Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Health Services Research
Published in: BMC Health Services Research 1/2012

Open Access 01-12-2012 | Research article

Equity of access to reproductive health services among youths in resource-limited suburban communities of Mandalay City, Myanmar

Authors: Phyu Phyu Thin Zaw, Tippawan Liabsuetrakul, Thien Thien Htay, Edward McNeil

Published in: BMC Health Services Research | Issue 1/2012

Login to get access

Abstract

Background

Inequity of accessibility to and utilization of reproductive health (RH) services among youths is a global concern, especially in resource-limited areas. The level of inequity also varies by cultural and socio-economic contexts. To tailor RH services to the needs of youths, relevant solutions are required. This study aimed to assess baseline information on access to and utilization of RH services and unmet needs among youths living in resource-limited, suburban communities of Mandalay City, Myanmar.

Methods

A community-based, cross-sectional study was conducted in all resource-limited, suburban communities of Mandalay City, Myanmar. A total of 444 randomly selected youths aged between 15 and 24 years were interviewed for three main outcomes, namely accessibility to and utilization of RH services and youth's unmet needs for these services. Factors associated with these outcomes were determined using multivariate logistic regression.

Results

Although geographical accessibility was high (79.3%), financial accessibility was low (19.1%) resulting in a low overall accessibility (34.5%) to RH services. Two-thirds of youths used some kind of RH services at least once in the past. Levels of unmet needs for sexual RH information, family planning, maternal care and HIV testing were 62.6%, 31.9%, 38.7% and 56.2%, respectively. Youths living in the south or south-western suburbs, having a deceased parent, never being married or never exposed to mass media were less likely to access RH services. Being a young adult, current student, working as a waste recycler, having ever experienced a sexual relationship, ever being married, ever exposed to mass media, having a high knowledge of RH services and providers or a high level of accessibility to RH services significantly increased the likelihood of utilization of those services. In addition to youths’ socio-demographic characteristics, exposure to mass media, norm of peer exposure and knowledge on types of providers and services significantly influenced the unmet needs of youths towards RH services.

Conclusion

Despite the availability of RH services, youth’s accessibility to and utilization of those services were unsatisfactory. The levels of youths’ unmet RH needs were alarmingly high.
Literature
1.
2.
3.
Stidham HK, Moreau C, Trussell J: Discouraging trends in reproductive health service use among adolescent and young adult women in the USA, 2002–2008. Hum Reprod. 2011, 26: 2541-2548. 10.1093/humrep/der184.CrossRef
4.
Rahman M, Haque SE, Mostofa MG, Tarivonda L, Shuaib M: Wealth inequality and utilization of reproductive health services in the Republic of Vanuatu: insights from the multiple indicator cluster survey, 2007. Int J Equity Health. 2011, 10 (58): 58.CrossRefPubMedPubMedCentral
5.
Braeken D, Rondinelli I: Sexual and reproductive health needs of young people: matching needs with systems. Int J Gynaecol Obstet. 2012, 119 (Suppl 1): S60-S63. Aug 11.CrossRefPubMed
6.
7.
Leon Carmona JC, Hernandez Alvarez LA, Hernandez Hernandez MA: Effect of sociocultural factors on maternal and perinatal morbidity with or without mortality among adolescents seen in 3 states of the Mexican Republic. Ginecol Obstet Mex. 2002, 70: 320-327.PubMed
8.
Pathak PK, Singh A, Subramanian SV: Economic inequalities in maternal health care: prenatal care and skilled birth attendance in india. PLoS One. 2010, 5: 112-115.CrossRef
9.
Ziraba AK, Madise N, Mills S, Kyobutungi C, Ezeh A: Maternal mortality in the informal settlements of Nairobi city: what do we know?. Reprod Health. 2009, 6: 112-117.CrossRef
10.
Simoes PP, Almeida RM: Geographic accessibility to obstetric care and maternal mortality in a large metropolitan area of Brazil. Int J Gynaecol Obstet. 2011, 112: 25-29. 10.1016/j.ijgo.2010.07.031.CrossRefPubMed
11.
12.
Atuyambe L, Mirembe F, Tumwesigye NM, Annika J, Kirumira EK, Faxelid E: Adolescent and adult first time mothers' health seeking practices during pregnancy and early motherhood in Wakiso district, central Uganda. Reprod Health. 2008, 5: 13-19. 10.1186/1742-4755-5-13.CrossRefPubMedPubMedCentral
13.
14.
Kaljee LM, Green M, Riel R, Lerdboon P, Tho LH, Thoa LTK, et al: Sexual stigma, sexual behaviors, and abstinence among vietnamese adolescents: implications for risk and protective behaviors for HIV, STIs, and unwanted pregnancy. J Assoc Nurses AIDS Care. 2007, 18: 48-59.CrossRefPubMedPubMedCentral
15.
Singh S: Global consequences of unsafe abortion. Womens Health (Lond Engl). 2010, 6: 849-860. 10.2217/whe.10.70.CrossRef
16.
Adinma JI, Adinma ED: Impact of reproductive health on socio-economic development: a case study of Nigeria. Afr J Reprod Health. 2011, 15: 7-12.PubMed
17.
Hazarika I: Women's Reproductive health in slum populations in India: evidence from NFHS-3. J Urban Health. 2010, 87: 264-277. 10.1007/s11524-009-9421-0.CrossRefPubMedPubMedCentral
18.
19.
Regmi PR, van Teijlingen E, Simkhada P, Acharya DR: Barriers to sexual health services for young people in Nepal. J Health Popul Nutr. 2010, 28: 619-627.CrossRefPubMedPubMedCentral
20.
21.
Henshaw SK: Factors hindering access to abortion services. Fam Plann Perspect. 1995, 27 (2): 54-58. 10.2307/2135905. 87CrossRefPubMed
22.
Chayovan N, Hermalin AI, Knodel J: Measuring accessibility to family planning services in rural Thailand. Stud Fam Plann. 1984, 15: 201-211. 10.2307/1965734.CrossRefPubMed
23.
Mroz TA, Bollen KA, Speizer IS, Mancini DJ: Quality, accessibility, and contraceptive use in rural Tanzania. Demography. 1999, 36: 23-40. 10.2307/2648132.CrossRefPubMed
24.
Islam MS, Asktar S: Measuring physical accessiblity to health facilities: a case study on Khunla City. World Health Popul. 2011, 12: 123-127.CrossRef
25.
Gage AJ, Guirlene CM: Effects of the physical accessibility of maternal health services on their use in rural Haiti. Popul Stud (Camb). 2006, 60: 271-288. 10.1080/00324720600895934.CrossRef
26.
Tuladhar JM: Effect of family planning availability and accessibility on contraceptive use in Nepal. Stud Fam Plann. 1987, 18: 49-53. 10.2307/1966421.CrossRefPubMed
27.
28.
29.
Gulliford M, Figueroa-Munoz J, Morgan M, Hughes D, Gibson B, Beech R, et al: What does 'access to health care’ mean?. J Health Serv Res Policy. 2002, 7: 186-188. 10.1258/135581902760082517.CrossRefPubMed
30.
Acuna DL, Gattini C, Pinto M, Andersson B: Access to and finances of health care: ways to measure and improve inequites. Equity in Health. 2001, Pan American Health Organization, 115-127. Views from the Pan American Sanitary Bureau. Occasional Publication No. 8
31.
Ray N, Ebener S: Computing geographic coverage and accessibility to health care services using anisotropic movement of patients. Int J Health Geogr. 2008, 7: 63-68. 10.1186/1476-072X-7-63.CrossRefPubMedPubMedCentral
32.
33.
Becker S, Peters DH, Gray RH, Gultiano C, Black RE: The determinants of use of maternal and child health services in Metro Cebu, the Philippines. Health Transit Rev. 1993, 3: 77-89.PubMed
34.
Heard NJ, Larsen U, Hozumi D: Investigating access to reproductive health services using GIS: proximity to services and the use of modern contraceptives in Malawi. Afr J Reprod Health. 2004, 8: 164-179. 10.2307/3583189.CrossRefPubMed
35.
Kurtz LC, Sword W, Ciliska D: Urban women's socioeconomic status, health service needs and utilization in the four weeks after postpartum hospital discharge: findings of a Canadian cross-sectional survey. BMC Health Serv Res. 2008, 8: 203-10.1186/1472-6963-8-203.CrossRef
36.
Fotso JC, Ezeh AC, Essendi H: Maternal health in resource-poor urban settings: how does women's autonomy influence the utilization of obstetric care services?. eprod Health. 2009, 6: 9.
37.
Yao J, Murray AT, Agadjanian V, Hayford SR: Geographic influences on sexual and reproductive health service utilization in rural Mozambique. Appl Geogr. 2012, 32: 601-607. 10.1016/j.apgeog.2011.07.009.CrossRefPubMed
38.
Kesterton AJ, Cleland J, Sloggett A, Ronsmans C: Institutional delivery in rural India: the relative importance of accessibility and economic status. BMC Pregnancy Childbirth. 2010, 10: 30-10.1186/1471-2393-10-30.CrossRefPubMedPubMedCentral
39.
Chen B, Lu YN, Wang HX, Ma QL, Zhao XM, Guo JH, et al: Sexual and reproductive health service needs of university/college students: updates from a survey in Shanghai. China Asian J Androl. 2008, 10: 607-615. 10.1111/j.1745-7262.2008.00413.x.CrossRefPubMed
40.
Rahman M, Nakamura K, Seino K, Kizuki M: Intimate partner violence and use of reproductive health services among married women: evidence from a national Bangladeshi sample. BMC Publ Health. 2012, 12: 913-10.1186/1471-2458-12-913.CrossRef
41.
Tangmunkongvorakul A, Banwell C, Carmichael G, Utomo ID, Seubsman SA, Kelly M, et al: Use and perceptions of sexual and reproductive health services among northern Thai adolescents. Southeast Asian J Trop Med Public Health. 2012, 43: 479-500.PubMedPubMedCentral
42.
Namasivayam A, Osuorah DC, Syed R, Antai D: The role of gender inequities in women's access to reproductive health care: a population-level study of Namibia, Kenya, Nepal, and India. Int J Womens Health. 2012, 4: 351-364.PubMedPubMedCentral
43.
Hall KS, Moreau C, Trussell J: Determinants of and disparities in reproductive health service use among adolescent and young adult women in the United States, 2002–2008. Am J Public Health. 2012, 102: 359-367. 10.2105/AJPH.2011.300380.CrossRefPubMedPubMedCentral
44.
Hall KS, Moreau C, Trussell J: Associations between sexual and reproductive health communication and health service use amongUS Adolescent women. Perspect Sex Reprod Health. 2012, 44: 6-12. 10.1363/4400612.CrossRefPubMedPubMedCentral
45.
Frost JJ: Trends in US women's use of sexual and reproductive health care services, 1995–2002. Am J Public Health. 2008, 98: 1814-1817. 10.2105/AJPH.2007.124719.CrossRefPubMedPubMedCentral
46.
Islam M: Progress towards achieving Millennium Development Goal 5 in South-East Asia. BJOG. 2011, 118 (Suppl 2): 6-11.CrossRefPubMed
47.
Panitchpakdi P, Podhipak A, Sein UK, Kywe B: Family planning: knowledge, attitudes and practice survey in Zigone, Myanmar. Southeast Asian J Trop Med Public Health. 1993, 24: 636-646.PubMed
48.
Rafiqul HC: Unmet Need for Contraception in South Asia: Levels, Trends and Determinents. Asia- Pacific Population Journal. 2001, 16: 3-22.
49.
Myo MM, Liabsuetrakul T: Factors influencing married youths' decisions on contraceptive use in a rural area of Myanmar. Southeast Asian J Trop Med Public Health. 2009, 40: 1057-1064.
50.
Rosenstock IM, Strecher VJ, Becker MH: Social learning theory and the Health Belief Model. Health Educ Q. 1988, 15: 175-183. 10.1177/109019818801500203.CrossRefPubMed
51.
52.
Tint HS, Thaw P, Oo YN, Zaw KK, Sein T, Tun T: Sexual and reproductive health needs of vulnerable youth in Myanmar. Southeast Asian J Trop Med Public Health. 2008, 39: 1126-1138.
53.
Cheng YM, Wang XY, Lv YH, Cai YM, Li Y, Guo X, et al: Study on the risk factors of repeated abortion among unmarried adolescents. Zhonghua Liu Xing Bing Xue Za Zhi. 2006, 27: 669-672.PubMed
54.
Forrest JD: Epidemiology of unintended pregnancy and contraceptive use. Am J Obstet Gynecol. 1994, 170: 1485-1489.PubMed
55.
Sychareun V: Meeting the contraceptive needs of unmarried young people: attitudes of formal and informal sector providers in Vientiane Municipality. Lao PDR. Reprod Health Matters. 2004, 12: 155-165. 10.1016/S0968-8080(04)23117-2.CrossRefPubMed
56.
Nalwadda G, Mirembe F, Tumwesigye NM, Byamugisha J, Faxelid E: Constraints and prospects for contraceptive service provision to young people in Uganda: providers' perspectives. BMC Health Serv Res. 2011, 11: 220-10.1186/1472-6963-11-220.CrossRefPubMedPubMedCentral
57.
Sedgh G, Singh S, Shah IH, Ahman E, Henshaw SK, Bankole A: Induced abortion: incidence and trends worldwide from 1995 to 2008. Lancet. 2012, 379: 625-632. 10.1016/S0140-6736(11)61786-8.CrossRefPubMed
58.
Tegegn A, Yazachew M, Gelaw Y(E): Reproductive Health Knowledge and Attitude among Adolescents: A community based study in Jimma Town, Southwest Ethiopia. Ethiopian Journal of Health Development. 2008, 22: 144-150.
59.
Yang C, Latkin C, Luan R, Nelson K: Peer norms and consistent condom use with female sex workers among male clients in Sichuan province. China. Soc Sci Med. 2010, 71: 832-839.CrossRefPubMed
60.
Fishbein M, Ajzen I: Belief, Attitude, Intention, and Behavior: An Introduction to Theory and Research. 1975, Reading, MA: Addison-Wesley
61.
Char A, Saavala M, Kulmala T: Assessing young unmarried men's access to reproductive health information and services in rural India. BMC Publ Health. 2011, 11: 476-10.1186/1471-2458-11-476.CrossRef
62.
Lou C, Cheng Y, Gao E, Zuo X, Emerson MR, Zabin LS: Media's contribution to sexual knowledge, attitudes, and behaviors for adolescents and young adults in three Asian cities. J Adolesc Health. 2012, 50: S26-S36.CrossRefPubMedPubMedCentral
63.
Liu Z, Zhu M, Dib HH, Li Z, Shi S, Wang Z: RH knowledge and service utilization among unmarried rural-to-urban migrants in three major cities. China. BMC Public Health. 2011, 11: 74-79. 10.1186/1471-2458-11-74.CrossRefPubMed
Metadata
Title
Equity of access to reproductive health services among youths in resource-limited suburban communities of Mandalay City, Myanmar
Authors
Phyu Phyu Thin Zaw
Tippawan Liabsuetrakul
Thien Thien Htay
Edward McNeil
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2012
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-12-458

Other articles of this Issue 1/2012

BMC Health Services Research 1/2012 Go to the issue

Research article

Is the health of people living in rural areas different from those in cities? Evidence from routine data linked with the Scottish Health Survey

Research article

Experiences of community pharmacists involved in the delivery of a specialist asthma service in Australia

Research article

Assessment of service quality of public antiretroviral treatment (ART) clinics in South Africa: a cross-sectional study

Research article

Cost-effectiveness analysis of different rescue therapies in patients with lamivudine-resistant chronic hepatitis B in China

Research article

The retention of health human resources in primary healthcare centers in Lebanon: a national survey

Research article

Clinicians' adherence versus non adherence to practice guidelines in the management of patients with sarcoma: a cost-effectiveness assessment in two European regions