Gender, mosquitos and malaria: implications for community development programs in Laputta, Myanmar.

This paper examines the gender roles linked to division of labor and potential exposure to mosquitos and malaria prevention activities. A "Human Development Initiative" (HDI) Project has been launched in Laputta, a mangrove delta region of Myanmar assisted by United Nations Development Program since 1994. The project aims to improve rural community access to primary health care and provide micro-credit programs, income generation schemes, and educational opportunities as a basis for community empowerment. Women and children of low-income households are the target beneficiaries. Prior to self-care training program and distribution of self-care manuals, altogether 20 focus group discussions (separately assigned to men and women) were conducted in eight study villages between January to February 2000. The primary vector for malaria in study area is Anopheles sundaicus. Rural women were prone to malaria due to exposure to mosquitos within the peak biting period at night because of their gender assigned roles. Both men and women perceived that mosquitos commonly bite before midnight, more at dusk. Lack of awareness of correlation between mosquitos and malaria together with lack of affordability enhance either non-use or shared use of bed-nets at home. Rural women did not consider destruction of breeding places of mosquitos as their major concern. Thus, it is essential for program planners to motivate local women for more active participation in vector control measures within and beyond their households in the context of community development programs.

The use of Moringa oleifera (dan-da-lun) seed for the sedimentation and decontamination of household water Part II: Community-based study

The seeds of Moringa oleifera were tested as clearing and sedimentation agents in household water in Thaung Gyi Lay village with 110 households. Questionnaires were completed for each household and follow-up visits were carried out to ascertain the hypothetical acceptability (attitude), initial acceptability (behaviour) and experimental acceptability. It was observed that 78.9 per cent of the people accepted to use Moringa oleifera seeds if these were easily available. For continuous use of Moringa oleifera seeds, 47.3 per cent wanted to use, 44.7 per cent could not decide and only three households (2.7 per cent) did not want to use these. It was observed that the taste and pH of water did not change after treatment with Moringa oleifera seeds. There was no complaint about the treated water. This study will highlight the acceptance to use Moringa oleifera seeds for the sedimentation of turbid water.

The usefulness of Moringa oleifera (dan-da-lun) seed for the sedimentation and decontamination of turbid water from ponds and revers Part I: Laboratory investigations

The seeds of Moringa oleifera were tested as the clearing and sedimentation agents in tubid water from various sources (1) DMR pond (2) Yangon river (3) Bago River (4) Hline River (5) Hlinethaya Pond (6) artesian well from laydaunkkan and (7) Thanlyin River. the turbidity reduction of 80.00 to 99.5 percent paralled by a primary bacterial reduction of 90.00 to 99.99 per cent were obtained within the first one to two hours of treatment, the bacteria being concentrated in the coagulated sediment. It was observed that 100 mg (one ywe) of the seed powder served as a clearing agent in one litre of turbid water. However, the difference of clearing activity was not significant with different amounts of powder, lwhen 50 mg, 100 mg and 200 mg respectively were used with constant water quantity (one litre) within 24 hours. Moreover, the effect of the seeds could not alter the original pH of the tested water samples. The powder of M. oleifera leaves, bark and roots had no power to clear the turbidity of tested water samples.

Social determinants of induced abortion: A qualitative study

The purpose of the study was to explore the community perceptions of the socio-economic, socio-cultural and socio-psychological determinants of women with induced abortion. Qualitative data was obtained by means of focus group discussions with induced abortion patients admitted to Gynaecological Ward of the North Okkalapa General Hospital. Future sub-grouping of patients with respect to parity and contraceptive usage was done. Content analysis of focus group discussion revealed the following data. Regarding family formation, the best age at first union was 20 years, the desired number of children was two to three and the ideal birth interval two to three years. With respect to family planning, they felt that most pregnancies were unplanned. They were aware of traditional and modern contraceptive methods but most were uncertain of correct methods of usage. Information regarding contraception was obtained mainly from lay persons.

Maternal influences on low birth weight

A total of 2613 babies delivered in North Okkalapa General Hospital (N.O.G.H) during 9 months period from January 1990 to September 1990 were studied with the view to determine maternal influences on low birth weight. Maternal variables assessed and recorded were completed age, parity, height, education, smoking, last birth interval. Fetal variables assessed and recorded were birth weight and gestational age in weeks. The incidence of L.B.W in N.O.G.H during the study period was 21.0 percent, 18.1 percent due to intrauterine growth retardation and 2.9 percent due to preterm. The highest proportion of L.B.W was found in the < 20 years age group, parity one, last birth interval > 3-4 years, maternal height < = 145cm., maternal education 1-4 years and in smoking group. Increased risk and significant association with L.B.W was found among teenage (< 20 years) pregnancies, primiparity, maternal height < = 145 cm, smokers and maternal education < = 8 years. Odds ratio > 1 but no significant association with L.B.W was found among maternal age > 35 years, last birth interval< = 1 year and > 3 years, and parity 5 + groups.

The Cost of Abortion

The cost of abortion in 20 patients with unsafe abortion were compared with 40 patients each of spontaneous abortion and spontaneous vaginal delivery. The mean duration of hospital stay was 1.95 days, 2.8 days and 12.9 days-while antibiotic usage was 52, 82 and 100 percent respectively in normal deliveries, spontaneous abortions and unsafe abortions. Intravenous infusions and blood transfusions were used in 80 percent and 35 percent of unsafe abortion patients. Evacuation of the uterus was performed in 82 percent if spontaneous abortion patients and 35 percent with unsafe abortion while 40 percent of the latter required operative drainage of pus. The cost of unsafe abortion was calculated as expenditure before admission and costs and loss of income during hospitalization. The average total costs bome by patients with unsafe abortion was Kyats 2480/-. Hospital costs for unsafe abortion at Kyats 1431/- were twice as much as the comparison groups.