy (p < 0.05). While not statistically significant, migrants were 1.29 times more likely to deliver with a skilled attendant and 1.08 times more likely to deliver in a facility.

Conclusions

This study found that female migrants in Myanmar reported better health outcomes compared to non-migrant women in regards to family planning and maternal health. Future research should focus on monitoring the outcomes of migrants and their children over time to assess long-term impacts.