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© 2013 Koe Koe Tech and PSI Myanmar, Courtesy of Photoshare Antenatal Care Delivery and postnatal care Other health issues © 2013 Koe Koe Tech and PSI Myanmar, Courtesy of Photoshare

Antenatal Care by Provider Percent distribution of women age 15-49 with a live birth in the five years before the survey 81% of women received ANC from a skilled provider* 81% of mothers receive antenatal care from a skilled provider, with54% receiving antenatal care from a nurse/midwife or lady health visitor *Skilled provider includes doctor, and nurse/midwife, and lady health visitor

Timing of Antenatal Care and Number of Visits 40% of women went to their first ANC visit during the 1st trimester of pregnancy, as recommended. 59% of women had 4 or more ANC visits. 40% of women make their first antenatal care visit during the 1st trimester of pregnancy. 59% of pregnant women make 4 or more ANC visits during their pregnancy.

Components of Antenatal Care Among women age 15-49 who received ANC for most recent birth in the past 5 years, percent receiving the following services: Nearly all women who received ANC for their most recent birth had blood pressure measured (91%). Only about 609% of women had a blood or urine sample taken. 76% were informed about pregnancy complications. 87% of women with a live birth in the last 5 years took iron tablets. Among women age 15-49 with a live birth in the past 5 years, percent who:

Tetanus Toxoid Vaccination 70% of pregnant women received two or more tetanus toxoid injections during their last pregnancy. 72% of last births were protected against neonatal tetanus.

© 2003 Aung Kyaw Moe, Courtesy of Photoshare Antenatal Care Delivery and postnatal care Other health issues © 2003 Aung Kyaw Moe, Courtesy of Photoshare

Place of Delivery Percent distribution of live births in the 5-year period before the survey 37% of births in Myanmar take place in a health facility; 31% in a public facility, 6% in a private facility. 63% of births occur at home. Delivery in a health facility is more common in urban areas (70%) than in rural areas (28%). In rural areas, 72% of births are delivered at home.

Delivery in a Health Facility by Region/State Percent of live births in the 5-year period before the survey delivered in a health facility Myanmar 37% Regionally, health facility-based deliveries range from a low of 15% in Chin to a high of 65% in Yangon.

Assistance during Delivery Percent distribution of live births in the 5-year period before the survey 60% of births were delivered by a skilled provider* 60% of births are delivered by a skilled provider. Doctors assist with 32% of deliveries and Nurses, midwives, or Lady Health visitors assist with 29% of deliveries. TBAs, which are not considered a skilled provider, assist with 29% of deliveries, and auxiliary midwives assist with 6%. *Skilled provider includes doctor, nurse/midwife, and lady health visitor (LHV).

Assistance during Delivery by Region/State Percent of births in the last 5 years that were assisted by a skilled provider Myanmar 60% Regionally, assistance by a skilled provider is lowest in Rakhine and Chin States and high in Yangon and Mandalay regions. *Skilled provider includes doctor, nurse/midwife, and lady health visitor (LHV).

Assistance during Delivery by Education Percent of births in the last 5 years that were assisted by a skilled provider Assistance during delivery increases dramatically with education

Assistance during Delivery by Household Wealth Percent of births in the last 5 years that were assisted by a skilled provider Assistance at delivery also increases with household wealth. Poorest households Wealthiest households

Place of Delivery and Assistance at Delivery in the Region Percent of live births in the 5 years before the survey that received assistance from a skilled provider Myanmar lags behind Cambodia and Pakistan health-facility births, but is ahead of all neighboring countries but Cambodia in skilled assistance at delivery. *Bangladesh is based on the 3 years before the survey

Timing of Postnatal Care (PNC) for Mother and Infant Percent of live births in the 5-year period before the survey 71% of women received postnatal care for their last birth within the first 2 days following delivery. 24% of women had no postnatal checkup. Only 36% of newborns received their first postnatal checkup within 2 days after birth. 60% of newborns did not receive a postnatal checkup.

© 2012 Kyaw Kyaw Winn, Courtesy of Photoshare Antenatal Care Delivery and postnatal care Other health issues © 2012 Kyaw Kyaw Winn, Courtesy of Photoshare

Problems in Accessing Health Care Percent of women age 15-49 who report the following problems in accessing health care for themselves when they are sick: Nearly half of women report having at least one problem accessing health care for themselves. Getting money for treatment and not wanting to go alone are the most frequently cited problems.

Key Findings 81% of women received antenatal care from a skilled provider at least once. 59% had 4+ ANC visits 40% received ANC in first trimester 37% of births were delivered in a health facility. 60% of births were assisted by a skilled provider. 71% of women and 36% of newborns received a postnatal check up within 2 days of birth. 49% of women report at least one problem in accessing health care for themselves when sick.

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.© 2008 Aung Kyaw Tun, Courtesy of Photoshare Vaccination coverage Childhood illness and treatment .© 2008 Aung Kyaw Tun, Courtesy of Photoshare

Basic Vaccinations Children age 12-23 months who have received: BCG Measles 3 doses of DPT (DPT-HepB-Hib) 3 doses of Polio Have received “all basic vaccinations”

Basic Childhood Vaccinations Percent of children age 12-23 months vaccinated Overall, 55% of children age 12-23 months have received all basic vaccinations. 88% of children received the BCG vaccination and 77% are vaccinated against measles. Coverage of the first two doses of the DPT/pentavalent and polio vaccines is relatively high (77% or above); however, only 62% received the third dose of DPT/pentavalent and 67% received the third dose of polio. 8% of children did not receive any vaccination at all. DPT/Pentavalent Polio

Basic Vaccination Coverage Region/State Percent of children age 12-23 months with all basic vaccines Myanmar 55% Regionally, vaccination coverage ranges from a low of 34% in Ayeyarwady to a high of 81% in Mandalay.

Basic Vaccination Coverage in the Region Percent of children age 12-23 months with all basic vaccines Many countries in the region have higher vaccination rates than Myanmar.

© 2007 Kyaw Kyaw Winn, Courtesy of Photoshare Vaccination coverage Childhood illness and treatment © 2007 Kyaw Kyaw Winn, Courtesy of Photoshare

Acute Respiratory Infection (ARI) In the 2 weeks before the survey, 3% of children under 5 were ill with cough and rapid breathing, symptoms of ARI. Among these children, 58% were taken to a health facility or provider for advice or treatment. 43% of these children received antibiotics.

Diarrhea In the 2 weeks before the survey, 10% of children under 5 had diarrhea. Among these children, 54% were taken to a health facility or provider for advice or treatment. During the 2 weeks before the survey, 10% of Myanmar children under 5 had diarrhoea. 54% of children with diarrhoea were taken to a health facility or provider.

Diarrhea Prevalence by Age Percent of children under 5 with diarrhea in the 2 weeks before the survey Diarrhea is most common among children age 12-23 months

Diarrhea Treatment Percent of children under 5 with diarrhea in the 2 weeks before the survey Oral Rehydration Therapy (ORT) Children with diarrhea should drink more fluids, particularly through oral rehydration therapy (ORT). Nearly 7 in 10 children with diarrhea were treated with ORT or increased fluids. However, 14% of children received no treatment from a medical professional or at home.

Feeding Practices during Diarrhea: Liquids Offered Percent distribution of children under 5 who had diarrhea in the 2 weeks before the survey by amount of liquids offered compared with normal practice Recommended Children with diarrhea should receive more liquids than usual. 56% of children with diarrhea were given the same amount of liquid as usual and only 22% were given more.

Feeding Practices during Diarrhea: Foods Offered Percent distribution of children under 5 who had diarrhea in the 2 weeks before the survey by amount of foods offered compared with normal practice Children with diarrhea should receive continued foods as usual. 47% of children with diarrhea were given the same amount of foods as usual and 7% were given more. 56% of children continued feeding and were given ORT and/or increased fluids Overall, 56% of children continued feeding and were given ORT and/or increased fluids, as recommended

Key Findings 55% of children age 12-23 months received all basic vaccinations. 58% of children with symptoms of ARI are taken to a health facility. 54% of children with diarrhoea are taken to a health facility. 68% of children with diarrhoea are given ORT or increased fluids.