Poor maternal health care widespread in eastern Burma
Public release date: 22-Dec-2008
Poor maternal health care widespread in eastern Burma
Press release from PLoS Medicine
Access to maternal health-care is extremely limited and poor nutrition, anemia and malaria are widespread in eastern Burma, which increases the risk of pregnancy complications, says new research published in the open access journal PLoS Medicine. Human rights violations—such as displacement and forced labur—are also widely present, and in some communities forced relocation doubled the risk of women developing anemia and greatly decreased their chances of receiving any antenatal care.
Luke Mullany and colleagues from Johns Hopkins University in Baltimore, USA and the Burma Medical Association surveyed 3000 women along the Eastern Burmese border as part of a baseline assessment of women’s needs for their Mobile Obstetric Maternal Health Workers (MOM) Project, which was set up in collaboration with a health worker training clinic in Thailand called Mae Tao Clinic. They also conducted health assessments. Nearly 90% of the women reported a home delivery for their last baby, a skilled attendant was present at only 5% of births, and only a third of women had any antenatal or postnatal care, the authors report. Only a third of the women surveyed reported access to effective contraceptives.
Mullany and colleagues report that very few women had received iron supplements or had used insecticide-treated bednets, and consequently found that more than half the women were anemic and 7.2% were infected with malaria. Many women also showed signs of poor nutrition, the research says.
Frequency and types of human rights violations varied across the project sites in Eastern Burma. In the Karen region, more than 10% of household were forced to move, in the Karenni ceasefire region a third of women reported members of their household being forced to work, and in the Shan region many women reported forced labor, forced relocation, threats to food security, and direct attacks. In analyses looking at the relationship between human rights violation and maternal health, the authors found that the odds of receiving no antenatal care services were almost 6 times higher among those forcibly displaced.
The authors conclude that “coverage of basic maternal health interventions is woefully inadequate in these selected populations and substantially lower than even the national estimates for Burma, among the lowest in the region.” It is clear, the authors say, “that considerable political, financial, and human resources will be needed to improve maternal health in this region.”
In a commentary on the research article, Macaya Douoguih from the National Institutes of Health, USA (not involved in the study) says that the study provides “useful information on access to care and health indicators, which will help to prioritize unmet needs.” “There is no question that an increase in access to services is desperately needed to improve health in this region,” says Dr. Douoguih. “This study lays the foundation for an innovative community-based mobile health system that could greatly enhance the health of communities in eastern Burma.”
Citation: Mullany LC, Lee CI, Yone L, Paw P, Oo EKS, et al. (2008) Access to essential maternal health interventions and human rights violations among vulnerable communities in eastern Burma. PLoS Med 5(12): e242. doi:10.1371/journal.pmed.0050242
IN YOUR COVERAGE PLEASE USE THIS URL TO PROVIDE ACCESS TO THE FREELY AVAILABLE PAPER: http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0050242
PRESS-ONLY PREVIEW OF THE ARTICLE: http://www.plos.org/press/plme-05-12-mullany.pdf
READ THE EDITORS’ SUMMARY OF THE PAPER: http://www.plos.org/press/plme-05-12-mullany-summary.pdf
Luke C Mullany
Johns Hopkins Bloomberg School of Public Health
Department of International Health
615 N Wolfe Street, E8646
Baltimore, MD 21205
United States of America
Related PLoS Medicine Perspective
Citation: Douoguih M (2008) Accessing maternal health services in eastern Burma. PLoS Med 5(12): e250. doi:10.1371/journal.pmed.0050250
IN YOUR COVERAGE PLEASE USE THIS URL TO PROVIDE ACCESS TO THE FREELY AVAILABLE PAPER: http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0050250
PRESS-ONLY PREVIEW OF THE ARTICLE: http://www.plos.org/press/plme-05-12-douoguih.pdf
Myanmar mothers have poor access to healthcare
Tue Dec 23, 2008 8:00am IST
HONG KONG (Reuters) – Access to maternal healthcare in eastern Myanmar is inadequate and most expectant mothers suffer from poor nutrition, anemia and malaria, raising the risk of pregnancy complications, researchers said.
In an article in the medical journal PLoS Medicine, they said forced relocation doubled the risk of women developing anemia and greatly decreased their chances of receiving any antenatal care.
Researchers from Johns Hopkins University in the United States and the Burma Medical Association surveyed 3,000 women along the border in eastern Myanmar and found that nearly 90 percent of them delivered their last baby at home.
“Coverage of basic maternal health interventions is woefully inadequate in these selected populations and substantially lower than even the national estimates for Burma, among the lowest in the region,” they wrote.
“Considerable political, financial and human resources will be needed to improve maternal health in this region.”
A skilled attendant, or midwife, was present at only five percent of births, and only a third of women had any antenatal or postnatal care, they said. Only a third of the women surveyed reported access to effective contraceptives.
Few women received iron supplements or used insecticide-treated bednets. Consequently more than half the women were anemic and 7.2 percent were infected with malaria. Many women showed signs of poor nutrition, they found.
They said human rights violations impacted greatly on women’s health. In the Karen region, more than 10 percent of households were forced to move, while in the Shan region many women reported forced labor, forced relocation, threats to food security, and direct attacks.
The odds of receiving no antenatal care services were almost six times higher among those forcibly displaced, it said.
(Reporting by Tan Ee Lyn; Editing by Sugita Katyal)
Health: Violence creates medical crisis for many, says report
New York , 22 Dec. (AKI) – Iraq, Pakistan, Burma and war-torn Sudan suffered some of the worst medical emergencies in the world during 2008, according to the humanitarian organisation, Medecins Sans Frontieres. In its annual ‘Top Ten’ list released in New York on Monday, MSF said forced displacement and violence had produced several humanitarian crises.
The report also pointed to the growing prevalence of HIV-tuberculosis infection and the critical need for increased global efforts to prevent and treat childhood malnutrition— the underlying cause of death for up to five million children per year.
“Working on the frontlines of crisis zones throughout the world, MSF medical teams witness first-hand the medical and psychological consequences people endure from extreme violence, displacement, and neglected—yet treatable—diseases,” said MSF International Council President Christophe Fournier.
“In some of these places, it is extremely difficult for aid groups to access populations requiring help. Where we are able to provide assistance, we have a special responsibility to bear witness and speak out about intolerable suffering and draw attention to basic humanitarian needs—needs that are often largely ignored.”
MSF said that many of the countries on this year’s list made it extremely difficult to deliver aid to the vulnerable and worst affected.
Aid organisations now operate with increased security risks and in generally more hazardous and threatening environments. In highly politicised and volatile conflicts such as those in Somalia, Pakistan, Sudan, and Iraq, MSF said it was limited in its ability to address immense medical needs.
The organisation said in places such as Myanmar and Zimbabwe — where governments fail to make health care a priority or view NGOs with suspicion—humanitarian organisations are limited in the type of assistance they can provide.
In Burma, where MSF is the main provider of HIV care, hundreds of thousands of people are needlessly dying due to a severe lack of AIDS services. It says 75,000 people currently need cures and therapies for the disease.
“The reality on the ground is that the humanitarian community is unable to do nearly enough for populations in grave need of medical assistance,” Fournier said.
“With the release of this list, we hope to focus much needed attention on the millions of people who are trapped in conflict and war, affected by medical crises, whose immediate and essential health needs are neglected, and whose plight often goes unnoticed.”
MSF began producing the ‘Top Ten’ list in 1998, when a devastating famine in southern Sudan went largely unreported in US media. Drawing on MSF’s emergency medical work, the list seeks to generate greater awareness of the magnitude and severity of crises that may or may not be reflected in media accounts.