Empowerment and health care access barriers among currently married women in Myanmar.

BACKGROUND: Although Myanmar is moving to attain UHC in 2030, health care utilization indicators are still low, especially among women. Women's health outcomes are determined by the lack of access to health care, and many factors influence this condition. The objective of the present work was to identify the association between women's empowerment and barriers to accessing health care among currently married women in Myanmar. METHOD: We performed a secondary analysis using the Myanmar Demographic and Health Survey (2015-16), including 7759 currently married women aged 15-49 years. The outcome variable, barriers to accessing health care, were asked about in terms of whether the respondent faced barriers to getting permission to go, getting money to go, the distance to the health facility, and not wanting to go alone. The variables were recoded into zero, one, and more than one barrier. After performing the exploratory factor analysis for women's empowerment indicators (decision-making power and disagreement to justification to wife-beating), a multinomial logistic regression was carried out. RESULTS: Among currently married women, 48% experienced no barriers when accessing health care services, 21.9% had one barrier, and 30.1% had more than one barrier. After the exploratory factor analysis, scores were recoded into three levels. Women with low and middle empowerment had 1.5 odds (AOR 1.5, 95% CI: 1.2-1.8) and 1.5 odds (AOR 1.5, 95% CI: 1.3-1.9), respectively, to have barriers to accessing health care when compared to those with high empowerment for one barrier group. For the women who had more than one barrier, women with low empowerment were 1.4 times more likely (AOR 1.4, 95% CI: 1.1-1.7) to experience barriers in comparison to women with high empowerment. The barriers were seen to be reduced in the case of women who had a high level of education, had fewer children, came from rich households, and lived in urban areas. CONCLUSION: When women are more empowered, they tend to face fewer barriers when accessing health care services. This finding could contribute to the policy formulation for reducing health inequity issues by increasing women's empowerment.

Stunting: an overlooked problem in Myanmar - an economic evaluation.

OBJECTIVES: Stunting increases a child's susceptibility to diseases, increases mortality, and is associated over long term with reduced cognitive abilities, educational achievement, and productivity. We aimed to assess the most effective public health nutritional intervention to reduce stunting in Myanmar. METHODS: We searched the literature and developed a conceptual framework for interventions known to reduce stunting. We focused on the highest impact and most feasible interventions to reduce stunting in Myanmar, described policies to implement them, and compared their costs and projected effect on stunting using data-based decision trees. We estimated costs from the government perspective and calculated total projected cases of stunting prevented and cost per case prevented (cost-effectiveness). All interventions were compared to projected cases of stunting resulting from the current situation (e.g., no additional interventions). RESULTS: Three new policy options were identified. Operational feasibility for all three options ranged from medium to high. Compared to the current situation, two were similarly cost-effective, at an additional USD 598 and USD 667 per case of stunting averted. The third option was much less cost-effective, at an additional USD 27,741 per case averted. However, if donor agencies were to expand their support in option three to the entire country, the prevalence of 22.5 percent would be reached by 2025 at an additional USD 667 per case averted. CONCLUSIONS: A policy option involving immediate expansion of the current implementation of proven nutrition-specific interventions is feasible. It would have the highest impact on stunting and would approach the WHO 2025 target.

Job satisfaction among Myanmar working population, a cross-sectional study.

The gap between expectations and reality could lead to low job satisfaction. Although much literature has been described on job satisfaction among different categories of people, more research is needed to acknowledge the judgment of job satisfaction among some of the Myanmar working population. The study aims to find out the satisfaction level of a job and the factors related to it. The cross-sectional study was conducted in January 2019 by calling for face-to-face interviews with 536 respondents selected using a convenient sampling technique using a pre-tested questionnaire. The highest satisfied respondents were >50 years age group (86.11%), females (71.89%), higher officials (90.53%), and more than three years of service (78.35%). In the adjusted analysis, having 41-50 year age group (AOR 2.72; 95% CI: 1.08-6.83), part-time job nature (AOR 2.16; 95% CI: 1.17-3.99), and the higher official (AOR 5.71; 95% CI: 2.48-13.13) were significantly associated with job satisfaction. Relationships with the direct executive and, organization and management were the main determinants of job satisfaction. Moreover, the respondents with higher positions were more likely to have higher job satisfaction in the study.

Changes in physical activity, dietary and sleeping pattern among the general population in COVID-19: A systematic review protocol.

BACKGROUND: COVID-19 is a highly infectious respiratory disease caused by a new coronavirus known as SARS-CoV-2. Home confinement and movement restrictions can affect lifestyle changes and may lead to non-communicable diseases (NCD). This systematic review will provide a detailed summary of changing patterns of physical activities, diet and sleep among the general public in COVID-19. METHODS: PubMed, Google Scholar, EMBASE, Science Direct, and Scopus will be, among eight bibliographic databases, applied and search work will take one month (from January 2021 until February 2021). Key search terms will include common characteristics of physical activity, dietary pattern, sleeping pattern, and COVID-19. The reviewers will fully apply the inclusion and exclusion criteria framed by PICOS as well as the screening form and the PRISMA flow for selecting the papers eligible for this review. Moreover, the reviewers will use a self-developed excel table to extract the required information on dietary pattern changes, physical activities and sleep patterns changes, and the Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS) for practicing quality assessment. We will include only observational studies and analyze the extracted information qualitatively and the review output will be based on the eligible studies' outcomes. DISCUSSION: Changes in physical activity, dietary and sleep patterns are challenging to the public health professionals regarding the risk factors for NCD, and long-term effects might impact the controlling of the NCD. Evidence-based research information is needed regarding the COVID-19 pandemic, and there are a few global data on changes in physical activity, dietary and sleep patterns. Furthermore, innovative public health interventions or implementations are needed to maintain the positive health status of the population in the long run as the consequences of the COVID-19 pandemic. SYSTEMATIC REVIEW REGISTRATION: This systematic review is based on a protocol registered with PROSPERO CRD42021232667.