A reproductive health needs assessment in Myanmar

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A Reproductive Health Needs Assessment in Myanmar Foreword It is generally accepted that there is a need for expanded and improved reproductive health services in Myanmar. The ability to address these needs is inhibited, in part, by the scarcity of available information. Both the Government and the donor agencies interested in the promotion of reproductive health in Myanmar recognise the need for a more comprehensive base of information regarding the broad reproductive health situation in Myanmar. Such information is essential if appropriate and well co-ordinated interventions are to be developed. The Reproductive Health Needs Assessment mission was first conceived during the Tripartite Review of the UNFPA-supported Birth Spacing Project in October 1997 and proposed as part of the 1998 work plan. This was discussed at the United Nations Country Team Meeting in November 1997 and also in the United Nations Thematic Working Group on Primary Health Care and Reproductive Health. The United Nations agencies welcomed the idea and extended their full support in the conduct of the mission activities. Mission activities were conducted in a highly participatory manner by a broad based and interdisciplinary team. The assessment team began its activities by meeting with policy makers and representatives of a number of United Nations agencies. This was followed by a workshop of approximately 30 key stakeholders in reproductive health in Myanmar. The views and suggestions expressed during these initial meetings informed the process and content of the field assessment. On returning from the field assessment, a dissemination workshop was held to present the draft findings, and to solicit further input from policy makers, the United Nations agencies and other key stakeholders. The report of the assessment presented here will provide an essential information base for the activities of all the United Nations agencies in the area of reproductive health, and will be an important input into the programme development of other organizations and agencies. I wish to express my appreciation to all the assessment team members for their hard work in conducting this extremely important activity. Thank you also to the many individuals, both in Yangon and in the townships visited, who took their time to meet and talk with the assessment team. Dr Sheila Macrae Country Director, Myanmar UNFPA 2
A Reproductive Health Needs Assessment in Myanmar Table of Contents Introduction Reproductive health status Reproductive health services Assessment objectives and methodology Structure of the report Maternal Health Maternal mortality in Myanmar Antenatal care Routine delivery care Post-delivery care Causes of maternal morbidity and mortality The problem of abortion Constraints to basic obstetric care Birth Spacing Unmet need for birth spacing Social acceptability of birth spacing User and provider perspectives on birth spacing Birth spacing services Birth spacing practices Role of men in birth spacing Constraints to the provision of quality birth spacing services Reproductive Tract Infections Overview of RTI prevalence Community knowledge and perceptions Providers perspectives Critical issues concerning RTIs, including STDs, and HIV/AIDS Adolescent Reproductive Health Previous studies on teenage pregnancy and adolescent reproductive health Adolescent sexual behaviour Adolescents knowledge of reproductive health issues Access to services Information material and sources Conclusions and Recommendations Cross-cutting issues in reproductive health services Specific Recommendations Operationalizing Reproductive Health Care Programmes Essential service package An approach to programme development Critical inputs for operationalizing reproductive health programmes References 4 4 6 11 15 16 16 16 18 21 21 22 24 27 27 28 28 30 32 34 35 39 39 42 47 49 51 51 52 53 53 54 57 57 60 77 77 85 87 89 3
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ANNEX I Summary of Reproductive Hea
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Agency UNHCR Programme Local Reinte
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ANNEX III Summary Reproductive Heal
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Assuming that: (1) TFR in 1990 was
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A reproductive health needs assessment in Myanmar

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