Page 97 - GHES-3-1

Global Health Economics and
Sustainability
Institutional delivery within rural Myanmar

who may prefer traditional practices. Women’s education Conflict of interest
may also empower them to make independent decisions
about seeking and receiving skilled maternal health-care The authors declare that they have no competing interests.
services. Previous studies in Myanmar and Vietnam have Author contributions
documented that women living in extended families were
less likely to opt for institutional delivery (Duong et al., Conceptualization: Aye Sandar Mon
2004; Sein, 2012). Moreover, a lack of birth preparedness Methodology: All authors
contributed to a low institutional delivery rate. Women Formal analysis: Aye Sandar Mon
without birth preparedness were 63% less likely to use Writing – original draft: Aye Sandar Mon
health facilities compared with those with a birth plan. This Writing – review & editing: All authors
finding aligns with a prospective cohort study conducted Ethics approval and consent to participate
in Nepal, which showed that increased birth preparedness
correlated with higher health facility delivery rates (Karkee This study protocol and the final version of written informed
et al., 2013). Similarly, a study conducted in semi-urban consent were approved by the Khon Kaen University Ethics
Ethiopia identified birth preparedness as a significant Committee for Human Research with reference number
predictor of institutional delivery (Rosado et al., 2019). [HE592256] and the Ethical Committee of the University
of Public Health, Yangon, Myanmar (Ethical[6/2016]).
5. Conclusion Permission to conduct this study was attained from local
responsible persons and health authorities. Participation
The provision of information about high-risk pregnancies, in this study was entirely voluntary and informed consent
the importance of birth preparedness, and the benefits of was taken from all participants before the interview. For
institutional delivery should be intensified among rural participants younger than 18 years, consent was obtained
reproductive-aged women, especially those in high-risk age from their respective guardians. All the authors made
groups and those with lower levels of education. Health-care essential contributions and agreed with the present
providers should receive training and resources to support submission.
maternal health education, ensuring that the information
delivered to rural communities is valid, precise, and easily Consent for publication
understood. Given that skilled and adequate ANC is a key Written informed consent was obtained from each study
factor in ensuring quality maternal health, every pregnant participant. The following statement was included in
woman should be informed at every antenatal visit about the information sheet of the informed consent form and
safe motherhood, including the importance of institutional communicated to every study participant: “We will publish
delivery. the results so that other interested people may learn from
The study had some limitations. As the participants the research after deidentification, ensuring your privacy
reported their past experiences and practices, recall bias and confidentiality.”
may have occurred. To minimize this bias, a 2-year recall
period was selected. In addition, this study did not account Availability of data
for the quality of services or satisfaction of rural women The data underlying the results presented in the study are
with the services they received, which are crucial factors available from the corresponding author upon reasonable
for increasing institutional deliveries in rural settings. request.
Further studies are recommended to focus on the quality
of care and satisfaction with institutional delivery among References
rural women in Myanmar. Anyait, A., Mukanga, D., Oundo, G.B., & Nuwaha, F. (2012).
Predictors for health facility delivery in Busia district of
Acknowledgments Uganda: A cross sectional study. BMC Pregnancy and

The health authorities and staff from Magway Regional Childbirth, 12(1):1-9.
Health Division and the University of Community Health, https://doi.org/10.1186/1471-2393-12-132
Magway, are acknowledged for their kind assistance in Berelie, Y., Yeshiwas, D., Yismaw, L., & Alene, M. (2020).
field data collection. Determinants of institutional delivery service utilization in
Ethiopia: A population based cross sectional study. BMC
Funding Public Health, 20(1):1077.
None. https://doi.org/10.1186/s12889-020-09125-2

Volume 3 Issue 1 (2025) 89 https://doi.org/10.36922/ghes.3954