Determinants of institutional maternity services utilization in Myanmar
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Issued Date
2022-04-01
Resource Type
eISSN
19326203
Scopus ID
2-s2.0-85128871329
Pubmed ID
35468140
Journal Title
PLoS ONE
Volume
17
Issue
4 April
Rights Holder(s)
SCOPUS
Bibliographic Citation
PLoS ONE Vol.17 No.4 April (2022)
Suggested Citation
Lwin K.Z., Punpuing S. Determinants of institutional maternity services utilization in Myanmar. PLoS ONE Vol.17 No.4 April (2022). doi:10.1371/journal.pone.0266185 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/86528
Title
Determinants of institutional maternity services utilization in Myanmar
Author(s)
Author's Affiliation
Other Contributor(s)
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.