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Geographic disparities are an important consideration in the health equity of a country. Understanding regional disparities, the determinants of anemia, and the use of modern contraception by women of reproductive age would help to reduce the anemic burden, unwanted pregnancy, and related deaths. The aim of this study is to determine regional disparities and determinants of anemic health outcomes and use of modern contraception methods by women of reproductive age in Myanmar. The study is a secondary analysis that used cross-sectional data from the 2015-16 Myanmar Demographic and Health Survey. The unit of analysis for the anemic outcome is based on weighted samples of 12,489 eligible women of reproductive age (age 15-49). Analysis of modern contraception use was restricted to a weighted sample of 12,419 women age 15-49 who were not currently pregnant.
The findings show that there are regional disparities in anemia and use of modern contraception within geographical zones, and that the disparities across States and Regions in Myanmar were especially large. Rakhine State in the Coastal zone was the most vulnerable region for anemic disparities (55.4%), while women of Chin State (17.5%) in the Hilly zone and Rakhine State (23%) in the Coastal zone were the least likely to use modern contraception. The determinants for anemia were biological and factors related to pregnancy, and not socioeconomic factors. Determinants of the use of modern contraception methods were region, age, education, marital status, wealth, and number of children. Regional disparities in anemia health outcomes and the low use of modern contraception methods remain major public health problems in Myanmar.
The study recommends qualitative research that would explore food patterns and nutrient contents of households in the assessment of anemia status and cultural perspectives on family planning methods among communities in the different geographic areas. Providing iron tablets for women of reproductive age and all pregnant women would be the easiest, most effective way to prevent anemia in women. Investments in family planning and maternal and child health care services that focus on vulnerable areas in Myanmar would be a better solution for narrowing the geographic disparities in Myanmar.