Dynamics Shaping Access to Reproductive Health Services in Peri-Urban Yangon, Myanmar: A Multi-Methods Study
Bibliographic record
Abstract
PURPOSE: The purpose of our study was to explore and identify the reproductive health needs of women of reproductive age living in peri-urban Yangon, a dynamic series of townships on the periphery of Myanmar’s largest city. Specifically, we sought to identify the availability and accessibility of reproductive health services and products, as well as potential avenues for improving the delivery and accessibility of services. Our overall study focused on maternal health, delivery care, contraception, abortion and post-abortion care. In this paper we focus specifically on the dynamics shaping access to reproductive health services. PRINCIPAL RESULTS: Our findings suggest that barriers to access specific to both urban and rural settings converge in peri-urban Yangon and create significant challenges for service delivery organizations to reach this population, and for this population to reach health care facilities. While contraceptives are relatively affordable and accessible, non-evidence based fears of side effects, including significant and noticeable weight gain, illness, organ damage and infertility, hinder consistent use among peri-urban women. Finally, our findings suggest that unmarried women and young women are largely excluded from reproductive health care and services, and face considerable barriers to access, including discrimination from providers. MAJOR CONCLUSIONS: Our findings illustrate that despite an overarching availability of reproductive health services in peri-urban Yangon, a variety of geographic, socio-economic, information and socio-cultural barriers to access persist and there remains a dearth of services tailored to young and unmarried women. The peri-urban population requires a unique and tailored service delivery approach.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".