A reproductive health needs assessment in Myanmar

A Reproductive Health Needs Assessment in Myanmar
Despite knowing of a number of methods, the assessment team found that women’s
knowledge is often superficial and is derived largely from their own or other women’s
experiences of using the method.
Provisional data from the recent FRHS show that the fear of side effects of modern
contraception is a major reason why women do not use contraception. The FRHS found that,
of 10,486 currently married women who weren’t using contraception at the time of the
survey, 14 per cent were not doing so because of “health concerns”. This was the second
most common reason after “desire to get pregnant” (see Table 8)
Table 8. Reasons for non use of contraception
Lack of knowledge
Opposition to use
Respondent’s opposition
Husband’s opposition
Others’ opposition
Religious prohibition
Fertility related reasons
Menopausal
Postpartum/breast feeding
Infrequent sex
Desire to get pregnant
Pregnant
Method related reasons
Health concern
Access/availability
Costs too much
Inconvenient to use
Other
7.7
11.0
1.9
0.1
0.8
8.9
8.2
1.9
18.9
11.8
14.0
1.4
0.7
0.6
12.0
The team found that all hormonal methods are perceived to be associated with a number of
common side-effects, although some women claim that pills are worse, and others that
injectables are worse. For example one woman said that pills cause giddiness and vomiting,
and that therefore women prefer injections, whilst another woman said that injectables are
associated with irregular menstruation and that therefore pills were better. Becoming thin
was another of the negative side-effects mentioned in relation to taking the pill. The choice
between one-monthly and three-monthly injectables is also reported to be, in part, dependent
on a woman’s attitude towards irregular menstruation. Method failure and the risk of
infertility after extended use were also mentioned as problems with hormonal methods.
Providers in particular attributed method failure to the woman not taking the pills regularly,
or not returning at the right time for a re-injection. These side effects do not seem to be
stopping women from using these methods, but many women report constantly changing
between various hormonal methods in an attempt to avoid the negative consequences.
Most providers and community members interviewed perceived the condom solely as a
means to prevent sexually transmitted infection, and not as a birth spacing method. The
condom is often perceived to be an inconvenient method to use, and disposal and storage
problems were also mentioned as reasons for non-use of the method.
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