Equity of access to reproductive health services among youths in resource-limited suburban communities of Mandalay City, Myanmar.

Phyu Phyu Thin Zaw,Thien Thien Htay,Tippawan Liabsuetrakul,Edward Mcneil

doi:10.1186/1472-6963-12-458

Abstract

BackgroundInequity of accessibility to and utilization of reproductive health (RH) services among youths is a global concern, especially in resource-limited areas. The level of inequity also varies by cultural and socio-economic contexts. To tailor RH services to the needs of youths, relevant solutions are required. This study aimed to assess baseline information on access to and utilization of RH services and unmet needs among youths living in resource-limited, suburban communities of Mandalay City, Myanmar.MethodsA community-based, cross-sectional study was conducted in all resource-limited, suburban communities of Mandalay City, Myanmar. A total of 444 randomly selected youths aged between 15 and 24 years were interviewed for three main outcomes, namely accessibility to and utilization of RH services and youth's unmet needs for these services. Factors associated with these outcomes were determined using multivariate logistic regression.ResultsAlthough geographical accessibility was high (79.3%), financial accessibility was low (19.1%) resulting in a low overall accessibility (34.5%) to RH services. Two-thirds of youths used some kind of RH services at least once in the past. Levels of unmet needs for sexual RH information, family planning, maternal care and HIV testing were 62.6%, 31.9%, 38.7% and 56.2%, respectively. Youths living in the south or south-western suburbs, having a deceased parent, never being married or never exposed to mass media were less likely to access RH services. Being a young adult, current student, working as a waste recycler, having ever experienced a sexual relationship, ever being married, ever exposed to mass media, having a high knowledge of RH services and providers or a high level of accessibility to RH services significantly increased the likelihood of utilization of those services. In addition to youths’ socio-demographic characteristics, exposure to mass media, norm of peer exposure and knowledge on types of providers and services significantly influenced the unmet needs of youths towards RH services.ConclusionDespite the availability of RH services, youth’s accessibility to and utilization of those services were unsatisfactory. The levels of youths’ unmet RH needs were alarmingly high.

Highlights

Inequity of accessibility to and utilization of reproductive health (RH) services among youths is a global concern, especially in resource-limited areas
This study aimed to assess the level of accessibility to, utilization of and unmet needs for RH services and to identify the associated factors with respect to individual, family and various socio-economic characteristics among youths in resource-limited communities in suburban areas of Mandalay City, Myanmar
An RH report from the Ministry of Health, Myanmar, which surveyed three townships during 1991 to 2001, mentioned that the distance and travelling time were not the main barriers of access to RH services whereas financial impoverishment hindered utilization of contraceptives among the poor [32]. These findings indicate that inaccessibility to RH services due to the financial aspects has been present for a decade

Summary

Introduction

Inequity of accessibility to and utilization of reproductive health (RH) services among youths is a global concern, especially in resource-limited areas. Youths, defined as individuals aged between 15 to 24 years, constitute 18% of the world’s population, of which nearly 80% live in developing countries [1]. The stigmatization of premarital sexual relations among young women deters them from seeking information about RH, engaging in safer sex and fulfilling their RH needs [14]. Those disparities of access to RH care affect the individuals and their families, society and health systems as a whole at both national and global levels [15,16]. The inequity of access to RH services between the rich and the poor, and those living in urban and rural areas are a global equity issue of high priority

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