Evaluating the Impact of Healthcare Access on Maternal and Child Mortality in a Rural Region of Myanmar
Abstract
This study evaluates the impact of healthcare access on maternal and child mortality rates in the rural region of Kayin State, Myanmar, where disparities in healthcare services significantly affect vulnerable populations. Utilizing a cross-sectional study design from February to July 2024, the research employs both quantitative and qualitative methodologies. Quantitative data is gathered from government health records and local healthcare facilities, including maternal and child mortality rates, healthcare facility availability, and healthcare worker distribution. Qualitative insights are obtained through semi-structured interviews with healthcare providers, mothers, and local stakeholders, focusing on barriers to healthcare access. The findings reveal alarming maternal mortality rates of 250 per 100,000 live births and child mortality rates of 80 per 1,000 live births in rural areas, compared to urban counterparts. Major barriers identified include geographic isolation, economic challenges, and cultural factors limiting healthcare utilization. This study underscores the urgent need for targeted interventions to improve healthcare access in rural communities. Future research should investigate longitudinal impacts of healthcare interventions and the effectiveness of health education programs to further understand and mitigate healthcare disparities in rural Myanmar.
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M. Syairaji, D. S. Nurdiati, B. S. Wiratama, Z. D. Prüst, K. W. Bloemenkamp, dan K. J. Verschueren, "Trends and causes of maternal mortality in Indonesia: a systematic review," BMC Pregnancy Childbirth, vol. 24, no. 1, p. 515, 2024.
M. T. Benner, O. Mohr, W. Kaloy, A. Sansoenboon, A. Moungsookjarean, P. Kaiser, dan R. McGready, "Mother, child and adolescent health outcomes in two long-term refugee camp settings at the Thai-Myanmar border 2000–2018: a retrospective analysis," Primary Health Care Research & Development, vol. 25, p. e27, 2024.
J. Moon, S. J. Kang, Y. D. Kwon, E. M. Song, dan J. W. Noh, "Current status and needs in the primary healthcare system in Yangon, Myanmar: a mixed-method evaluation," Primary Health Care Research & Development, vol. 24, p. e37, 2023.
E. E. Kim, Q. Alemi, C. Stempel, dan H. Siddiq, "Health disparities among Burmese diaspora: an integrative review," The Lancet Regional Health-Southeast Asia, vol. 8, 2023.
T. S. KHAI, "A socio-ecological barrier to regular migration, regularization and healthcare access for Myanmar irregular migrant workers in Thailand," 2023.
M. E. Akokuwebe dan E. S. Idemudia, "Factors associated with choice of home birth as place of delivery among women of reproductive age in South Africa," African Journal of Reproductive Health, vol. 27, no. 1, pp. 22-40, 2023.
J. Priebe, J. Amuasi, T. Dartanto, G. Mombo-Ngoma, dan M. Guigas, "Factors associated with skilled birth attendance in 37 low-income and middle-income countries: a secondary analysis of nationally representative, individual-level data," The Lancet Global Health, vol. 12, no. 7, pp. e1104-e1110, 2024.
K. K. Than, M. P. Bertone, T. La, dan S. Witter, "Assessing the role of non-state actors in health service delivery and health system resilience in Myanmar," 2024.
J. Moon, S. J. Kang, Y. D. Kwon, E. M. Song, dan J. W. Noh, "Current status and needs in the primary healthcare system in Yangon, Myanmar: a mixed-method evaluation," Primary Health Care Research & Development, vol. 24, p. e37, 2023.
World Health Organization, "Trends in maternal mortality 2000 to 2020: estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA/Population Division," World Health Organization, 2023.
I. Ilic dan M. Ilic, "Global patterns of trends in cholera mortality," Tropical Medicine and Infectious Disease, vol. 8, no. 3, p. 169, 2023.
M. Bango dan S. Ghosh, "Reducing infant and child mortality: assessing the social inclusiveness of child health care policies and programmes in three states of India," BMC Public Health, vol. 23, no. 1, p. 1149, 2023.
S. A. Hong dan D. Buntup, "Maternal depression during pregnancy and postpartum period among the association of southeast asian nations (ASEAN) countries: a scoping review," International Journal of Environmental Research and Public Health, vol. 20, no. 6, p. 5023, 2023.
P. P. Win, T. Hlaing, dan H. H. Win, "Factors influencing maternal death in Cambodia, Laos, Myanmar, and Vietnam countries: A systematic review," PLOS ONE, vol. 19, no. 5, p. e0293197, 2024.
C. Lama, "Factors in seeking skilled care during the perinatal period: An exploratory study from Golche, Nepal," Doctoral dissertation, University of Pittsburgh, 2024.
Z. Lwin, "A study of mother's knowledge and practice on maternal, newborn and child health (MNCH) care services in Thanatpin Township, Bago Region, Myanmar," Doctoral dissertation, MERAL Portal, 2023.
J. Moon, S. J. Kang, Y. D. Kwon, E. M. Song, dan J. W. Noh, "Current status and needs in the primary healthcare system in Yangon, Myanmar: a mixed-method evaluation," Primary Health Care Research & Development, vol. 24, p. e37, 2023.
P. P. Win, T. Hlaing, dan H. H. Win, "Factors influencing maternal death in Cambodia, Laos, Myanmar, and Vietnam countries: A systematic review," PLOS ONE, vol. 19, no. 5, p. e0293197, 2024.
H. N. N. Lwin, P. Punnakitikashem, dan T. Thananusak, "E-Health research in Southeast Asia: a bibliometric review," Sustainability, vol. 15, no. 3, p. 2559, 2023.
M. Lall, "Overview of education in Myanmar," in International Handbook on Education in South East Asia, pp. 1-23, Singapore: Springer Nature Singapore, 2023.
Y. Feng, M. Maimaitiming, J. Shi, M. Wang, N. Li, Y. Jin, dan Z. J. Zheng, "Inequity of maternal-child health services in ASEAN member states from 1993 to 2021," International Journal for Equity in Health, vol. 22, no. 1, p. 149, 2023.
World Health Organization, National health workforce accounts: a handbook, World Health Organization, 2023.
Y. Feng, M. Maimaitiming, J. Shi, M. Wang, N. Li, Y. Jin, dan Z. J. Zheng, "Inequity of maternal-child health services in ASEAN member states from 1993 to 2021," International Journal for Equity in Health, vol. 22, no. 1, p. 149, 2023.
T. S. KHAI, "A socio-ecological barrier to regular migration, regularization and healthcare access for Myanmar irregular migrant workers in Thailand," 2023.
C. S. Tinn, S. C. Paek, dan N. Meemon, "Unmet healthcare needs and their determining factors: addressing inequalities in access to healthcare in Myanmar," Journal of Population and Social Studies [JPSS], vol. 32, pp. 591-608, 2024.
K. L. Show, T. M. Maung, G. Disney, M. A. Bohren, P. Lumbiganon, and C. Ngamjarus, "Socioeconomic inequalities in skilled attendance at birth and caesarean section rates in Myanmar 2015–2016: a cross-sectional study," BMJ Open, vol. 14, no. 3, p. e076646, 2024.
M. C. Oo, S. S. Myint Aung, P. L. Aung, and A. Panza, "Effectiveness of men in maternity health (MiM) intervention on male involvement in maternal health care to improve maternal health outcomes in Naypyitaw, Myanmar," F1000Research, vol. 13, p. 939, 2024.
M. I. A. Adee, G. H. Y. Lee, and H. Rahman, "The post-disaster economic resilience: a study on the economic impact of flooding, and influence of cash and non-cash assistance across local and refugee population of Cox Bazar, Bangladesh," 2023.
N. N. Lhing and T. Nanseki, "Impacts of microfinance program on rural households in Myanmar: An application of logistic regression model," in Agricultural Innovation in Asia: Efficiency, Welfare, and Technology, pp. 161-168, Singapore: Springer Nature Singapore, 2023.
T. N. H. Dang and D. D. Le, "Explaining socioeconomic inequality in psychological well-being among older people: A comparison between Vietnam and Myanmar," Journal of Population Ageing, pp. 1-25, 2024.
N. N. Naila, M. M. Islam, A. Alam, G. Karmakar, M. Mahfuz, I. Mostafa, dan M. Rahman, "Caregivers’ socio-cultural influences on health-seeking behavior for their wasted children among forcibly displaced Myanmar Nationals and their nearest host communities," Frontiers in Nutrition, vol. 10, p. 1252657, 2023.
C. H. Saing, M. Ung, S. Suy, S. Oy, C. Dary, E. L. Y. Yam, dan S. Yi, "i-MoMCARE: Innovative mobile technology for maternal and child health care in Cambodia—study protocol of a cluster randomized controlled trial," Trials, vol. 24, no. 1, p. 692, 2023.
H. K. Kyaw, K. K. Than, K. Diaconu, dan S. Witter, "Community stressors and coping mechanisms in accessing the health system during a double crisis: a qualitative case study from Yangon Region, Myanmar," International Journal for Equity in Health, vol. 22, no. 1, p. 39, 2023.
P. P. Win, T. Hlaing, dan H. H. Win, "Factors influencing maternal death in Cambodia, Laos, Myanmar, and Vietnam: A systematic review," PLOS ONE, vol. 19, no. 5, p. e0293197, 2024.
A. Décobert, A. Richards, dan S. Thura, "Public health: state and non-state systems in a changing society," in Myanmar, pp. 191-206, Routledge, 2024.
S. Gomersall and A. Floyd, "Resilience: Myanmar students’ experiences of overcoming eLearning challenges during COVID-19 and political instability," Asia Pacific Education Review, vol. 24, no. 3, pp. 447-459, 2023.
P. P. Win, T. Hlaing, dan H. H. Win, "Factors influencing maternal death in Cambodia, Laos, Myanmar, and Vietnam: A systematic review," PLOS ONE, vol. 19, no. 5, p. e0293197, 2024.
J. Johnson, R. Mansha, dan A. Musaddique, "Determinants of underutilization of maternal health services in ANC clinics in LMICs: A narrative review," Journal of Asian Midwives (JAM), vol. 11, no. 1, pp. 98-111, 2024.
M. I. A. Adee, G. H. Y. Lee, dan H. Rahman, "The post-disaster economic resilience: a study on the economic impact of flooding, and influence of cash and non-cash assistance across local and refugee population of Cox Bazar, Bangladesh," 2023.
M. Zhang, N. S. N. Htun, S. Islam, A. Sen, A. Islam, A. K. Neogi, dan T. J. Peto, "Protocol: Defining the hidden burden of disease in rural communities in Bangladesh, Cambodia and Thailand: a cross-sectional household health survey protocol," BMJ Open, vol. 14, no. 3, 2024.
Y. Feng, M. Maimaitiming, J. Shi, M. Wang, N. Li, Y. Jin, dan Z. J. Zheng, "Inequity of maternal-child health services in ASEAN member states from 1993 to 2021," International Journal for Equity in Health, vol. 22, no. 1, p. 149, 2023.
L. Hanna-Trainor, L. Dornan, W. G. Kernohan, M. Sinclair, dan J. McCoy, "Birth across the borders: Exploring the experiences of mothers in Myanmar," in Trinity Health and Education International Research Conference 2024: New Horizons in Healthcare: Global Impact, Local Relevance, March 2024.
P. P. Win, T. Hlaing, dan H. H. Win, "Factors influencing maternal death in Cambodia, Laos, Myanmar, and Vietnam: A systematic review," PLOS ONE, vol. 19, no. 5, p. e0293197, 2024.
G. Z. Cheng, A. Chen, Y. Xin, dan Q. Q. Ni, "Using the teach-back method to improve postpartum maternal-infant health among women with limited maternal health literacy: a randomized controlled study," BMC Pregnancy and Childbirth, vol. 23, no. 1, p. 13, 2023.
J. Ball, "Early childhood education in Myanmar," in International Handbook on Education in South East Asia, pp. 1-21, Singapore: Springer Nature Singapore, 2023.
K. Rao and A. Schmidt, "Human resources for health in South-East Asia: Challenges and strategies," WHO South-East Asia Journal of Public Health, vol. 12, no. 1, pp. 1-3, 2023.
J. Moon, S. J. Kang, Y. D. Kwon, E. M. Song, dan J. W. Noh, "Current status and needs in the primary healthcare system in Yangon, Myanmar: a mixed-method evaluation," Primary Health Care Research & Development, vol. 24, p. e37, 2023.
F. Campbell, T. T. Sein, T. S. Htoo, W. Y. K. Khine, N. Howard, dan D. Balabanova, "Policy space and pro-health equity national policymaking: a case study of Myanmar during political transition (2006–16)," Health Policy and Planning, vol. 38, no. 2, pp. 170-180, 2023.
A. Kurjak, M. Stanojević, dan J. Dudenhausen, "Why maternal mortality in the world remains a tragedy in low-income countries and a shame for high-income ones: will sustainable development goals (SDG) help?," Journal of Perinatal Medicine, vol. 51, no. 2, pp. 170-181, 2023.
A. M. Epure, E. Courtin, P. Wanner, A. Chiolero, S. Cullati, dan C. Carmeli, "Effect of covering perinatal health-care costs on neonatal outcomes in Switzerland: a quasi-experimental population-based study," The Lancet Public Health, vol. 8, no. 3, pp. e194-e202, 2023.
M. F. Chersich, F. Scorgie, V. Filippi, S. Luchters, Climate Change and Heat‐Health Study Group, A. Huggett, dan W. Mavhu, "Increasing global temperatures threaten gains in maternal and newborn health in Africa: A review of impacts and an adaptation framework," International Journal of Gynecology & Obstetrics, vol. 160, no. 2, pp. 421-429, 2023.
B. B. Masaba and R. Mmusi-Phetoe, "A strategy for reducing maternal mortality in rural Kenya," International Journal of Women's Health, pp. 487-498, 2023.
M. E. Wallace, D. Vilda, L. Dyer, I. Johnson, dan L. Funke, "Health care use and health consequences of geographic lack of access to abortion and maternity care," Birth, vol. 51, no. 2, pp. 363-372, 2024.
E. V. Ezeneme, C. E. Nwokike, U. C. Portion, dan I. C. Nwanekezi, "The influence of socioeconomic inequality on maternal and child health outcomes in Nigeria: A critical analysis," GSJ, vol. 11, no. 10, 2023.
N. A. Damayanti, R. D. Wulandari, dan I. A. Ridlo, "Maternal health care utilization behavior, local wisdom, and associated factors among women in urban and rural areas, Indonesia," International Journal of Women's Health, pp. 665-677, 2023.
A. A. Creanga, M. A. Dohlsten, E. K. Stierman, A. C. Moran, M. Mary, E. Katwan, dan B. Maliqi, "Maternal health policy environment and the relationship with service utilization in low-and middle-income countries," Journal of Global Health, vol. 13, 2023.
S. Witter, S. Thomas, S. M. Topp, E. Barasa, M. Chopra, D. Cobos, dan A. Ager, "Health system resilience: a critical review and reconceptualisation," The Lancet Global Health, vol. 11, no. 9, pp. e1454-e1458, 2023.