Maternal and neonatal mortality remains high in Myanmar. Whilst the proportion of deliveries assisted by a skilled birth attendant (SBA) is moderate, the proportion of institutional deliveries is low in Myanmar. Home births have life-threatening risks for mothers and their newborn due to the limited emergency care available at home. This study explores the socio-cultural and maternal health factors, which were associated with mothers’ place of delivery using secondary data.
This study used nationally representative data from the Myanmar Demographic Health Survey (DHS) conducted in 2015-16. The data was obtained from mothers aged 15-49 years with their most recent births in five years preceding the survey (n=3856). A multivariable logistic regression analysis was undertaken, and the adjusted Odds Ratio (aOR) and 95% Confidence Interval (CI) of home deliveries were provided.
The study shows that 62% of women in Myanmar delivered at home. The aOR of home deliveries was 6.18 (95% CI: 4.17-9.16) for women with no antenatal care (ANC) compared to those with four or more ANC visits, 4.46 (3.19-6.22) for the lowest wealth quintile in comparison with the highest wealth quintile, and 2.94 (2.28-3.80) for women having four or five children relative to women with only one child. The place of residence, women’s educational attainment, women’s and their husbands’ occupations were also associated with the place of delivery. On the other hand, maternal age, husbands’ education levels, women’s media exposure levels and women’s decision-making power were not associated with home deliveries.
This study has identified populations which service providers should target to attend for institutional deliveries in Myanmar. It appears necessary to improve accessibility of health services, including ANC, to promote institutional deliveries and have better health outcomes among mothers and their newborn.
Electronic health information systems (HISs) are believed to improve access to health information. The District Health Information System Version 2 (DHIS2) is used widely in developing countries. While numerous successful cases highlighting the introduction of DHIS in facility-based settings have been reported, it remains unclear how similarly effective results can be obtained in developing countries.
We conducted a literature review to clarify the achievements and challenges regarding the use of DHIS2, and extracted 62 papers from PubMed and Google Scholar using the search term ‘District Health Information Software System’. Eleven papers that described the process of introducing DHIS2 were selected for analysis.
We categorized the achievements into two groups: ‘Improvement of the reporting system’ and ‘Human resources development’. The challenges were categorized into eight groups, of which most commonly reported were human resources-related issues, followed by system complexity and data collection inadequacy.
The introduction of DHIS2 contributed to the improvement of the timeliness and completeness of data reporting, as well as human resources development, while utilization of data should be further strengthened. The most common challenges reported consisted of human resources-related issues. The HISs should be simple and easy to understand, even for individuals with low computer literacy.