Family Planning in Asia and the Pacific - International Council on ...

FigureIn Myanmar, birth-spac<strong>in</strong>g projects started only <strong>in</strong>1991 <strong>in</strong> 20 townships, prior to which time differentcontraceptive methods were available only <strong>in</strong> privatepharmacies; permanent family plann<strong>in</strong>g methods for men<strong>and</strong> women are not popular. Birth spac<strong>in</strong>g was exp<strong>and</strong>edto 72 townships <strong>in</strong> 1997 <strong>and</strong> gradually exp<strong>and</strong>ed fur<strong>the</strong>rby 7 townships per year dur<strong>in</strong>g <strong>the</strong> period 2002-2005,until reach<strong>in</strong>g 100 townships. In 2006, birth spac<strong>in</strong>g wasexp<strong>and</strong>ed to 12 additional townships; <strong>in</strong> 2009 <strong>and</strong> 2010,<strong>the</strong> rate of expansion was <strong>in</strong>creased to 10 additionaltownships per year. Currently <strong>the</strong>re are 132 townshipsthat receive UNFPA support out of 325 townships <strong>in</strong> <strong>the</strong>country as a whole.Birth spac<strong>in</strong>g <strong>and</strong> contraceptiveprevalenceUnder <strong>the</strong> 2009-2013 Reproductive Health StrategicPlan, a CPR (for modern methods) of 45 per cent has beenset as a target to be achieved by 2013. CPR for marriedwomen has gradually <strong>in</strong>creased from 37 per cent <strong>in</strong> 2001to 41 per cent <strong>in</strong> 2007, which is still low compared witho<strong>the</strong>r countries <strong>in</strong> <strong>the</strong> region 25 .Nationally, <strong>the</strong> unmet need for contraception has decreasedfrom 20.6 per cent <strong>in</strong> 1991 to 19.1 per cent <strong>in</strong> 1997 <strong>and</strong> 17.7per cent <strong>in</strong> 2007 among married women of reproductiveage (4.9% for spac<strong>in</strong>g <strong>and</strong> 12.8% for limit<strong>in</strong>g) 26 , a slightreduction from 19.1 per cent <strong>in</strong> 1997 (5.8% unmet needfor spac<strong>in</strong>g <strong>and</strong> 13.3% for limit<strong>in</strong>g) 27 . However, unmetneed for contraception may be underestimated <strong>and</strong> couldbe higher if unmarried women were also <strong>in</strong>cluded <strong>in</strong> <strong>the</strong>calculation. The data show that a large proportion ofwomen need or want to use contraceptives but <strong>the</strong>ir needrema<strong>in</strong>s unmet. Thus, birth-spac<strong>in</strong>g commodity provisionshould be exp<strong>and</strong>ed <strong>in</strong> order to reduce MMR <strong>and</strong> enableMyanmar to reach <strong>the</strong> MDG targets. Practical <strong>in</strong>novativemethods <strong>and</strong> youth-friendly strategies need to be applied sothat birth-spac<strong>in</strong>g services could be accessed also by youngpeople, <strong>the</strong> unmarried <strong>and</strong> hard-to-reach populations.Contraceptive methods <strong>and</strong>availabilityMethods of contraception practiced today <strong>in</strong> Myanmar<strong>in</strong>clude “modern” <strong>and</strong> “traditional” methods. The formerrefers to cl<strong>in</strong>ical <strong>and</strong> supply methods, such as voluntarysurgical sterilization, IUDs, oral contraceptives, implants,<strong>in</strong>jectables, condoms <strong>and</strong> vag<strong>in</strong>al barrier methods. The ma<strong>in</strong>traditional or non-supply methods are periodic abst<strong>in</strong>ence<strong>and</strong> withdrawal, as well as traditional folk methods (whichhave uncerta<strong>in</strong> efficacy). 28 The use of contraceptive methodsis usually <strong>in</strong>fluenced by <strong>the</strong> availability of options or <strong>the</strong>methods promoted by <strong>the</strong> family plann<strong>in</strong>g programme ofa country. Birth-spac<strong>in</strong>g services <strong>in</strong> Myanmar are providedthrough both <strong>the</strong> public <strong>and</strong> private sectors.For <strong>the</strong> present report, <strong>the</strong> mix of methods refers to <strong>the</strong>number of contraceptive methods available from whichwomen <strong>and</strong> men may choose. Knowledge of contraceptivemethods <strong>and</strong> sources are among <strong>the</strong> important determ<strong>in</strong>antsFigure5Trends <strong>in</strong> contraceptive prevalence rate <strong>and</strong> unmet need, 1991-200745404135373032,7Percent25201520,616,819,117,817,7Unmet needCPR10501991 1997 2001 2007YearSource: Fertility <strong>and</strong> Reproductive Health Survey, 2007.268