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      Unmet Need for Family Planning among Urban and Rural Married Women in Yangon Region, Myanmar—a Cross-Sectional Study

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          Abstract

          Despite increasing contraceptive use and prevalence, many women who want to avoid or delay pregnancy are not using contraceptives. This results in unintended pregnancies, which increases the risk of unsafe abortions. This study aimed to explore the extent of the unmet need for family planning (FP) among urban and rural married women in Myanmar and their demand for and satisfaction with FP. A cross-sectional survey using adapted Demographic and Health surveys questions was conducted in south and north Yangon from September 2016 to November 2016. A total of 1100 currently married women of 18–49 years participated. The contraceptive prevalence was 67.2% in total, 63% urban, and 70% rural. About 19.4% (95% CI: 16.7%–22.4%) of the studied women had an unmet need for FP, significantly higher in urban than rural women (22.6% versus 16.6%). Rural women also showed significant lesser odds (adjusted OR: 0.63; 95% CI: 0.461–0.849) of unmet need than the urban counterparts. About 86% of the women had demand for contraception and 77% of them satisfied their demand. The study population revealed a fairly good contraceptive coverage; however, a considerable proportion of women had an unmet need for FP, especially the urban women. The demand for contraception is increasing, and contraceptive services need to expand coverage to marginalized groups in order to reduce the risk of unsafe abortions.

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          Unsafe abortion and abortion-related death among 1.8 million women in India

          Introduction Unsafe abortion is a preventable cause of maternal mortality. While studies report high number of abortions in India, the population-level rates of unsafe abortion and their risk factors are not well understood. Our objective was to analyse the rates of and risk factors for unsafe abortion and abortion-related maternal death in India. Methods We conducted a secondary analysis of data from 1 876 462 pregnant women aged 15–58 years from nine states in the Indian Annual Health Survey (2010–2013). We calculated the rate of unsafe abortion and abortion-related mortality with 95% CI. Multivariable logistic regression models examined the associations of sociodemographic characteristics, health seeking behaviours and family planning with unsafe abortion and abortion-related mortality. Results There were 89 447 abortions among 1 876 462 pregnant women in 2007–2011 (4.8%; 95% CI 4.8 to 4.9). Of these, 58 266 were classified as unsafe (67.1%; 95% CI 66.7 to 67.5). There were 253 abortion-related maternal deaths (0.3%; 95% CI 0.2 to 0.3). Factors associated with unsafe abortion: maternal age 20–24 years (adjusted OR (aOR): 1.13; 95% CI 1.09 to 1.18), illiteracy (aOR: 1.48; 95% CI 1.39 to 1.59), rural residence (aOR: 1.26; 95% CI 1.21 to 1.32), Muslim religion (aOR: 1.16; 95% CI 1.12 to 1.22), Schedule caste social group (aOR: 1.08; 95% CI 1.04 to 1.12), poorest asset quintile (aOR: 1.45; 95% CI 1.38 to 1.53), antenatal care (aOR: 0.69; 95% CI 0.67 to 0.72), no surviving children (aOR: 1.30; 95% CI 1.16 to 1.46), all surviving children being female (aOR: 1.12; 95% CI 1.07 to 1.17), use of family planning methods (aOR: 0.69; 95% CI 0.66 to 0.71). Factors associated with abortion-related deaths: maternal age 15–19 (aOR: 7.79; 95% CI 2.73 to 22.23), rural residence (aOR: 3.28; 95% CI 1.76 to 6.11), Schedule tribe social group (aOR: 4.06; 95% CI 1.39 to 11.87). Conclusion Despite abortion being legal, the high estimated prevalence of unsafe abortion demonstrates a major public health problem in India. Socioeconomic vulnerability and inadequate access to healthcare services combine to leave large numbers of women at risk of unsafe abortion and abortion-related death.
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            Dynamics shaping access to reproductive health services in peri-urban Yangon, Myanmar: a multi-methods study

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              Family planning/Contraception

              (2025)

                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                04 October 2019
                October 2019
                : 16
                : 19
                : 3742
                Affiliations
                [1 ]Ministry of Health and Sports, NayPyiTaw 15011, Myanmar; htaythein90@ 123456gmail.com (T.T.H.); anmoemyint@ 123456gmail.com (A.N.M.M.)
                [2 ]Department of Community Medicine and Global Health, University of Oslo, 0318 Oslo, Norway; espen.bjertness@ 123456medisin.uio.no (E.B.); hein.stigum@ 123456medisin.uio.no (H.S.); johanne.sundby@ 123456medisin.uio.no (J.S.)
                [3 ]Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand; ltippawa@ 123456yahoo.com
                Author notes
                [* ]Correspondence: m.m.wai@ 123456medisin.uio.no ; Tel.: +95-9-420-772-196
                Author information
                https://orcid.org/0000-0002-5220-2355
                Article
                ijerph-16-03742
                10.3390/ijerph16193742
                6801744
                31590239
                4f35b417-1b7f-4c7e-9aab-2f6d432faaf9
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 15 September 2019
                : 01 October 2019
                Categories
                Article

                Public health
                contraceptives,unmet need for family planning,demand,satisfaction,urban and rural women

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