Factors associated with the choices of home deliveries in Myanmar: A secondary data analysis of the Demographic Health Survey in Myanmar in 2015-2016 / 国際保健医療

ABSTRACT

Objectives  Maternal and neonatal mortality remains high in Myanmar. Whilst the proportion of deliveries assisted by a skilled birth attendant (SBA) is moderate, the proportion of institutional deliveries is low in Myanmar. Home births have life-threatening risks for mothers and their newborn due to the limited emergency care available at home. This study explores the socio-cultural and maternal health factors, which were associated with mothers’ place of delivery using secondary data.Methods  This study used nationally representative data from the Myanmar Demographic Health Survey (DHS) conducted in 2015-16. The data was obtained from mothers aged 15-49 years with their most recent births in five years preceding the survey (n=3856). A multivariable logistic regression analysis was undertaken, and the adjusted Odds Ratio (aOR) and 95% Confidence Interval (CI) of home deliveries were provided. Results  The study shows that 62% of women in Myanmar delivered at home. The aOR of home deliveries was 6.18 (95% CI 4.17-9.16) for women with no antenatal care (ANC) compared to those with four or more ANC visits, 4.46 (3.19-6.22) for the lowest wealth quintile in comparison with the highest wealth quintile, and 2.94 (2.28-3.80) for women having four or five children relative to women with only one child. The place of residence, women’s educational attainment, women’s and their husbands’ occupations were also associated with the place of delivery. On the other hand, maternal age, husbands’ education levels, women’s media exposure levels and women’s decision-making power were not associated with home deliveries. Conclusion  This study has identified populations which service providers should target to attend for institutional deliveries in Myanmar. It appears necessary to improve accessibility of health services, including ANC, to promote institutional deliveries and have better health outcomes among mothers and their newborn.