survey report by dr akm version 2
TRANSCRIPT
Dr.Aung Kyaw Myint | AMI survey report 1
EVALUATION REPORT BASED ON A SURVEY
CONDUCTED AT WA SPECIAL REGION (2)
Dr. Aung Kyaw Myint
External Surveyor
AMI
CONTENTS
1. Summary
2. Introduction
3. Objectives
4. Research Methodology
5. Findings
6. Discussion and Conclusion
7. Recommendations
8. References
Dr.Aung Kyaw Myint | AMI survey report 2
EXECUTIVE SUMMARY
One month survey was done in order to explore the social, demographic, and economic
profile of the locality in Wa Special Administrative Region (2). A total of 268 respondents from
27 villages among four townships and 91 school children from three schools were interviewed by
pre-structured, pre-tested interview questionnaires.
It was found that majority of local people had lack of formal education, insufficient
hygienic practice, and are not available, accessible and affordable for government provided
formalized health services. Unqualified health providers such as quacks, traditional birth
attendants are their health care providers and too high out-of-pocket payments for treatment of
illnesses with those non-professionals may lead to catastrophic health expenditures and that may
sink them deeper into poverty.
Although the respondents know and eager to follow healthy habits and hygienic means,
the reverse is true for their practice i.e. their practices were very unhygienic and leading
towards unhealthy behaviors and diseases. But the story was different in school children. School
children know very well about healthy habits, had positive attitude and also had good practices.
In order to improve the standard of living of that local community, just supporting and
strengthening community health network seemed to be not sufficient. Health infrastructures and
strategies should be revised with the aid of local authorities and community participation should
be appraised in order to fulfill the desired objectives.
Dr.Aung Kyaw Myint | AMI survey report 3
INTRODUCTION
AMI is a European international non-profit organization providing humanitarian
assistance in developing countries and currently runs projects in 2 regions in Myanmar:
South Yangon Region in Dala, Seikkyi and Twantay Townships and
Wa Special Administrative Region of Shan State
With the general objective to improve the live standard of the former displaced people and their
host communities in Wa Special Administrative Region (2) by supporting and strengthening the
community health network and to reinforce the involvement of the community in the local health
system since 2001.
In order to access the fulfillment of this objective, a baseline survey was conducted by
survey team lead by an external surveyor on December 2011 to January 2012 (one month). An
internal evaluation report was prepared by external surveyor and was submitted to the
responsible authorities.
Dr.Aung Kyaw Myint | AMI survey report 4
OBJECTIVES
General Objective
To study social and health related characteristics and the knowledge, attitude and practice
of community in Wa SAR 2 on health and hygiene
Specific Objectives
1. To describe the socio-demographic characteristics, environmental sanitation status, health
service utilization and opinion on willingness to pay for health services of respondents
2. To determine the level of knowledge, attitude and practice of respondents and school
children on health and hygiene
3. To find out the association between knowledge, attitude and practice of respondents and
school children on health and hygiene
Dr.Aung Kyaw Myint | AMI survey report 5
RESEARCH METHODOLOGY
Study Design
Community based cross-sectional descriptive study.
Study Population
Household representative (age above 18 years of both sexes) of community residing in
Wa SAR 2
Sample size determination
The following formula will use used for sample size determination.
n = z2 pq
d2
n = Minimum required Sample size
z = reliability coefficient
p = proportion of persons with a good knowledge on health & hygiene
(assumption: 0.75)
q = 1-p (0.25)
d = precision error (0.05)
n = (1.96)2 x 0.75 x 0.25
(0.05)2
= 288.12 300 households
Dr.Aung Kyaw Myint | AMI survey report 6
Sampling Plan
Three-stage random sampling procedure was expected to be practiced as follows:
1st stage- 3 townships from Wa SAR 2 will be chosen at random by fishbowl draw method
2nd
stage- among 3 randomly selected townships, 5 villages in each township will be randomly
chosen to get a total of 15 villages
3rd
stage- 20 households from each village will be randomly chosen to get a total of 300
household samples.
Actual Sampling Procedure
Although planned to conduct three stage random sampling method to be practiced in
order to avoid selection bias, information bias and confounding bias, the difficulties in actual
survey were unfortunately paramount to encounter. First, Wa local authorities did not permit the
survey team to go to the assigned villages in Man Man Hseing (because local authorities were
not at office when survey team ask for permission) Secondly, many assigned villages did not
have enough households for sampling (there were so many villages with only 10 or 11
households). Thirdly, survey team itself was in difficult situation. Most of the staffs’ contracts
with AMI were ended and not refreshed yet. So they were not able to go to survey sites without
signed contracts and survey was delayed. At last, instead of 3 townships, survey team rushed to
collect data from 4 townships, 27 villages. Finally, it is just a convenient sampling due to above
uncontrollable factors and variety of reasons.
Study Area
Townships surveyed
Township Villages Households Ethnicity
Man Man Hseing 3 villages 30 Wa
Naung Khit 1 village 9 Wa
Mong Phen 3 villages 29 Lahu & Akha
Mong Pawk 20 villages 200 Lahu
Dr.Aung Kyaw Myint | AMI survey report 7
Actual number of household surveyed - 268
Schools surveyed
1. Wei Kao Myanmar School –20 students
2. Wei Kao Chinese School - 40 students
3. Mong Pawk Wa Orphan School - 30 students
Detailed surveyed sites
No Sr No Name of village Village tract Township HH
supervised
survey
1 1-9 Man Long Man Long Naung Khit 9 Yes
2 10-19 Nam Par Khar Kon Hein Mong Phen 10 Yes
3 20-29 Par San Kya Wa Pang Mong Phen 10 Yes
4 30-38 Par Khu Par San Kya Mong Phen 9 Yes
5 39-48 Pan Hai Mong Pouk Mong Pouk 10 Yes
6 49-58 Kaung Pet Mong Pouk Mong Pouk 10 Yes
7 59-68 Nam Tim Law Kaw Bar Kaw Mong Pouk 10 Yes
8 69-79 Hwe Lone Tong Fa Mong Pouk 11 Yes
9 80-88 Nam Maung Tai Mong Pouk Mong Pouk 9 Yes
10 89-98 Nan Par Kal Tong Fa Mong Pouk 10 No
11 99-108 Pa Shan Tong Fa Mong Pouk 10 No
12 109-118 Tong Ka Pway Tong Fa Mong Pouk 10 No
13 119-128 Pan Fone Yaung Het Mong Pouk 10 No
14 129-138 Paw Nar Noo Wan Kaung Mong Pouk 10 No
15 139-148 Ar Koo Day Nan Maung Mong Pouk 10 No
16 149-158 Mar Lar Dee Wan Kaung Mong Pouk 10 No
17 159-168 Tong Ji Nam Eu Mong Pouk 10 No
18 169-178 Mon Khan Hou Nam Eu Mong Pouk 10 No
19 179-188 Mong Pouk new village Mong Pouk Mong Pouk 10 No
20 189-198 Wang Kaung Mong Pouk Mong Pouk 10 No
21 199-208 Nar Naw Bar Kaw Mong Pouk 10 No
22 209-218 Po Pay Mong Pouk Mong Pouk 10 No
23 219-228 Paw Kway Mong Pouk Mong Pouk 10 No
24 229-238 Nar Mar Day Bar Kaung Mong Pouk 10 No
25 239-248 Ohm Lone Man Phan
Man Man
Hseing 10 No
26 249-258 Yaung Ou Man Man Hseing
Man Man
Hseing 10 No
27 259-268 Kaung Lone Man Kar
Man Man
Hseing 10 No
Dr.Aung Kyaw Myint | AMI survey report 8
Study period
From December 2nd
week 2011 to January 2nd
week 2012
Data collection method, tools and technique
External surveyor and AMI staffs (including driver) interviewed the respondents with
preformed and pre-tested structured interview questionnaire. Before data collection, first the
team obtained the valid consent from respective respondent for interview.
Data analysis
Data were analyzed by surveyor himself after data entry by Microsoft Excel Spreadsheet.
Then using SPSS version 16.0 and Microsoft Excel, Descriptive analysis was done on socio-
economic and demographic characteristics of respondents by using tables and graphs. KAP data
were described by frequency distribution tables and graphs as necessary. Association between
knowledge, attitude and practice of the respondents as well as school children were determined
by chi-square test with p value <0.05 for significant level.
Overview on Knowledge, Attitude and Practice (KAP) Survey
There are various models and approaches in health behavior research. The most
frequently used studies in health-seeking behavior research is Knowledge, Attitudes and
Practices (KAP) surveys. Knowledge is usually assessed in order to see how far community
knowledge corresponds to biomedical concepts. Typical questions include knowledge about
causes and symptoms of the illness under study.
Attitudes form a more complicated issue. Attitude had been defined by Ribeaux and
Poppleton in 1978 as “a learned predisposition to think, feel and act in a particular way towards a
given object or class of objects”3. As such, attitudes result from a complex interaction of beliefs,
feelings, and values. They are important in designing health promotion campaigns which aim to
change attitude. Attitude may be inferred from a variety of statements and answers, but direct
Dr.Aung Kyaw Myint | AMI survey report 9
asking is usually problematic since people often respond in terms of what they think is the
correct answer. Therefore attitudes are not easy to obtain. However, attitudes are central to
understand behavior, an element which is better acknowledged in cognitive models.
Questions related to practices in KAP surveys usually enquire about the use of preventive
measures or different health care options. Since majority of practice questions are hypothetical,
they therefore hardly permit statements about actual practices. Practice questions usually yield
information on people’s normative behaviors or on what they know should be done or they
expect the interviewer wants to hear4.
KAP surveys yield highly descriptive data but without providing an explanation for why
people do what they do. Many KAP studies are based on the underlying assumption that there is
a direct relationship between knowledge and action. Researchers using this tool assume that by
changing knowledge, behavior is automatically changed as well. This is overtly over-simplistic
becomes clear if one considers that there are many other factors which influence health-seeking
behavior. Although knowledge about an illness may be high, illness recognition during an actual
episode is much less clear. KAP surveys do not consider motivational factors and stigma which
may influence health-seeking behavior. Neglected are other factors like treatment expectations,
satisfaction with health care services, decision making for health care, and external barriers. All
this makes clear that knowledge is just one element in a broad array of factors which determine
health seeking behavior5.
However, on the whole, KAP surveys are very useful for assessing distribution of
community knowledge in large-scale projects and for evaluating changes in knowledge after
education and media campaigns. They permit rapid assessments, yielding quantitative data, and
are therefore a cheap way to gain quick insights into main knowledge data.
Dr.Aung Kyaw Myint | AMI survey report 10
FINDINGS
The analysis was based on the primary source information on knowledge, attitudes and
practices on health and hygiene of community residing in four townships of Wa Special
Administrative Region (2) and school children at three schools by structured interview
questionnaires. A total of 268 respondents and 91 school children participated in this study.
I. DESCRIPTIVE SURVEY
1. Socio-demographic profile of the respondents
1.1. Age of the household heads
The age of the household heads of respective respondents were classified into six age
groups. Frequency and percent distribution of the household heads according to age groups were
described in table 1.
Table 1. Frequency and percent distribution of household heads according to age group
Age group Frequency Percent
18-30 63 24.51
31-43 82 31.91
44-56 81 31.52
57-69 24 9.34
70-82 5 1.95
83-95 2 0.78
Total 257 100.00
257 out of 268 respondents answered the question and the response rate is 95.9%. Age of
the household head ranged between 18 to 90 years with the mean of 42.2 years. About two third
of household heads aged between 31 to 56 years.
Dr.Aung Kyaw Myint | AMI survey report 11
1.2. Gender of the household heads
The number and percentage of household heads according to their gender was described
in table 2.
Table 2. Gender of the household heads
Gender Frequency Percent
Male 202 77.10
Female 60 22.90
Total 262 100.00
262 out of 268 respondents answered the question and the response rate is 97.7%. More
than three-forth of the household heads were male and the remainders were female household
heads.
1.3. Ethnicity of the household heads
Table 3. Frequency and percent distribution of household heads according to ethnicity
Race Frequency Percent
Bamar 1 0.38
Wa 34 12.98
Lahu 215 82.06
Akha 12 4.58
Total 262 100.00
Since 20 out of 27 villages were from Mong Pawk township and are Lahu villages. So
more than 80% of the household heads were Lahu tribes and the remainders were Wa, Akha and
Bamar respectively.
Dr.Aung Kyaw Myint | AMI survey report 12
1.4. Education status of the household heads
Educational status was classified into six groups. The results were as follows.
Table 4. Frequency and percent distribution of household heads according to education
Education Frequency Percent
Illiterate 200 76.6
Just read & write 29 11.1
Monastery education 25 9.6
Primary school 3 1.1
Secondary school 2 0.8
High school 1 0.4
College/university 1 0.4
Total 261 100.0
Figure 1. Bar chart of household heads’ educational status
76.6
11.1
9.6
1.1
0.8
0.4
0.4
0.0 20.0 40.0 60.0 80.0 100.0
Illiterate
Just read & write
Monestry education
Primary school
Secondary school
High school
Colleage/university
Dr.Aung Kyaw Myint | AMI survey report 13
More than three-fourths of household heads were illiterates and total of seven household heads
out of 261 had formal school experiences. 11% of household heads confessed that they were
merely literates but just able to read and write but the source of their education was unknown.
1.5. Occupation of the household heads
Occupations of the household heads were declared by the respondents by their own
words. Those were categorized and presented in table 5 and figure 2 respectively.
Table 5. Frequency and percent distribution of household head according to occupation
Occupation Frequency Percent
Farmer 243 92.75
Rubber plant worker 10 3.82
Soldier 4 1.53
Preacher 4 1.53
Policeman 1 0.38
Total 262 100.00
Figure 2. Bar chart showing occupation of household heads
More than 90% of household heads were said-to-be farmers. Minority of the household
heads were rubber plantation workers, local soldiers, policeman and preachers.
92.75
3.82 1.53 1.53 0.380.00
10.00
20.00
30.00
40.00
50.00
60.00
70.00
80.00
90.00
100.00
Farmer Rubber plant worker
Soldier Preacher Policeman
Dr.Aung Kyaw Myint | AMI survey report 14
1.6. Age of the respondents
Ages of the respondents were also categorized into six groups. Age range between 18 to
90 years and mean age was 39.8 years.
Table 6. Frequency and percent distribution of respondents according to age group
Respondent age group Frequency Percent
18-30 84 31.82
31-43 78 29.55
44-56 79 29.92
57-69 17 6.44
70-82 5 1.89
83-95 1 0.38
Total 264 100.00
Nearly one-third of the respondents aged between 18 to 30 years and almost all were in
working age group (18 to 56 years).
1.7. Gender of the respondents
Table 7. Frequency and percent distribution of respondents according to gender
Respondent gender Frequency Percent
Male 127 47.39
Female 141 52.61
Total 268 100.00
Male respondents accounted for 47% whereas female respondents were 53%.
Dr.Aung Kyaw Myint | AMI survey report 15
Figure 3. Pie chart showing sex distribution among respondents
1.8. Ethnicity of the respondents
Table 8. Frequency and percent distribution of respondents according to ethnicity
Respondent ethnicity Frequency Percent
Wa 40 14.93
Lahu 218 81.34
Shan 1 0.37
Akha 9 3.36
Total 268 100.00
Like their household heads, majority of the respondents were Lahu tribes and there was
no bamar among the respondents.
47.39
52.61
Male
Female
Dr.Aung Kyaw Myint | AMI survey report 16
1.9. Education of the respondents
Table 9. Frequency and percent distribution of respondents according to their education
Respondents' education Frequency Percent
Illiterate 201 75.0
Just read & write 30 11.2
Monastery education 24 9.0
Primary school 2 0.7
Secondary school 8 3.0
High school 2 0.7
College/university 1 0.4
Total 268 100.0
Figure 4. Bar chart of respondents’ education
75% of the respondents were illiterates. Nearly 20% were just able to read and/or just had
experiences of monastery education.
75.0
11.2
9.0
0.7
3.0
0.7
0.4
0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0
Illiterate
Just read & write
Monestry education
Primary school
Secondary school
High school
Colleage/university
Dr.Aung Kyaw Myint | AMI survey report 17
1.10. Occupation of the respondents
Current occupation of the respondents was asked and self declared occupations were
recorded. The results were as follows;
Table 10. Frequency and percent distribution of respondents by their occupation
Respondents' occupation Frequency Percent
Farmer 250 93.28
Rubber plant worker 10 3.73
Teacher 1 0.37
No response 7 2.61
Total 268 100.00
More than 90% of the respondents answered that they are farmers. The vast minority
were rubber plant workers and a teacher. But about 3% of the respondents refused to answer the
question.
Figure 5. Bar diagram for respondents’ occupation
1.11. Household size
Average household size of respondent was 5.8 members per household with averages of
male 1.64, female 1.6 and children 2.8 members.
0.00 20.00 40.00 60.00 80.00 100.00
Farmer
Rubber plant worker
Teacher
No response
93.28
3.73
0.37
2.61
Dr.Aung Kyaw Myint | AMI survey report 18
2. Environmental Sanitation
2.1. Type of housing
Housing pattern of the respondents were observed & recorded by survey team. Table 11
and figure 6 showed the results.
Table 11. Frequency distribution of housing patterns
Type of house Frequency Percent
Brick 1 0.37
Wood with zinc roof 116 43.28
Wood with palm roof 43 16.04
Bamboo houses with palm roof 107 39.93
Bamboo houses with plastic sheet roof 1 0.37
Total 268 100.00
Figure 6. Housing patterns
43% of houses were wooden houses with zinc roofs. Nearly 40% were bamboo houses
(huts) with palm roofs.
0.37
43.28
16.04
39.93
0.37
0.00 10.00 20.00 30.00 40.00 50.00
Brick
Wood with zinc roof
Wood with palm roof
Bamboo house with palm roof
Bamboo house with plastic sheet roof
Dr.Aung Kyaw Myint | AMI survey report 19
2.2. Water
2.2.1. Sources of drinking water
Table 12. Frequency distribution of respondent according to their drinking water sources
Drinking water source Frequency Percent
Mountain stream 226 84.33
Lake water 19 7.09
Well 11 4.10
Artificial water reservoir 10 3.73
River water 2 0.75
Total 268 100.00
Figure 7. Diagrammatic presentation of table 12
Majority of the respondents used mountain streams as their drinking water and the
remainders used lake water, well water, water from artificial reservoirs and river water as well.
0.00
10.00
20.00
30.00
40.00
50.00
60.00
70.00
80.00
90.00
Mountain stream
Lake water Well Artificial water
reservoir
River water
84.33
7.09 4.10 3.73 0.75
Dr.Aung Kyaw Myint | AMI survey report 20
2.2.2. Sources of domestic (usable) water
Table 13. Frequency distribution of respondent according to their domestic water sources
Domestic water source Frequency Percent
Mountain stream 225 83.96
Lake water 19 7.09
Well 11 4.10
River water 8 2.99
Artificial water reservoir 5 1.87
Total 268 100.00
Figure 8. Sources of domestic water
It was found that there is no significant difference among drinking water and domestic
water sources. Almost all respondents answered that their domestic and drinking water source
was mountain stream water. The answer was almost the same in every villages regardless of
different townships.
0.00
10.00
20.00
30.00
40.00
50.00
60.00
70.00
80.00
90.00
Mountain stream
Lake water Well River water Artifical water
reservoir
83.96
7.09 4.10 2.99 1.87
Dr.Aung Kyaw Myint | AMI survey report 21
2.2.3. Purification of drinking water
The respondents were asked whether they purified the drinking water or not. The results
were as follows;
Table 14. Frequency distribution table for drinking water purification
Water purification Frequency Percent
Purified before drink 36 13.43
No purified before drink 232 86.57
Total 268 100.00
Figure 9. Donut chart showing drinking water purification status
Very small proportion of respondents answered that they purified their drinking water
and the majority remainders never purified their drinking water by any means. But water
purification methods among the purifiers were not explored.
13%
87%
Purified before drink
No purified before drink
Dr.Aung Kyaw Myint | AMI survey report 22
2.3. Excreta
The respondents were asked as well as the survey team observed whether their household
had latrine or not.
Table 15. Frequency and percent distribution of household according to their latrine status
Latrine Frequency Percent
Latrine present 99 36.94
Latrine absent 169 63.06
Total 268 100.00
Figure 10. Pie chart for latrine status
Only one-third of the household surveyed possessed the latrine and two-thirds of the
household had no latrine. Among the households with latrine, type and sanitary status of their
latrine had been observed by survey team and the results were shown as follow:
Table 16. Type of latrine
Type of latrine Frequency Percent
Indirect pit latrine 68 68.69
Direct pit latrine 31 31.31
Total 99 100.00
37%
63%
Latrine present
Latrine absent
Dr.Aung Kyaw Myint | AMI survey report 23
Figure 11. Donut diagram for table 16
Table 17. Sanitary status of the latrine
Sanitary status of latrine Frequency Percent
Sanitary 57 57.58
Non-sanitary 42 42.42
Total 99 100.00
Figure 12. Pie chart for sanitary status of the latrine
68.69
31.31
Indirect pit latrine
Direct pit latrine
58%
42%
Sanitary
Non-sanitary
Dr.Aung Kyaw Myint | AMI survey report 24
57% of latrines were sanitary and the remainders were non-sanitary according to the
criteria of fly proof, odour free and privacy standards.
The respondents without latrine were again asked for the reasons of absentee. Their
answers were complied as follows;
Table 18. Reasons for absence of latrine
Reasons for absence of latrine Frequency Percent
Used to open air defecation 91 53.85
No money for latrine 60 35.50
Lack of space 6 3.55
Use public toilet 3 1.78
No time to build 3 1.78
No response 6 3.55
Total 169 100.00
Figure 13. Reasons for absence of latrine
0.00 10.00 20.00 30.00 40.00 50.00 60.00
Used to open air defecation
No money for latrine
Lack of space
Use public toilet
No time to build
No response
53.85
35.50
3.55
1.78
1.78
3.55
Dr.Aung Kyaw Myint | AMI survey report 25
2.4. Pest activity
Pest is a troublesome animals or things those can deteriorate human health such as
mosquitoes, flies, flees, bugs, ticks and mites. The survey team asked the respondents about pest
activity in their houses but no time to observe the actual pest activity among the households. The
answers were categorized and were presented in table 19 and figure 14.
Table 19. Pest activity
Pest activity Frequency Percent
Absent 24 8.96
Mild 165 61.57
Moderate 70 26.12
Plenty 5 1.87
No response 4 1.49
Total 268 100.00
Figure 14. Bar chart showing pest activity
0.00
10.00
20.00
30.00
40.00
50.00
60.00
70.00
Absent Mild Moderate Plenty No response
8.96
61.57
26.12
1.87 1.49
Dr.Aung Kyaw Myint | AMI survey report 26
3. Maternal and Child Health
Table 20. Frequency and percent distribution of current pregnancies in the households of the
respondents
Current pregnancy in family Frequency Percent
Present 16 5.97
Absent 250 93.28
No response 2 0.75
Total 268 100.00
Table 21. Township analysis regarding current pregnancy
Township Current pregnancy Present Current Pregnancy Absent
Naung Khit 1 (11.1%) 8 (88.9%)
Mong Phen 0 (0%) 48 (100%)
Man Man Hseing 4 (13.3%) 26 (86.7%)
Mong Pawk 11 (5.5%) 189 (94.5%)
About 6 % of the respondents answered that there were pregnant women currently
present in their families. Proportions of pregnancy per townships are shown in above table. Then
the respondents were asked furthermore about maternal death in their family.
Table 22. Frequency and percent distribution of maternal death within 1 year
Maternal death in family Frequency Percent
Present 9 3.36
Absent 253 94.40
No response 6 2.24
Total 268 100.00
Academically maternal death is defined as the death of mother during pregnancy,
delivery or in puerperium (6 weeks after delivery) due to either direct or indirect obstetric related
causes among their families. However the question here was just asking is there any maternal
death within your family? and there are no further clarification in the question. So it was not
Dr.Aung Kyaw Myint | AMI survey report 27
appropriate to calculate maternal mortality rate based on this finding. Here 3.36% of the
respondents answered that there were maternal death in their families within the past 12 months
but it cannot be interpreted like MMR in surveyed area was found to be 33.6 per 1000 live births.
The respondents were asked also about any death of under 5 children in their households within
one year and their answers were as follows.
Table 23. Frequency and percent distribution of under 5 death within 1 year
Under 5 death in family Frequency Percent
Present 98 36.57
Absent 168 62.69
No response 2 0.75
Total 268 100.00
One-third of the respondents admitted that there were deaths of under 5 children within
their families. Those respondents were asked again about the causes of those deaths.
Table 24. Frequency and percent distribution of causes of under 5 death
Causes of U5MR Frequency Percent
Fever & ARI 26 26.53
Unknown cause 18 18.37
Neonatal death 17 17.35
Vomiting & diarrhea 13 13.27
Starving 6 6.12
Malaria 3 3.06
Generalized spasm (tetanus?) 3 3.06
Chronic disease 4 4.08
Measles 2 2.04
Accident 1 1.02
Anaphylactic shock 1 1.02
Drowning 1 1.02
Worm infestation 1 1.02
Oedema 1 1.02
Premature birth 1 1.02
Total 98 100.00
Dr.Aung Kyaw Myint | AMI survey report 28
It was found that ARI, diarrhea and starving (malnutrition) accounted for most frequent
causes of death of under five children.
Regarding Ante-Natal Care (ANC), the respondents were asked about any ANC for
pregnant women in their families and households.
Table 25. Frequency and percent distribution of ANC
ANC during pregnancy Frequency Percent
ANC received 140 52.24
ANC not received 101 37.69
No response 27 10.07
Total 268 100.00
Figure 15. Bar diagram for percent distribution of ANC
According to their response, only 52% of pregnant women received Ante-Natal Care and
about 37% had no ANC during their pregnancies.
The respondents who answered yes to ANC were asked again for identification of service
provider in ANC. The results were:
0.00
10.00
20.00
30.00
40.00
50.00
60.00
ANC received ANC not received No response
52.24
37.69
10.07
Dr.Aung Kyaw Myint | AMI survey report 29
Table 26. Service provider of ANC
Service provider for ANC Frequency Percent
AMI health personals 89 63.57
AMW 28 20.00
MCH mobile teams 8 5.71
VHV 6 4.29
Hospital 4 2.86
Private Clinic 2 1.43
No response 3 2.14
Total 140 100.00
Figure 16. Service provider of ANC
63% responded that ante-natal service provider was AMI health personals. They just said
AMI health personals and no further clarification about that statement. Another 20% admitted
that their ANC provider was auxiliary mid-wife (Also AMI trained). Others ANC providers were
AMI mobile MCH teams, village health volunteers, hospital and private clinic respectively. So it
can be said that almost all ante-natal care in that locality were covered by AMI.
But when the respondents were asked about the accuchers who delivered the last baby in
the family, the responses were varied.
63.57
20.00
5.71
4.29
2.86
1.43
2.14
0.00 10.00 20.00 30.00 40.00 50.00 60.00 70.00
AMI health personals
AMW
MCH mobile teams
VHV
Hospital
Private Clinic
No response
Dr.Aung Kyaw Myint | AMI survey report 30
Table 27. Type of accuchers in last child birth
Accuchers in last child birth Frequency Percent
TBA 74 34.26
Neighbors 41 18.98
Husband 39 18.06
Self 36 16.67
Relatives 11 5.09
Parents 8 3.70
Hospital 4 1.85
VHV 2 0.93
Doctor 1 0.46
Total 216 100.00
Figure 17. Type of accuchers
Traditional Birth Attendants (TBA) delivered about one-third of the last births. TBA are
the persons who are used to deliver the baby in Myanmar villages. In areas covered by formal
public health sector, TBAs are trained by basic health staffs such as lady health visitors and mid-
wives. Here the respondents just answered TBA and it was unclear that whether that TBA was
trained or un-trained. It was followed by non-trained accuchers: delivered by neighbors, husband
and self accounted for nearly half of the births. Neither of the respondents said that their last
baby was delivered by AMW or AMI health personals.
0.00
5.00
10.00
15.00
20.00
25.00
30.00
35.0034.26
18.98 18.0616.67
5.093.70
1.85 0.93 0.46
Dr.Aung Kyaw Myint | AMI survey report 31
Regarding exclusive breast feeding, the respondents’ answers were;
Table 28. Frequency distribution of exclusive breast feeding
Exclusive breast feeding Frequency Percent
EBF done 228 85.07
EBF not done 15 5.60
No response 25 9.33
Total 268 100.00
EBF is the type of breast feeding as soon as the baby born up to 6 months only breasts
milk and no other fluid. 85% of the respondents answered mother practiced exclusive breast
feeding habit to new born in their families.
Table 29. Child morbidity in the family within one year
Child Morbidity Frequency Percent
Yes 251 93.66
No 17 6.34
Total 268 100.00
Figure 18. Pie diagram for child morbidity
94%
6%
Yes
No
Dr.Aung Kyaw Myint | AMI survey report 32
Regarding childhood illness mainly under fives’ illnesses, 94% of respondent said that
there were varieties of childhood illnesses within their families within one year. 6% denied that.
There are only question whether childhood illness present or not and no further clarification
about type of illnesses. Then the respondents were asked how they response to common health
problems such as diarrhea, malaria, ARI and malnutrition. The responses were then categorized
and presented. Those are the chronological categorization of community responses verbatim and
no technical categorizations are used here.
Table 30. Community responses for diaorrhoea
Treatment for diarrhea Frequency Percent
Go to VHV 122 45.52
No idea at all 63 23.51
Buy drug from pharmacy 35 13.06
Go to AMW 20 7.46
ORS 17 6.34
Traditional medicine 5 1.87
Go to AMI RHC 4 1.49
Go to clinic 1 0.37
Go to hospital 1 0.37
Total 268 100.00
Figure 19. Diagrammatic presentation of table 30
0.005.00
10.0015.0020.0025.0030.0035.0040.0045.0050.00 45.52
23.51
13.067.46 6.34
1.87 1.49 0.37 0.37
Dr.Aung Kyaw Myint | AMI survey report 33
Table 31. Community responses for malaria
Treatment for malaria Frequency Percent
No idea at all 141 52.61
Go to VHV 46 17.16
Buy drug from pharmacy 35 13.06
Go to AMW 11 4.10
Go to HU clinic 8 2.99
Traditional medicine 8 2.99
Blood for MP 7 2.61
Quack treatment 4 1.49
Go to clinic 3 1.12
Go to hospital 3 1.12
Do matkalung 2 0.75
Total 268 100.00
Table 20. Diagrammatic presentation of table 31
0.00
10.00
20.00
30.00
40.00
50.00
60.00 52.61
17.1613.06
4.10 2.99 2.99 2.61 1.49 1.12 1.12 0.75
Dr.Aung Kyaw Myint | AMI survey report 34
Table 32. Community responses for ARI
Treatment for ARI Frequency Percent
Go to VHV 105 39.18
No idea at all 88 32.84
Buy drug from pharmacy 32 11.94
Go to AMW 18 6.72
Matkalung 11 4.10
Treat with Amoxicillin 9 3.36
Traditional medicine 5 1.87
Total 268 100.00
Figure 21. Diagrammatic presentation of table 32
0.005.00
10.0015.0020.0025.0030.0035.0040.00
39.18
32.84
11.946.72
4.10 3.36 1.87
Dr.Aung Kyaw Myint | AMI survey report 35
Table 33. Community responses for malnutrition
Treatment for malnutrition Frequency Percent
No idea at all 196 73.13
Go to VHV 39 14.55
Go to AMW 11 4.10
Buy drug from pharmacy 8 2.99
Feeding 6 2.24
Go to Chinese clinic 5 1.87
HE 3 1.12
Total 268 100.00
Figure 22. Diagrammatic presentation of table 33
Regarding those health problems, most common community responses were do nothing
(no idea at all) and go to VHV for some treatment and self treatment (buy drug from pharmacy).
Here pharmacy means local drug stores with or without qualified pharmacist. Actually it means
self medication or self treatment. And quack means local unqualified persons who treat variety
of illnesses of community with some charges. Matkalung is traditional Chinese way of treatment
of fever by scraping the skin with some sharp instruments.
0.0010.0020.0030.0040.0050.0060.0070.0080.00
73.13
14.554.10 2.99 2.24 1.87 1.12
Dr.Aung Kyaw Myint | AMI survey report 36
4. Health services and Health Care Utilization
Are there any formal (permanent) health center providing reliable health services in that
region? It means are there any government health services in their locality and community
response for above question is as follows:
Table 34. Availability of formal health services
Formal HC service in your area Frequency Percent
Present 14 5.22
Absent 254 94.78
Total 268 100.00
Figure 23. Donut chart for availability of health services
Only 5% of the respondent said that their locality had formalized health services. The
vast majority responded that they had no formal health services in their residing areas. Then in
order to know is health care accessible to them? The respondents were asked about estimated
duration (distance) to access health care.
5%
95%
Present
Absent
Dr.Aung Kyaw Myint | AMI survey report 37
Table 35. Access to health care
Estimated duration to access HC Frequency Percent
1-4 hour walk 122 45.52
4-8 hour walk 62 23.13
8-12 hour walk 23 8.58
12-24 hour walk 10 3.73
No response 51 19.03
Total 268 100.00
Figure 24. Bar diagram for health care access
Nearly half of the respondent answered they had to walk at least 1 to 4 hours in order to
get health services and nearly 20% did not response that question.
Who is your reliable health care provider? Personal opinion of the respondents in
response to this question by following fashion:
0.00 10.00 20.00 30.00 40.00 50.00
1-4 hour walk
4-8 hour walk
8-12 hour walk
12-24 hour walk
No response
45.52
23.13
8.58
3.73
19.03
Dr.Aung Kyaw Myint | AMI survey report 38
Table 36. Reliable health care provider
Reliable HC provider Frequency Percent
VHV 139 51.87
AMW 41 15.30
Medical doctor 35 13.06
AMI staff 19 7.09
Traditional healer 18 6.72
Quack 6 2.24
Self treatment 6 2.24
BHS 4 1.49
Total 268 100.00
Figure 25. Bar diagram for reliable health care provider
Village health volunteers ranked first (51%). It was followed by auxiliary mid-wife
(15%), medical doctors (13%), AMI medical staffs (7%). Minority still relied on traditional
healers and quacks. 2% answered that self treatment is more reliable.
Is there any illness episode in your household within past 12 months? The answers to
those questions were as follows:
0.00 10.00 20.00 30.00 40.00 50.00 60.00
VHV
AMW
Medical doctor
AMI staff
Traditional healer
Quack
Self
BHS
51.87
15.30
13.06
7.09
6.72
2.24
2.24
1.49
Dr.Aung Kyaw Myint | AMI survey report 39
Table 37. Illness within past 12 months
Illness during past 12 months Frequency Percent
Yes 188 70.15
No 74 27.61
Don't know 6 2.24
Total 268 100.00
Figure 26. Pie chart for illness within past 12 months
70% of the respondents said that there were varieties of illnesses in their household
(family) during past 12 months in one of their family members. How did they response to those
illnesses?
70%
28%
2%
Yes
No
Don't know
Dr.Aung Kyaw Myint | AMI survey report 40
Table 38. Response to illnesses
Response to illness Frequency Percent
AMW treatment 73 38.83
Quack treatment 38 20.21
VHV treatment 29 15.43
Buy drug from pharmacy (Self treatment) 19 10.11
Private clinic treatment 13 6.91
AMI treatment 10 5.32
Do not treat 5 2.66
Hospital treatment 1 0.53
Total 188 100.00
Figure 27. Bar diagram for responses to illnesses
38% were treated by auxiliary mid-wife and 15% by village health volunteers. 20% were
treated by quacks and 10% were treated by buying drugs from pharmacy.
Paying for health care by what mechanism? 151 respondents answered that they had to
pay by themselves (out-of-pocket payment) for health care. Total costs of health care in those
respondents were 191298 Chinese Yuan with an average of 1266 Yuan. The details of the cost of
health care per household were shown in data master sheet. Cost groups for paying health care
are as follows:
0.005.00
10.0015.0020.0025.0030.0035.0040.00
38.83
20.2115.43
10.116.91 5.32
2.66 0.53
Dr.Aung Kyaw Myint | AMI survey report 41
Table 39. Paying for health care for one episode of illness per year per household
Cost group (Chinese Yuen) Frequency Percent
10-500 77 50.99
550-1000 35 23.18
1050-2000 15 9.93
2050-3000 6 3.97
3050-4000 11 7.28
5000-20000 7 4.64
Total 151 100.00
Figure 28. Bar chart of paying for health care
Table 40. Mortality within one year
Mortality within one year Frequency Percent
Yes 24 8.96
No 244 91.04
Total 268 100.00
About 9% of the respondents had some mortality in their families but majority denied any
mortality within one year.
0.00 10.00 20.00 30.00 40.00 50.00 60.00
10-500
550-1000
1050-2000
2050-3000
3050-4000
5000-20000
50.99
23.18
9.93
3.97
7.28
4.64
Dr.Aung Kyaw Myint | AMI survey report 42
5. Satisfaction and willingness to pay for health care
Table 41. Satisfaction of currently available health services
Satisfaction of current health services Frequency Percent
Satisfied 237 88.43
Not satisfied 31 11.57
Total 268 100.00
Figure 29. Pie diagram for table 41.
88% of respondents satisfied the health services currently available but 12% did not. It
can be said that although currently available health services are poor, the respondents satisfied it
but the exact reason for this answer is unknown.
Table 42. Reasons for non-satisfaction
Reason of non-satisfaction Frequency Percent
Not enough drugs 7 22.58
Not enough services 3 9.68
No service at all 4 12.90
Useless VHV 2 6.45
Not relieve symptoms 4 12.90
Costly 2 6.45
No comment 9 29.03
Total 31 100.00
88%
12%
Satisfied
Not satisfied
Dr.Aung Kyaw Myint | AMI survey report 43
Figure 30. Bar diagram for table 42
Then the respondents were asked if they satisfied, are they willing to pay for the cost of
health care or not.
Table 43. Willingness to pay
Willing to pay for health service Frequency Percent
Yes 252 94.03
No 16 5.97
Total 268 100.00
0.00
5.00
10.00
15.00
20.00
25.00
30.0022.58
9.6812.90
6.45
12.90
6.45
29.03
Dr.Aung Kyaw Myint | AMI survey report 44
Figure 31. Donut chart for willingness to pay
94% of respondent willing to pay for health services if they satisfied but 6% did not have
such willingness. Those respondents who willing to pay were asked again for what kind of health
services they want to pay:
Table 44. Type of services willing to pay
Type of service willing to pay Frequency Percent
Curative 89 35.3
Preventive 84 33.3
Promotive 68 27.0
Rehabilitative 1 0.4
Transport 7 2.8
All 3 1.2
Total 252 100.0
94%
6%
Yes
No
Dr.Aung Kyaw Myint | AMI survey report 45
Figure 32. Bar diagram for willingness to pay
One-third of the respondents wanted to pay for curative service. 60% wanted to pay for
preventive and promotive services. About 3% responded that they wanted to pay for transport
service not health services.
Regarding the type of health care provider those they willing to pay, the responses were
categorized in table 45 as well as in figure 33.
Table 45. Type of health care provider willing to pay
Type of HC provider willing to pay Frequency Percent
Doctor 95 37.70
VHV 77 30.56
AMW 43 17.06
Traditional healer 22 8.73
Any service provider 15 5.95
Total 252 100.00
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
40.0 35.333.3
27.0
0.42.8
1.2
Dr.Aung Kyaw Myint | AMI survey report 46
Figure 33. Bar chart for table 45
37% responded that they are willing to pay doctors for their services and 5% said that
they are ready to pay for any health service providers who are responsible for their health.
Regard cash amount they are willing to pay for health care provider per illness episode,
the respondents’ answers were categorized as follows;
Table 46. Amount willing to pay per illness episode
Amount willing to pay per illness episode (Chinese Yuen) Frequency Percent
1-100 111 50.5
101-1000 12 5.5
As much as it cost 52 23.6
As much as they can 38 17.3
Half of actual cost 3 1.4
Negotiated price 2 0.9
Will pay if cure 1 0.5
Will pay food not money 1 0.5
Total 220 100.0
0.00 5.00 10.00 15.00 20.00 25.00 30.00 35.00 40.00
Doctor
VHV
AMW
Traditional healer
Any service provider
37.70
30.56
17.06
8.73
5.95
Dr.Aung Kyaw Myint | AMI survey report 47
Figure 34. Amount willing to pay
Half of the respondents said that they are willing to pay up to 100 Chinese Yuen to health
care provider per illness episode. 23% responded that they are ready to pay as much as it cost
and 17% wanted to pay as much as they can.
0.0
10.0
20.0
30.0
40.0
50.0
60.0 50.5
5.5
23.617.3
1.4 0.9 0.5 0.5
Dr.Aung Kyaw Myint | AMI survey report 48
II. KAP SURVEY
A total of 268 respondents were asked about very simple questions regarding health and
hygiene in order to access their knowledge, attitude and practice. There were 16 questions each
for knowledge, attitude and practice. Attitude score were set as Likart Scale. Since the questions
were very simplified, full scores for knowledge was 32, for attitude was 64 and for practice was
36 points. Less than 29, 46 and 29 points were assumed to be said that their knowledge, attitude
and practice are risky for health and hygiene. Questionnaires for knowledge, attitude and
practices are attached in the annex. Overall KAP scores can be calculated but KAP scores for
each township can’t neither be analyzed nor compared because of disproportionate sample size
among townships.
1. Overall knowledge scores
Table 47. Knowledge scoring
Knowledge Frequency Percent
Low (Score 1 to 29) 24 8.96
High (Score 30-32) 244 91.04
Total 268 100.00
Figure 35. Pie diagram for knowledge score
9%
91%
Low (Score 1 to 29)
High (Score 30-32)
Dr.Aung Kyaw Myint | AMI survey report 49
91% of respondents were regarded as they have high (sound) knowledge about health and
hygiene and only 9% of respondents had low knowledge.
2. Overall attitude scores
Table 48. Attitude scoring
Attitude Frequency Percent
Bad (28-46) 96 35.82
Good (47-64) 172 64.18
Total 268 100.00
Figure 36. Pie diagram for attitude scoring
64% of respondents had good (positive attitude) whereas 36% had bad or negative
attitude concerning health and hygiene habit.
36%
64%Bad (28-46)
Good (47-64)
Dr.Aung Kyaw Myint | AMI survey report 50
3. Overall practice scores
Table 49. Practice scoring
Practice Frequency Percent
Bad practice (16-29) 240 89.55
Good practice (30-36) 28 10.45
Total 268 100.00
Figure 37. Pie chart for practice scoring
Contrary to knowledge and attitude, 90% of the respondents had bad practice on health
and hygiene where only 10% practicing good health habits.
90%
10%
Bad practice (16-29)
Good practice (30-36)
Dr.Aung Kyaw Myint | AMI survey report 51
4. Association between knowledge and attitude of the respondents
Table 50. Association between knowledge and attitude
Total knowledge
score
Total attitude score Total
Bad Good
Low 14 (58.3%) 10 (41.7%) 24 (100%)
High 82 (33.6%) 162 (66.4%) 244 (100%)
Total 96 (35.8%) 172 (64.2%) 268 (100%)
2= 62.270 df=1 p=0.000
Figure 38. Association between knowledge and attitude
It was found that the respondents who had higher knowledge on health and hygiene
habits had more positive attitude on health and hygiene than the respondents who had lower
knowledge (there is strong association between knowledge and attitude) and the results were
statistically significant.
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
90.0
100.0
Low knowledge High knowledge
58.3
33.6
41.7
66.4
Good attitude
Bad attitude
Dr.Aung Kyaw Myint | AMI survey report 52
5. Association between knowledge and practice of the respondents
Association between knowledge and practice of the respondents was shown in following
table and figure.
Table 51. Association between knowledge and practice
Total knowledge
score
Total practice score Total
Bad Good
Low 23 (95.8%) 1 (4.2%) 24 (100%)
High 217 (88.9%) 27 (11.1%) 244 (100%)
Total 240 (89.6%) 28 (10.4%) 268 (100%)
2= 3.324 df=1 p= 0.1
Figure 39. Association between knowledge and practice
It was found that the regardless of the respondents knowledge whether it was low or high
on health and hygiene, they had bad practice on health and hygiene (there is no association
between knowledge and practice).
0.0
20.0
40.0
60.0
80.0
100.0
Low knowledge High knowledge
95.888.9
4.211.1
Good practice
Bad practice
Dr.Aung Kyaw Myint | AMI survey report 53
6. Association between attitude and practice
Association between attitude and practice of the respondents was shown in following
table and figure.
Table 52. Association between attitude and practice
Total attitude score
Total practice score
Total Bad Good
Good 156 (90.7%) 16 (9.3%) 172 (100%)
Bad 84 (87.5%) 12 (12.5%) 96 (100%)
Total 240 (89.6%) 28 (10.4%) 268 (100%)
2=0.025 df=1 p=0.5
Figure 40. Association between attitude and practice
It was also found that the regardless of the respondents attitude whether it was negative
or positive on health and hygiene, they had bad practice on health and hygiene (there is no
association between attitude and practice).
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
90.0
100.0
Good attitude Bad attitude
90.7 87.5
9.3 12.5
Good practice
Bad practice
Dr.Aung Kyaw Myint | AMI survey report 54
III. SCHOOL KAP SURVEY
A total of 91 primary school children from three schools were asked about very simple
questions regarding basic personal hygiene and general health in order to access their knowledge,
attitude and practice. There were 10 questions each for knowledge, attitude and practice. Attitude
score were set as Likart Scale. Since the questions were very simplified, full scores for
knowledge was 20, for attitude was 40 and for practice was 22 points. Less than 17, 32 and 18
points were regarded as low knowledge, bad attitude (negative attitude) and bad practice for
health and hygiene.
1. Overall Knowledge
Table 53. Knowledge scoring
Knowledge Frequency Percent
Low (Score 1 to 17) 10 10.99
High (Score 18-20) 81 89.01
Total 91 100.00
Figure 41. Donut diagram for knowledge score
11%
89%
Low (Score 10 to 17)
High (Score 18-20)
Dr.Aung Kyaw Myint | AMI survey report 55
89% of primary school children had good knowledge and only 11% had low knowledge
about health and hygiene.
2. Overall attitude
Table 54. Attitude scoring
Attitude Frequency Percent
Bad (10-32) 34 37.36
Good (33-40) 57 62.64
Total 91 100.00
Figure 42. Donut diagram for attitude scoring
Regarding attitude, 63% of school children had positive attitude on health and hygiene
while 37% had negative attitude.
37%
63%
Bad (10-32)
Good (33-40)
Dr.Aung Kyaw Myint | AMI survey report 56
3. Overall practice
Table 55. Practice scoring
Practice Frequency Percent
Bad practice (10-18) 16 17.58
Good practice (19-22) 75 82.42
Total 91 100.0
Figure 43. Donut chart for practice scoring
82% of school children had good practice while 18% had bad practice of health and
hygiene.
4. Association between knowledge and attitude
Table 56. Association between knowledge and attitude
Total knowledge
score
Total attitude score Total
Bad Good
Low 9 (90%) 1 (10%) 10 (100%)
High 25 (30.9%) 56 (69.1%) 81 (100%)
Total 34 (37.4%) 57 (62.6%) 91 (100%)
2= 14.428 df=1 p=0.000
18%
82%
Bad practice (10-18)
Good practice (19-22)
Dr.Aung Kyaw Myint | AMI survey report 57
Figure 44. Association between knowledge and attitude
It was found that the school children who had higher knowledge on health and hygiene
habits had more positive attitude on health and hygiene than the respondents who had lower
knowledge (there is an association between knowledge and attitude) and the results were
statistically significant.
5. Association between knowledge and practice
Table 57. Association between knowledge and practice
Total knowledge
score
Total practice score Total
Bad Good
Low 8 (80%) 2 (20%) (100%)
High 8 (9.9%) 73 (90.1%) (100%)
Total 16 (17.6%) 75 (82.4%) (100%)
χ2= 35.629 df=1 p=0.000
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
90.0
100.0
Low knowledge High knowledge
90.0
30.9
10.0
69.1
Good attitude
Bad attitude
Dr.Aung Kyaw Myint | AMI survey report 58
Figure 45. Association between knowledge and practice
It was clear that the school children who had higher knowledge on health and hygiene
habits had good practice on health and hygiene than the respondents who had lower knowledge
(there is an association between knowledge and practice) and the results were statistically
significant.
6. Association between attitude and practice
Table 58. Association between attitude and practice
Total attitude
score
Total practice score
Total Bad Good
Good 4 (7%) 53 (93%) 57 (100%)
Bad 12 (35.3%) 22 (64.7%) 34 (100%)
Total 16 (17.6%) 75 (82.4%) 91 (100%)
χ2= 19.649 df=1 p=0.000
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
90.0
100.0
Low knowledge High knowledge
80.0
9.9
20.0
90.1 Good practice
Bad practice
Dr.Aung Kyaw Myint | AMI survey report 59
Figure 46. Association between attitude and practice
It was evident that the school children who had positive attitude on health and hygiene
habits had good practice on health and hygiene than the respondents who had negative attitude
(there is an association between attitude and practice) and the results were also statistically
significant.
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
90.0
Good attitude Bad attitude
7.0
35.3
93.0
64.7
Good practice
Bad practice
Dr.Aung Kyaw Myint | AMI survey report 60
DISCUSSIONS AND CONCLUSION
I. Descriptive survey
Since this survey was conducted among 27 villages located in four townships of Wa
Special Administrative Region, overall socio-economic and demographic profiles of the
respondents are not so much different. Like other areas in Myanmar, the household heads are
male pre-dominant type. About four-fifths of the respondents are Lahu tribes because out of 27
villages, 20 villages are Lahu dominant villages.
The most striking feature in their profile is profound proportion of illiterates. Huge
amount of household heads as well as respondents never had proper education and no schooling
at all. And more than ninety percents are said to be farmers harvesting something in their native
lands.
Majority of the respondents live in wooden and bamboo houses, drink and use mountain
stream water (verbatim) without bothering to purify it and they thought that it is not necessary to
purify their already clean water. Moreover, about two-thirds of the respondents did not have any
latrine in their homes and they are used to open-air-defecation habits. About half of the latrines
also are unsanitary.
Those findings indicate the living standards of the respondents are extremely under par
and they have not enough education and sanitation for healthy living status. There are so many
things required to improve their living status.
Regarding maternal and child health status, about three percents of the respondents
claimed that there had been some maternal deaths within their family. Also more than one-thirds
of the respondents confirmed that there were the deaths of children before they reached their fifth
year birthday in their households with the causes of ARI, diarrhoea, malnutrition and malaria.
Ante-natal coverage is only about fifty-two percents and almost all ANC were in AMI facilities.
However, it was found that about one-third of the pregnancies were delivered by traditional birth
attendants and more surprisingly about three-fifths of the pregnancies were delivered by non-
trained accuchers such as neighbours, husbands and self respectively. In that kind of setting,
maternal mortality is inevitable and seemed to be a used-to-scenario. Although majority said
Dr.Aung Kyaw Myint | AMI survey report 61
exclusive breast feeding yes, more than ninety percent of children suffered some form of illness
episode. Regarding knowledge for treatment of common ailments such as diaorrhoea, malaria,
ARI and malnutrition, the commonest response was no idea at all. In general, it can be said that
MCH status of the surveyed area is in disastrous situation.
Concerning to health care services, only five percents of the respondents had regular and
formal health services in their native lands. And nearly two-thirds of the respondents had to walk
one to eight hours for health services and relied totally on non-professional health personals such
as village health volunteers and auxiliary mid-wives. Three-fourths of them had illness episodes
within one year and those illnesses were treated mainly by auxiliary mid-wives, quacks and
village health volunteers. Self medications by buying drugs from pharmacies are not uncommon
also. Almost all respondents with illness were treated with out-of-pocket payments and average
cost per illness was about 1200 Yuan (about 150,000 Kyats or nearly 200 US dollars per episode
of illness per household) and indeed it was very costly for poor quality service. But this figure
was as they said and the validity of the data was not guaranteed. Generally it can be concluded
that formal government health care was almost not available, inaccessible and currently available
health services are too costly for them. They received costly poor health services provided by
quacks and traditional birth attendants.
However, 88% of the respondents satisfied the currently available health services (May
be it means health services provided by AMI). Non-satisfiers gave some reasons underlying their
lack of satisfaction on currently available health services that they received (provider may or
may not be AMI health personnel): no drug, no services at all, no quality etc. The vast majority
(94%) were very willing to pay for health care if quality services they received and the health
care provider they most wanted to pay was unsurprisingly medical doctors but half of them
wanted to pay just 1 Yuen (120 kyats) up to 100 Yuen (12,000 kyats) per visit. So it can be said
that they want as well as demand the quality health care services those are not available and
accessible for them yet.
Dr.Aung Kyaw Myint | AMI survey report 62
II. Baseline KAP survey of respondents
KAP on respondents
Since knowledge questions were extremely easy even for poorly educated persons, the
respondents know very well which is right and what is wrong. So ninety-one percent of the
respondents gained higher scores and can be classified as high (acceptable) knowledge for health
and hygiene in very basic level. However knowledge alone could not grantee development of
preventive behavior of diseases. So also in attitude, about two-thirds of the respondents had
positive attitude on health and hygiene. And there is statistically significant association between
knowledge and attitude regarding health and hygiene.
But practice is a different story. Practice scores are found to be vice versa with the
knowledge score. Ninety percent of respondents had bad practice while just only ten percents
had good practice regarding health and hygiene. Also there are statistically significant non-
association between knowledge and practice as well as attitude and practice.
Therefore it can be said that the respondents knows very well about good health habits
and they felt that they should have health habits but in reality the reverse is true and their
practices run away from healthy behaviors. The main reason behind that scenario may be lack of
education and unchangeable risky behaviors predispose to diseases or lack of interest in
responding the questions or interviewer bias.
III. School KAP survey
Regarding knowledge, attitude and practice of the primary school children, there are
strong associations between knowledge and attitude, knowledge and practice, attitude and
practice were observed.
Therefore it could be said that the higher the knowledge, the better the attitude and the
stronger the good practice on healthy habits in formal school children. However, it could not be
hypothesized that there is a direct relationship between knowledge and action. It is not true that
by changing knowledge, behavior is automatically changed as well because there are many other
factors which influence the health seeking behavior of human.
Dr.Aung Kyaw Myint | AMI survey report 63
RECOMMENDATIONS
1. Health education in that locality should be encouraged.
2. Life skill education and behavior change communication (Health promotion) should be
emphasized in schools.
3. Community should be well informed about currently available health care services.
4. Health service providers should be trained to become qualified providers who can handle
basic medical problem.
5. Major problem in the local community is too poor education, misconception and lack of
formal health care services and health activities. In order to fulfill the objectives of
humanitarian assistance, one should not focus only on health but on education,
occupation and economic status of the community.
Dr.Aung Kyaw Myint | AMI survey report 64
REFERENCES
1. Ribeaux S. & Poppleton S E. (1978). Psychology and Work. An Introduction. London:
Macmillan.
2. Yoder P S (1997). Negotiating relevance: belief, knowledge and practice in international
health projects. Medical Anthropology Quaterly, 11 (2): 131-146.
3. Nichter M. (1993). Social Science lessons from diarrhea research and their application to
ARI. Human Organization, 52 (1): 53-54.
4. Lane S D. (1997). Television minidramas: Social marketing and evaluation in Egypt.
Medical Anthropology Quaterly, vol.11, n.2.
Dr.Aung Kyaw Myint | AMI survey report 65
Annex 1: Survey questionnaires
Survey questionnaire
Name of surveyor /ဆနးစစးသအမညး _____________________________
မ .နယး / township ၈ _________________________________________
ေက၄ျာအပးစ / village tract ၈ _________________________________________
quarter / village ရပးကျကး၇ ေကရျာ ၈ _______________________________________
SECTION (A)
I. Socio-demographic characteristics
၈ head of household / အမးေထာငးဥစအမညး ၈ _______________________________________
ဿ၈ အမးေထာငးဥစအသကး ၈ ႏြစး (ပညးၿပ အသကး) / head of household’s age
၀၈ အမးေထာငးဥစလငး ၈ ကာ မ / head of household’s sex
၁၈ အမးေထာငးဥစ လမ ၈ ဗမာ / Bamar
/ Wa
လာဟ / Lahu
ရြမး / Shan
အခါ / Akha
အခာ _________________________ ေဖားပရနး / other
၂၈ အမးေထာငးဥစ ၏ ပညာအရညး အခငး / head of household’s education
1. ေကာငးမေနဖ / never went to school 2. ေရတတးဖတးတတး / can read and write 3. ဘနးႀကေကာငးထျကး / attended monastery education
ရကးစျ/ date
အမြတးစဥး / no
Dr.Aung Kyaw Myint | AMI survey report 66
4. မလတနး (သငယးတနးမြ စတတတနးထ) / Primary school ( KG to 4th grade ) 5. အလယးတနး (ပဥၥမတနးမြ အဌမတနးထ) / middle school ( 5th grade to 8th grade ) 6. အထကးတနး (နဝမတနးမြ ဒမတနးထ) / high school ( 9th grade to 10th grade) 7. တကသလး၇ ေကာလပး ဒပလမာ / university - college diploma 8. တကသလး၇ ေကာလပး ဘျ႔ / university – bachelor degree
၃၈ အမးေထာငးဥစ၏ အလပးအကငး /occupation _____________________________________
၄၈ ေဖဆသအမညး / respondent’s name ၈ _______________________________________
၅၈ ေဖဆသ၏အသကး ၈ ႏြစး (ပညးၿပ အသကး) / respondent’s age
၆၈ ေဖဆသ၏လငး ၈ ကာ မ / respondent’s sex
ဝ၈ေဖဆသ၏ လမ / Respondent’s ethnic group ဗမာ / Bamar
/ Wa
လာဟ / Lahu
ရြမး / Shan
အခါ / Akha
အခာ / other _________________________ ေဖားပရနး
၈ ေဖဆသ၏ ပညာအရညး အခငး / respondent’s education
1. ေကာငးမေနဖ၇ / never went to school 2. ေရတတးဖတးတတး / can read and write 3. ဘနးႀကေကာငးထျကး / attended monastery education 4. မလတနး (သငယးတနးမြ စတတတနးထ) / Primary school ( KG to 4th grade ) 5. အလယးတနး (ပဥၥမတနးမြ အဌမတနးထ) / middle school ( 5th grade to 8th grade ) 6. အထကးတနး (နဝမတနးမြ ဒမတနးထ) / high school ( 9th grade to 10th grade) 7. တကသလး၇ ေကာလပး ဒပလမာ / university - college diploma 8. တကသလး၇ ေကာလပး ဘျ႔ / university – bachelor degree 9. ဘျ ႔လျနးဒကရရ / post graduate
ဿ၈ မသာစ/အမးေထာငးစအတျငး အမငးဆပညာေရ / highest education level within family
__________________________________
၀၈ ေဖဆသ၏ အလပးအကငး / respondent’s occupation ___________________________________
Dr.Aung Kyaw Myint | AMI survey report 67
၁၈ သငးအပါအဝငး အမးတျငးေနထငးသ လဥေရ (မသာစဝငးေပါငး) / no of family members including respondent
၈ ေယာကးာ / men (>18 yr) ဿ၈ မနးမ / women (> 18 yr) ၀၈ ကေလ / child (0-5 yr)
(5-18 yr)
၁၈ စစေပါငး / total II. Environmental Sanitation Status
၈ ေနအမးအမအစာ / type of household
၈ တကးအမး / brick house
ဿ၈ သစးအမး (သျပးမ၇ ထရကာ) / wooden house ( tin roof, wooden wall )
၀၈ သစးအမး (ဓနမ၇ ထရကာ) / wooden house ( thatch roof, wooden wall )
၁၈ ဝါအမး (ဓနမ၇ ဝါကပးကာ) / bamboo house (thatch roof, bamboo wall )
၂၈ ဝါအမး (တာေပၚလငးမ၇ ဝါကပးကာ) / bamboo house (tarpaulin roof, bamboo wall )
ဿ၈ ေသာကးေရ အမအစာ type of drinking water
၈ ကနးေရ / water from lake
ဿ၈ တျငးေရ / water from well
၀၈ အဝစ တျငးေရ / water from deep well
၁၈ အမာသေရေလြာငးကနး / water from common water tank
၂၈ ပကးေရ (ေရေပေရ) / water from pipe
၃၈ မစးေရ၇ ေခာငးေရ / water from river/ creek
၄၈ ေရသနး႔ / purified water
၅၈ အခာ ______________________________ / other
၀၈ သေရ၇ ခေရ အမအစာ type of utility water
ကနးေရ / water from lake
ဿ၈ တျငးေရ / water from well
၀၈ အဝစ တျငးေရ / water from deep well
၁၈ အမာသေရေလြာငးကနး / water from common water tank
Dr.Aung Kyaw Myint | AMI survey report 68
၂၈ ပကးေရ (ေရေပေရ) / water from pipe
၃၈ မစးေရ၇ ေခာငးေရ / water from river/ creek
၄၈ ေရသနး႔ / purified water
၅၈ အခာ ______________________________ / other
၁၈ ေသာကးေရက မသစျမြ သနး႔စငးေအာငး ပလပးေလရြသလာ do you purify water before drinking?
၈ လပး / do
ဿ၈ မလပး do not do
၂၈ လပးခလြငး မညးသညးနညးက သသလ၈ if yes, what method ?
၈ ႀကခကး / boil
ဿ၈ ေရစစးဖငးစစး / filter with water filter
၀၈ ကလရငးခတး / treat with chlorine
၁၈ အခာ __________________________________________ / other
၃၈ မလပးခလြငး မညးသညး အေၾကာငးမာေၾကာငး ဖစးသလ၈ / if not purified, why ?
၈ လပးရနးမလသဖငး (သနး႔စငးၿပဟ ယဆ၍) / not necessary ( assuming it is clean )
ဿ၈ အလပးရႈပး၍ / do not want to bother
၀၈ ေငျမရြ၍ / lack of money
၁၈ မညးသ႔လပးရမြနးမသ၍ / lack of technique
၂၈ အခာ ______________________________________ other
၄၈ သငးတ႔အမးတျငး ကယးပငးအမးသာရြသလာ၈ / do you have your own latrine?
၈ ရြ / have
ဿ၈ မရြ / do not have
၅၈ အမးသာမရြခလြငး မညးသညး အေၾကာငးမာေၾကာငးနညး၈ / if don’t have latrine, why?
၈ ေတာထငးသညးအကငးေၾကာငး (Open air defecation)
ဿ၈ ေနရာမရြခငးေၾကာငး / lack of space
၀၈ အမာသအမးသာရြခငးေၾကာငး / use public toilet
၁၈ ေငျမရြခငးေၾကာငး / lack of money
Dr.Aung Kyaw Myint | AMI survey report 69
၂၈ အခာ ______________________________________________ other
၆၈ အမးသာရြခလြငး မညးသညး အမအစာ အမးသာဖစးသနညး၈ / if your house have latrine,
what type of latrine?
၈ ပအမးသာ (Service type bucket latrine)
ဿ၈ ကငးတညးအမးသာ (Direct pit latrine)
၀၈ ကငးလႊအမးသာ (Indirect pit latrine)
၁၈ ဘထငးေရေလာငးအမးသာ (Water sealed latrine)
၂၈ အခာ ______________________________________ other
ဝ၈ သငးအမးရြအမးသာသညး ယငးလခငး (Fly proof) အန႔လခငး (Odourless) အရြကးလခငး (Privacy) ဆသညး အခကးမာႏြငး ပညးစပါသလာ၈ / is your latrine cover the criteria of fly proof, odourless and privacy?
၈ ပညးစသညး / cover
ဿ၈ မပညးစပါ၈ / do not cover
၈ အမးတျငး ခငး၇ ယငး၇ ကျကး၇ ၾကမးပ၇ ပဟပး၇ သနး စသညး အေကာငးမာရြသလာ၈ doe your house have mosquito, flies, rodents, fleas, cockroaches, and lice?
၈ မရြ / have
ဿ၈ အနညးငယး / alittle
၀၈ အတနးအသငး / moderate amount
၁၈ အလျနးမာ / plenty
III. Household Livelihood Status
(ဤေမချနးမာသညး သေတသန ပလပးရနးသကးသကးသာဖစးၿပ မသကးဆငးသမာ မသရြေစရပါ၈)
( these questions are strictly for research and must be kept confidential. )
၈ သငးတ႔အမးတျငး ဝငးေငျရြသဥေရ မညးမြရြသနညး၈ / how many family members have income in your house?
၈ တစးေယာကး / 1
ဿ၈ ႏြစးေယာကး / 2
၀၈ သေယာကး / 3
Dr.Aung Kyaw Myint | AMI survey report 70
၁၈ ေလေယာကးႏြငးအထကး / 4 and above
ဿ၈ အဆပါဝငးေငျရြသမာ၏ အလပးအကငးမာက ေဖားပပါ၈ / describe the occupations of family members with income
၈ _______________________________________
ဿ၈ ________________________________________
၀၈ ________________________________________
၁၈ ________________________________________
၂၈ ________________________________________
၀၈ ထဝငးေငျသညး အၿမ ပမြနး (လစဥး) ဝငးေငျ ဖစးပါသလာ၈ / Is the income regular ( monthly ) ?
၈ ဖစးပါသညး / yes
ဿ၈ မဖစးပါ / no
၁၈ ပမြနးလစဥးဝငးေငျ ဖစးခေသား ပမးမြအာဖငး တစးလလြငး မညးမြဝငးသနညး၈ if the income is regular, what is the amount of monthly income?
______________________________________________________________________________________________________________________________________________________________________________________
၂၈ ပမြနးဝငးေငျ အပငး ၾကာေပါကး ဝငးေငျမာရြေသသလာ၈ / besides regular income, are there any other income?
ထေပါကး၇ ခေပါကး၇ ႏြစးလေပါကး / win lottery/ thai lottery/ 2 digit lottery __________________________
ေဘာလပျႏငး၇ ဖႏငး / soccer betting/ win cards ________________________________
ၾကာေပါကးဝငးေငျ (ပျစာခကသ႔) / side income (.eg broker fees) ________________________________
အခာဝငးေငျမာ / other income ________________________________
၃၈ ဝငးေငျ ပမြနးမရြခလြငး မညးသညး အေၾကာငးမာေၾကာငးနညး၈ / if no regular income, why?
၈ ရာသဥတေၾကာငး (လယးယာလပးငနး) / weather ( farming)
ဿ၈ အလပးသဘာဝအရ (ေန႔စာ) / nature of job ( labourer)
၀၈ ကနးမာေရမေကာငး၍ / ill health
၁၈ အခာ _________________________________________________ other
၄၈ မေကာငးပါက မညးသညးအေၾကာငးမာေၾကာငးဖစးသနညး၈ / if not good, why?
Dr.Aung Kyaw Myint | AMI survey report 71
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
___________________________________________
၅၈ သငးတ႔အမး အေကျ တငးတတးသလာ၈ / does your family have debts?
၈ တငးသညး / have
ဿ၈ မတငးပါ / don’t have
၆၈ မညးသညးအတျကးေၾကာငး အေကျ တငးရပါသနညး၈ / why do you have debts?
IV. Maternal and Child Health / မခငး နြငး. ကေလကနးမာေ၄
၈ သငးတ႔မသာစတျငး ကယးဝနးေဆာငးမခငးရြပါသလာ / do you have pregnant mother in
your family?
၈ ရြသညး / yes
ဿ၈ မရြပါ / no
၈ သငးတ႔မသာစအတျငး ကယးဝနးေဆာငးမခငးေသဆခငးမ ရြခဖပါသလာ / does your
Family have maternal death?
၈ ရြဖသညး / have
ဿ၈ မရြဖပါ၈ / not have
ဿ၈ ရြခဖပါက ေသဆရခငးအေၾကာငးရငးက သပါသလာ / if yes, what is the cause of death?
_______________________________________________________________________________________________
_____________________________________________________________________
၀၈ သငးတ႔မသာစအတျငး ငါႏြစးေအာကး ကေလေသဆခငးမ ရြခဖပါသလာ
Dr.Aung Kyaw Myint | AMI survey report 72
Does your family have under 5 child death?
၈ ရြဖသညး / yes
ဿ၈ မရြဖပါ / no
၁၈ ရြခဖပါက ေသဆရခငးအေၾကာငးရငးက သပါသလာ / if there were under 5 child death, do you know the cause of
death?
_______________________________________________________________________________________________
_____________________________________________________________________
၂၈ ကယးဝနးေဆာငးမခငးမာရြခပါက ၁ငးတ႔ကယးဝနးေဆာငးေနစဥးအတျငး ကယးဝနးေစာငးေရြာကးမႈ ခယခပါသလာ
If there were pregnant mothers, do they take antenatal care during pregnancy?
၈ ခယသညး / yes
ဿ၈ မခယပါ / no
၃၈ မညးသက ကယးဝနးေစာငးေရြာကးမႈ ေပခပါသလ၈ / who gave the antenatal care?
_______________________________________________________________________________________________
_____________________________________________________________________
၄၈ ကယးဝနးေဆာငးမခငး ကေလေမျ ဖျာခစဥးက မညးသေမျ ေပခပါသလ၈ who deliver the baby during birth?
_______________________________________________________________________________________________
_____________________________________________________________________
၅၈ ကေလေမျ ၿပၿပခငး မခငးႏ႔ တကးေကျ ခပါသလာ / was the baby breastfed immediately
after birth?
၈ တကးေကျ ခသညး / breastfed
ဿ၈ မတကးေကျ ႏငးပါ၈ အေၾကာငးမြာ / not breastfed because
_______________________________________________________________________________________________
____________________________________________________________________
၆၈ သငးအမးရြကေလမာမြာ ဝမးပကးဝမးေလြာေရာဂါ၇ ဌကးဖာေရာဂါ၇ အသကးရႈလမးေၾကာငးပဝငး၍ ဖာနာ ရငးၾကပးသညးေရာဂါ၇
အာဟာရ ခ ႔တသညးေရာဂါ မာ ဖစးပျာဖပါသလာ
Do your children ever have diarrhoea, malaria and RTI?
၈ ဖစးဖသညး / have
Dr.Aung Kyaw Myint | AMI survey report 73
ဿ၈ မဖစးဖပါ / not have
ဝ၈ ဝမးပကး ဝမးေလြာ ေရာဂါ ဖစးဖခပါက မညးသ႔ေသာ ကသမႈမခယခပါသလ
What kind of treatment was received when your child have diarrhoea?
_______________________________________________________________________________________________
_____________________________________________________________________
၈ ဌကးဖာေရာဂါ ဖစးဖခပါက မညးသ႔ေသာ ကသမႈမခယခပါသလ
What kind of treatment was received when your child have malaria?
_______________________________________________________________________________________________
_____________________________________________________________________
ဿ၈ အသကးရႈလမးေၾကာငးပဝငး၍ ဖာနာရငးၾကပးေရာဂါ ဖစးဖခပါက မညးသ႔ေသာ ကသမႈမခယခပါသလ
What kind of treatment was received when your child have RTI?
_______________________________________________________________________________________________
_____________________________________________________________________
၀၈ အာဟာရခ ႔တသညး ေရာဂါ ဖစးဖခပါက မညးသ႔ေသာ ကသမႈမခယခပါသလ
What kind of treatment was received when your child have malnutrition?
_______________________________________________________________________________________________
_____________________________________________________________________
IV. Health care assess and health care cost
၈ သငးေနထငးရာေနရာတျငး ေဆရ၇ ေဆေပခနး၇ သာဖျာခနး၇ ေကလကးကနးမာေရဌာန၇ ေဆကခနး စသညး ကနးမာေရ
ေစာငးေရြာကးမႈ ေပရာဌာနမာ ရြပါသလာ? / are there health care services such as hospital, dispensary, labour room,
RHC, clinic in your village?
1. ရြသညး / yes 2. မရြပါ / don’t have 3. မသပါ / don’t know 4. မေဖလ / don’t want to answer
Dr.Aung Kyaw Myint | AMI survey report 74
ဿ၈ သငး၏ ေနအမးႏြငး အနဆကနးမာေရေစာငးေရြာကးမႈ ေပ၄ာဌာန သ. ေ၄ာကး၄နး အခနးဘယးေလာကးကာလ / how long does
it take to reach the nearest health care center from your house
ခနး႔မြနး အခနး / estimated time
လမးေလြာကးလငး / by walking _________________
ကာဖငး. / by car _________________
၀၈ သငး၏ ကနးမာေရအတျကး အာထာရေသာ ကနးမာေရေစာငးေရြာကးသ သညး / the person who you rely on as health
care provider
1. ဆရာဝနး / doctor 2. ကနးမာေရမြ / HA 3. သနာပ၇ အမသမကနးမာေရဆရာမ၇ သာဖျာဆရာမ / nurse/ women health staff/ midwife 4. အရသာဖျာ / AMW 5. လထကနးမာေရလပးသာ / VHV 6. တငးရငးေဆဆရာ၇ ပေယာဂဆရာ၇ ေပာကးေစ၇ ေရမနးဆရာ / traditional medicine/ healer 7. အရပးဆရာ (ရမးက) / quack 8. AMI ေက၄ျာကနးမာေ၄ဌာန (သ.) ေ၄ျ.လာေဆခနး / AMI RHC or mobile clinic
၁၈ ၿပခသညး တစးႏြစးအတျငး (ဿ လအတျငး) သငးမသာစမြာ နာမကနးဖစးေသာသ ရြပါသလာ / is there any family member
who got ill within one year?
1. ရြသညး / yes 2. မရြပါ / don’t have 3. မသ၇ မေသခာ / don’t know/ not sure
၂၈ အကယး၍ ရြခလြငး ဘယးလေရာဂါမေတျ ဖစးပါသလ၈ (အမးသာတစးေယာကးထကးပ၍ ေရာဂါ တစးမထကးပ၍ ဖစးပါက ဖစးသမြ
ကေမပါ၈ ေရပါ) / if there were sick family member, what type of disease? ( if there were more than one sick family
member, ask what happened and write down)
__________________________________________
__________________________________________
__________________________________________
__________________________________________
__________________________________________
Dr.Aung Kyaw Myint | AMI survey report 75
၃၈ ထသ႔ နာမကနးဖစးေသာအခါ ဘာလပးပါသလ၈ (အဓက လပးေသာ အေဖတစးခသာေပရနး) when sick, what do you do? ( ask
what they do mainly)
9. အရပးဆရာ (ရမးက) ႏြငးကသညး / treat with quack 10. ဗမာေဆဖငး ကသညး / treat with traditional medicone 11. အေခခကနးမာေရဝနးထမး (သာဖျာဆရာမ ကသ႔) ႏြငးကသညး / treat with primary health care staff 12. ဆရာဝနး (ပငးပေဆခနး) ပသညး / treat with doctor (private clinic) 13. အစရ ေဆရတျငးကသညး / attend govt hospital 14. ပဂၢလက ေဆရတျငး ကသညး / attend private hospital 15. ေဆဆငးမြ ေဆဝယးေသာကးသညး / buy drugs from pharmacy 16. ဘယးမြာမြ မက / do not treat 17. AMI ေက၄ျာကနးမာေ၄ဌာန (သ.) ေ၄ျ.လာေဆခနး တျငး ကသညး/ get treatment at AMI RHC or mobile
clinic
၄၈ အကယး၍ နာမကနးဖစးေသားလညး ဘယးမြာမြ၇ ဘယးနညးႏြငးမြ မကသခပါက ဘာေၾကာငးလ? / Although sick, if do not get
treatment, why ?
1. မတတးႏငး၍ / cant afford 2. ေပာကးမညး ေရာဂါမဟတး၍ / untreatable disease 3. လနာကယးတငးက ကသခရနး ငငးဆ၍ / patient refuse treatment 4. အခာအေၾကာငးမာ (ေပာသညးအတငး မြတးတမးတငးရနး) / other reasons (record exactly as respondent say)
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
___________________________________________
၅၈ အကယး၍ တစးနညးနညးဖငး ေဆဝါကသမႈ ခယခပါက ထေရာဂါ (မာ)အတျကး မညးမြ ကနးကခပါသလ၈ / if treated, how
much is the cost for those diseases?
(ကပး၇ ယျမး) / kyat/ Yuan
ကနးကစရတးမာ (ၿပခသညး တစးႏြစးအတျငးမသာစဝငး မာနာမကနးဖစးသဖငး ကသရာတျငးစစေပါငး ကနးကေငျမာ)
Cost ( total cost for getting treatment within one year)
Dr.Aung Kyaw Myint | AMI survey report 76
ေဆဖ၇ ဝါခမာ / drugs _____________________________
ေဆရတကးရသညးအတျကးကနးကေငျမာ / hospital cost _____________________________
ခရစရတး၇ စာစရတး၇ ေနစရတးမာ / travel cost/ food cost/ living cost _____________________________
အခာကနးေငျမာ / other cost _____________________________
၆၈ ၿပခသညး တစးႏြစးအတျငး မသာစ အတျငး ဆပါ၇ ကျယးလျနးသ ရြပါသလာ / is there any family who die within one year?
1. ရြပါသညး / yes 2. မရြပါ / no
၈ အကယး၍ ရြခေသား မညးသညး အေၾကာငး (ေရာဂါ) ေၾကာငးကျယးလျနးပါသလ၈ if there were deceased family member,
what is the cause of death?
__________________________________________________________________________
__________________________________________________________________________
V. Satisfaction & Willingness to Pay for Health Services
၈ ယခလကးရြ သငးရရြေနသညး ကနးမာေရ ေစာငးေရြာကးမႈ လပးငနးမာအေပၚသငးေကနပး အာရမႈရြပါသလာ၈
Are you satisfied with current health care services?
၈ ရြသညး / yes
ဿ၈ မရြပါ၈ / no
ဿ၈ မရြခပါက မညးသညးအေၾကာငးမာေၾကာငးနညး၈ if not satisfied, why?
၀၈ ေကနပးအာရသညးဆလြငး အကယး၍သာ အဆပါကနးမာေရေစာငးေရြာကးမႈလပးငနးမာအတျကး ကသငးသညး အဖအခက
ေတာငးခမညးဆပါက သငးေပလစတးရြသလာ၈ if satisfied, are you willing to pay if the health care services will be
charged?
၈ ရြသညး / yes
ဿ၈ မရြပါ / no
၁၈ေပလစတးမရြလငး ေပလစတး၄ြေအာငးဘယးလပ ပငေပာငးလမြ မ ဖစးသငး.သလ၈ if not willing to pay, which changes
should happen so that you are willing to pay?
Dr.Aung Kyaw Myint | AMI survey report 77
_______________________________________________________________________________________________
_______________________________________________________________________________________________
________________________________________________________
၂၈ ေပလစတးရြခပါလြငး မညးသညး ကနးမာေရေစာငးေရြာကးမႈအမအစာမက ေပလသနညး၈ If willing to pay, what kind of
health care services are you willing to pay?
၈ ကနးမာေရမြငးတငးမႈလပးငနးမာ (Promotive services) ကနးမာေရပညာေပခငးအမမ
ဿ၈ ေရာဂါကာကျယးေရလပးငနးမာ (Preventive services) ကာကျယးေဆထခငး၇ ကယးဝနးေဆာငး
ေစာငးေရြာကးမႈေပခငး၇ ေဆစမးခငးေထာငးေဝဌခငး၇ ခငးေဆဖနးခငး၇ ေရေကာငးေရသနး႔ရရြေအာငး ေရတျငးေရကနး ေဆခတးခငး၇
သနး႔ရြငးသညး အမးသာ တညးေဆာကးခငး၇ သနး႔ရြငးသညး အမႈကးစျနး႔စနစး ဖနးတေပ ခငး၈
၀၈ ေရာဂါ ကသေရလပးငနးမာ (Curative services ) ေဆခနး၇ ေဆရမာတျငး ေဆကသခငး၇ ချစတးက သခငး၇
တငးရငးေဆဖငး ေဆကခငး၇ ပေယာဂ ဆရာဖငး ေဆကခငး၈
၁၈ ပနးလညးထေထာငးေရလပးငနးမာ (Rehabilitative services ) ေဆစျသမာအာ ပနးလညးထေထာငး ခငး၈
ႏြစးသမးေဆျ ေႏျ အႀကေပခငး၇ ေခတလကးတ တပးဆငးေပခငး၇ နာမၾကာ၇ မကးမမငးမာအာ စာသငး ေပခငး၇ မဘမကေလမာ၇
ဘဘျာမာအတျကး ေဂဟာ၈
၂၈ အနဆကနးမာေရေစာငးေရြာကးမႈ ေပ၄ာဌာန ထ သယးယပ.ေဆာငးေပခငး ( transport service up to the service
delivery point)
၃၈ သငး အဖအခေပလစတးရြသညး ကနးမာေရေစာငးေရြာကးသသညး မညးသဖစးသနညး၈ / who is the health care provider you
are willing to pay?
၈ ဆရာဝနး / doctor
ဿ၈ တငးရငးေဆဆရာ / traditional medicine practitioner
၀၈ ပေယာဂဆရာ / witch doctor
၁၈ အရသာဖျာ / AMW
၂၈ လထကနးမာေရလပးသာ / VHV
၃၈ အခာ ____________________________________________________ other
၄၈ ကနးမာေရေစာငးေရြာကးမႈအတျကး ေယဘယအာဖငး သငးေပလသညး အဖအခ ပမာဏမြာ ဘယးေလာကး ဖစးသနညး၈
How much are you willing to pay for the health care services in general?
___________________________________________________ ကပး၇ ယျမး / Kyat/ Yuan
Dr.Aung Kyaw Myint | AMI survey report 78
VI. Internally Displaced Person (IDP)
၈ သငးတ႔၄ျာ/ ေက၄ျာအပးစ တျငး အေၾကာငးအမမေၾကာငး အခာေဒသမာမြ ခလႈေရာကးရြလာသညး
ဒကၡသညးေတျ ရြေနသလာ၈
Are there refugees who moved from other areas for various reasons in your village/ village tract?
၈ ရြသညး / yes
ဿ၈ မရြပါ / no
၀၈ မသပါ / don’t know
ဿ၈ ဒကၡသညးေတျ ရြေနလငး ဘယးေလကးမာလ ၈ if there are refugees, what is their estimate numbers? ___________________
၀၈ ဒကၡသညးေတျ ဘာေကာငး. ေ၄ျ.ေပာငးလာကသလ၈ why do the refugees move to your village?
၈ စစး / war
ဿ၈ သဘာေဘ / disaster
၀၈ စာနြပး၄ကၡာ၄ြာပါ / famine
၁၈ အလပးအကငးမေကာငး / lack of jobs
၁၈ ဒကၡသညးေတျ ၏ မလေန၄ာ သညး ဘယးေန၄ာလ၈ / where is their former area? __________________________________________________________________________________________
၂၈ ထဒကၡသညးမာသညး မညးသညးေနရာမာတျငး ခလႈေနထငးၾကသနညး၈ where are the refugees taking shelter?
______________________________________________________________________________________________________________________________________________________________________________________
၃၈ ၁ငးတ႔၏ စာဝတးေနေရ၇ ပညာေရ၇ ကနးမာေရ၇ လမႈေရ စသညးကစၥမာတျငး အခကးအခမာ ႀကေတျ႔ႏငးပါ သလာ၈ey
Can they have problems for livelihood, education, health and social affairs?
၈ ႀကေတျ႔ႏငးသညး / yes, they can
ဿ၈ မႀကေတျ႔ႏငးပါ၈ အဘယးေၾကာငးဆေသား / no, they can’t because
၄၈ ၁ငးတ႔အာ သငးတ႔နယးမြ နယးခမာက တတးႏငးသ၍ လအပးသညး အကအညမာ ေပၾကပါသလာ / do the local people from your area help the refugees?
Dr.Aung Kyaw Myint | AMI survey report 79
၈ ေပသညး / yes
ဿ၈ မေပပါ၈ အဘယးေၾကာငးဆေသား- no, beacuse
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
၅၈ အဆပါ ဒကၡသညးမာအာ လအပးသညး အကအညမာက ေပမညး အဖျ႔အစညးမာေပၚေပါကးလာလြငး သငး သေဘာတပါသလာ၈ / if there are organizations to help the refugees, do you agree?
၈ တပါသညး / agree
ဿ၈ မတပါ၈ အဘယးေၾကာငးဆေသား- / do not agree because
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
၆၈ သငးအေနဖငး အဆပါ ဒကၡသညးမာက လအပးသညး အကအညမာ ေပလပါသလာ
Do you want to give the refugees necessary help?
၈ ေပလသညး / want to give
ဿ၈ မေပလပါ၈ အဘယးေၾကာငးဆေသား- / do not want to give because
Dr.Aung Kyaw Myint | AMI survey report 80
SECTION (B)
KNOWLEDGE, ATTITUDE & PRACTICE ON HEALTH & HYGIENE
I. KNOWLEDGE
သငးႏြငး သငးအမးသာမာ (သငးမသာစ) ကနးမာေရ ေကာငးမျနးဖ႔ အတျကး- / for you and your family members to be healthy
K.1. ငယးစဥးက ေရာဂါကာကျယးေဆမာ ပညးစေအာငးထခငး
Complete immunization in childhood
၈ အေရႀကသညး / important
ဿ၈ အေရမႀကပါ / not important
K.2. သာဆကးခာခငး birth spacing is
၈ အေရႀကသညး / important
ဿ၈ အေရမႀကပါ / not important
K.3. ကယးဝနးေဆာငးေစာငးေရြာကးမႈ ခယခငး / antenatal care
၈ အေရႀကသညး / important
ဿ၈ အေရမႀကပါ / not important
K.4. ေမျ ကငးစကေလက မခငးႏ႔ တစးမထသာ တကးေကျ ခငး
/ exclusive breast feeding
အေရႀကသညး / important
ဿ၈ အေရမႀကပါ / not important
K.5. ေဆလပးေသာကးခငးမြေရြာငးၾကဥးခငး / avoiding smoking
၈ အေရႀကသညး / important
ဿ၈ အေရမႀကပါ / not important
K.6. အရကးေသစာ မေသာကးစာခငး / Avoiding alcohol
၈ အေရႀကသညး / important
ဿ၈ အေရမႀကပါ / not important
K.7. အေပားအပါမလကးစာပ အမးေထာငးဖကးအေပၚသစၥာရြခငး
Being faithful to spouse
Dr.Aung Kyaw Myint | AMI survey report 81
၈ အေရႀကသညး / important
ဿ၈ အေရမႀကပါ / not important
K.8. အဆအဆမးမာေသာအစာအေသာကး၇ ငနးလျနးသညးအစာအေသာကးမာက
ဆငးခငးခငး
Avoiding fatty food and salty food
၈ အေရႀကသညး / important
ဿ၈ အေရမႀကပါ / not important
K.9. ကယးလကးလႈပးရြာအာကစာလပးခငး / doing sports
၈ အေရႀကသညး / important
ဿ၈ အေရမႀကပါ / not important
K.10. ကနးမာေရဗဟသတလကးစာခငး / reading health knowledge
၈ အေရႀကသညး / important
ဿ၈ အေရမႀကပါ / not important
K.11. ကနးမာေရေစာငးေရြာကးသ၏ အႀကေပခကးမာက လကးနာခငး
Following advice of health care provider
၈ အေရႀကသညး / important
ဿ၈ အေရမႀကပါ / not important
K.12. သနး႔ရြငးေသာ ေရက သစျ ခငး / using clean water
၈ အေရႀကသညး / important
ဿ၈ အေရမႀကပါ / not important
K.13. ယငးလအမးသာ သစျ ခငး / using fly proof latrines
၈ အေရႀကသညး / important
ဿ၈ အေရမႀကပါ / not important
K.14. ယငးနာစာ မစာခငး avoiding food that has contact with flies
၈ အေရႀကသညး / important
ဿ၈ အေရမႀကပါ / not important
Dr.Aung Kyaw Myint | AMI survey report 82
K.15. တစးကယးေရသနး႔ရြငးခငး (ေရမြနးမြနးခခငး) good hygiene (regular shower)
၈ အေရႀကသညး / important
ဿ၈ အေရမႀကပါ / not important
K.16. အမးသာတကးၿပတငးလကးကဆပးပာဖငးေဆခငး washing hands after defecation
၈ အေရႀကသညး / important
ဿ၈ အေရမႀကပါ / not important
II. ATTITUDE
အလျနးသေဘာတ
Strongly agree
သေဘာတ
agree
သေဘာမတ
Don’t agree
အလျနးသေဘာမတ
Strongly do not agree
၈ မခငးႏ႔တကးေကျ ခငးသညး ကေလ၏ ကနးမာေရအတျကး အလျနးေကာငး၏
Breastfeeding is very good for the health of child.
ဿ၈ ကယးဝနးရခနးမြစ၍ ကနးမာေရေစာငးေရြာကးမႈခယခငးသညး မခငးႏြငး ကေလ၏ ကနးမာေရအတျကး လျနးစျာေကာငး၏
Getting care since pregnancy is very good for the health of mother and child.
၀၈ တငးရငးအာေဆမာမြနးမြနးေသာကးခငးသညး ကနးမာေရ အတျကး အလျနးေကာငး၏
Taking traditional medicine is very good for health.
၁၈ မမတ႔၏ ကနးမာေရေကာငးခငး မေကာငးခငးသညး ဆရာဝနး၇ သာဖျာဆရာမ၇ လထ ကနးမာေရလပးသာစသညး ကနးမာေရေစာငးေရြာကးသမာတျငး လဝ တာဝနးရြသညး
Health care providers such as doctor, AMW and VHV are responsible for my health.
၂၈ မမတ႔၏ ကနးမာေရေကာငးခငး မေကာငးခငးသညး မမတ႔တျငး လဝ တာဝနးရြသညး.
I am responsible for my health.
၃၈ ကနးမာေရေကာငးရနး ေဆလပး၇ အရကးႏြငး အေပားအပါ လကးစာခငးမာက ေရြာငးၾကဥးသငးသညး၈
Dr.Aung Kyaw Myint | AMI survey report 83
Smoking, alcohol and unprotected sexual intercourse should be avoided for good health.
၄၈ ကနးမာေရေကာငးရနးအတျကး အာကစာလကးစာသငးသညး
Sports should be practiced for good health.
၅၈ ကနးမာေရေကာငးရနးအတျကး ပါတးဝနးကငးသနး႔ရြငးေရ သညး အေရႀကသညး
Environmental sanitation is important for good health.
၆၈ ကနးမာေရေကာငးရနးအတျကး ေရေကာငးေရသနး႔ ရရြေရ သညး အထအေရႀကသညး
Access to clean water is important for good health.
ဝ၈ ကနးမာေရေကာငးရနးအတျကး ယငးလအမးသာ သစျႏငးေရ သညး အထအေရႀကသညး
Using fly proof latrine is important for good health.
၈ ကနးမာေရေကာငးရနးအတျကး တစးကယးေရ သနး႔ရြငးေရ သညး အထအေရႀကသညး
Personal hygiene is important for good health.
ဿ၈ ကနးမာေရေကာငးရနးအတျကး ကနးမာေရ ဗဟသတ ပညးစေရသညး အထအေရႀကသညး
Having health knowledge is important for good health.
၀၈ ကနးမာေရေကာငးရနးအတျကး စပျာေရ ေတာငးတငးခငးမာ ဖ႔ အထအေရႀကသညး
Having good income is important for good health
၁၈ ကနးမာေရေကာငးရနးအတျကး အထက ဆရာဝနးႀကမာႏြငး တစးႏြစးတစးခါ မြနးမြနးပသေရသညး အထအေရႀကသညး
Annual check-up with specialists is important for health.
၂၈ ကနးမာေရေကာငးရနးအတျကး အာရြေစမညးေဆဝါမာက မြနးမြနးသစျသငးသညး၈
Vitamins should be taken regularly for good health.
၃၈ ဌကးဖာေရာဂါကငးေဝေစရနးအတျကး အပးသညးအခါတျငး ခငးေထာငးဖငးအပးသငးသညး
Mosquito net should be used when sleeping to prevent malaria.
Dr.Aung Kyaw Myint | AMI survey report 84
III. PRACTICE
P.1. သငးငယးစဥးက ကာကျယးေဆမာ ထဖပါသလာ did you have immunization in your childhood?
၈ ထဖသညး / yes
ဿ၈ မထဖပါ / no
P.2. သငးအမးတျငးရြေသာ ငါႏြစးေအာကးကေလမာ ကာကျယးေဆ ထဖပါသလာ
Do under five children in your house have immunization?
၈ ထဖသညး / yes
ဿ၈ မထဖပါ / no
P.3. ကနးမာေရ ပညာေပ ေဟာေပာပျမာ တကးေရာကးနာေထာငးဖပါသလာ
Have you ever attended health education talk?
၈ ေထာငးဖသညး / yes
ဿ၈ မေထာငးဖပါ / no
P.3. ရပးမငးသၾကာ၇ ဗျဒယကာတ႔တျငးပါေလရြသညး ကနးမာေရ ပညာေပဇာတးလမးမာက ၾကညးဖပါသလာ
Have you ever watch HE programs from TV and video?
၈ ၾကညးသညး / watch
ဿ၈ မၾကညးပါ / do not watch
P.4. အစာမစာမြႏြငး အမးသာတကးၿပခနးမာတျကး လကးက အၿမတမးဆပးပာႏြငးေဆဖစးပါသလာ
Do you always wash your hands with soap before meals and after defecation?
၈ ေဆသညး / wash
ဿ၈ မေဆဖစးပါ / do not wash
P.5. ေသာကးေရက (ေရသနး႔ဗမဟတးခလြငး) ႀကခကး၍ ေသာကးသလာ
Do you boil drinking water ( if not bottled water) ?
၈ ေသာကးသညး / boil
ဿ၈ မေသာကးပါ / do not boil
P.6. တျငးေရက တစးႏြစးတစးခါ ကလရငးေဆ ခတးပါသလာ do you treat the well with
Chlorine once a year ?
Dr.Aung Kyaw Myint | AMI survey report 85
၈ ခတးသညး / treat
ဿ၈ မခတးဖစးပါ / do not treat
P.7. ေဆလပးေသာကးသလာ / do you smoke?
၈ ေသာကးသညး / smoke
ဿ၈ မေသာကးပါ / do not smoke
P.8. အရကးေသာကးသလာ / do you drink?
၈ ေသာကးသညး / drink
ဿ၈ မေသာကးပါ / do not drink
P.9. ေရာဂါတစးစတစးရာ ဖစးပျာလြငး ေဆခနးသျာေလရြသလာ
When you are sick, do you go to clinic?
၈ အၿမသျာ / always go
ဿ၈ ေရာဂါဆမြသျာ/ go when sickness gets worse
၀၈ မသျာ၇ တငးရငးေဆ၇ ေဆၿမတဖငးက / not go /treat with traditional medicine
P.10. ေရာဂါတစးခခဖစးပျာလြငး ေဆခနးမသျာဖစးပ ေဆဆငးမြ ေဆမာကသာ ဝယးေသာကးဖစးပါသလာ
When you are sick, do you buy drugs from pharmacy without going to clinic?
၈ အၿမဝယးေသာကးဖစးသညး / always buy
ဿ၈ ေရာဂါမဆပါက ေဆဆငးမြေဆဖငးသာ ကစၥၿပေလရြသညး get treated with drugs from pharmacy
၀၈ မေသာကးပါ၈ ေဆခနးသာ သျာေလရြသညး / do not buy drugs – go to clinic
P.11. အဆမာေသာ၇ ငနးေသာ အစာအေသာကးမာက စာဖစးပါသလာ
Do you eat fatty and salty food?
၈ အၿမစာဖစးသညး / always eat
ဿ၈ ရဖနးရခါစာဖစးသညး / eat occassionally
၀၈ မစာပါ၇ သတထာ၍ ေရြာငးၾကဥးသညး /do not eat / avoid with care
P.12. ကယးလကးလႈပးရြာ အာကစာ တစးမမက စျစျၿမၿမ လပးေလရြသလာ
Do you do any kind of sports activities regularly?
Dr.Aung Kyaw Myint | AMI survey report 86
၈ လပးသညး / do
ဿ၈ မလပးဖစးပါ / do not do
P.13. သငးမသာစ ညဖကးအပးစကးေသာအခါ ခငးေထာငးေထာငးေလရြပါသလာ
Does your family use mosquito net when sleeping?
၈ အၿမေထာငးသညး / always use
ဿ၈ တစးခါတစးရ မေထာငးဖစးပါ / do not use sometimes
၀၈ မညးသညးအခါမြ ခငးေထာငးဖငးမအပးပါ / never use mosquito net
P.14. ကေလငယးမာ ေန႔လညးေန႔ခငး အပးစကးပါက ခငးေထာငးေထာငးေပေလရြသလာ
Do you use mosquito net for children when they sleep in afternoon?
၈ ေထာငးေပပါသညး / yes
ဿ၈ မေထာငးေပဖစးပါ / no
P.15. အမးရြေရတငးကမာက သၿပလြငး အဖဖထာေလရြသလာ
Do you put covers on the water tank after use?
၈ ရြသညး / yes
ဿ၈ မရြပါ / no
P.16. အမးေဘပါတးလညးရြ ၿခႏျယးပတးေပါငးမာ၇ ေရေမာငးမာက ရြငးလငးေလရြသလာ
Do you clean bushes and drainage channels?
၈ ရြသညး / yes
ဿ၈ မရြပါ / no
Dr.Aung Kyaw Myint | AMI survey report 87
Annex 2: Data master sheet
Wa Raw Data- Excel spreadsheet