survey report by dr akm version 2

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


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.


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.


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


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


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


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


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


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.


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.


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.


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


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


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%.


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


Table 31. Community responses for malaria

Treatment for malaria Frequency Percent


Go to VHV 46 17.16


Go to AMW 11 4.10

Go to HU clinic 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


Table 32. Community responses for ARI

Treatment for ARI Frequency Percent

Go to VHV 105 39.18



Go to AMW 18 6.72

Matkalung 11 4.10

Treat with Amoxicillin 9 3.36


Total 268 100.00


0.005.00

10.0015.0020.0025.0030.0035.0040.00

39.18

32.84

11.946.72

4.10 3.36 1.87


Table 33. Community responses for malnutrition

Treatment for malnutrition Frequency Percent


Go to VHV 39 14.55

Go to AMW 11 4.10


Feeding 6 2.24

Go to Chinese clinic 5 1.87

HE 3 1.12

Total 268 100.00


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


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


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


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


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


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


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


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


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


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


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


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


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


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)


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)


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)


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


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


95.888.9

4.211.1

Good practice

Bad practice


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


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)


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)


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)


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


90.0

30.9

10.0

69.1

Good attitude

Bad attitude


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


80.0

9.9

20.0

90.1 Good practice

Bad practice


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


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


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.


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.


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.


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.


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


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 ___________________________________


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


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


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


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?


_______________________________________________________________________________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________

___________________________________________

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


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


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


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)

__________________________________________

__________________________________________

__________________________________________

__________________________________________

__________________________________________


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)


ေ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?


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?



၁၈ေပလစတးမရြလငး ေပလစတး၄ြေအာငးဘယးလပ ပငေပာငးလမြ မ ဖစးသငး.သလ၈ if not willing to pay, which changes

should happen so that you are willing to pay?


_______________________________________________________________________________________________

_______________________________________________________________________________________________

________________________________________________________

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


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?



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?


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


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



K.3. ကယးဝနးေဆာငးေစာငးေရြာကးမႈ ခယခငး / antenatal care



K.4. ေမျ ကငးစကေလက မခငးႏ႔ တစးမထသာ တကးေကျ ခငး

/ exclusive breast feeding

အေရႀကသညး / important


K.5. ေဆလပးေသာကးခငးမြေရြာငးၾကဥးခငး / avoiding smoking



K.6. အရကးေသစာ မေသာကးစာခငး / Avoiding alcohol



K.7. အေပားအပါမလကးစာပ အမးေထာငးဖကးအေပၚသစၥာရြခငး

Being faithful to spouse




K.8. အဆအဆမးမာေသာအစာအေသာကး၇ ငနးလျနးသညးအစာအေသာကးမာက

ဆငးခငးခငး

Avoiding fatty food and salty food



K.9. ကယးလကးလႈပးရြာအာကစာလပးခငး / doing sports



K.10. ကနးမာေရဗဟသတလကးစာခငး / reading health knowledge



K.11. ကနးမာေရေစာငးေရြာကးသ၏ အႀကေပခကးမာက လကးနာခငး

Following advice of health care provider



K.12. သနး႔ရြငးေသာ ေရက သစျ ခငး / using clean water



K.13. ယငးလအမးသာ သစျ ခငး / using fly proof latrines



K.14. ယငးနာစာ မစာခငး avoiding food that has contact with flies




K.15. တစးကယးေရသနး႔ရြငးခငး (ေရမြနးမြနးခခငး) good hygiene (regular shower)



K.16. အမးသာတကးၿပတငးလကးကဆပးပာဖငးေဆခငး washing hands after defecation



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


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.


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 ?


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?


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?



P.16. အမးေဘပါတးလညးရြ ၿခႏျယးပတးေပါငးမာ၇ ေရေမာငးမာက ရြငးလငးေလရြသလာ

Do you clean bushes and drainage channels?




Annex 2: Data master sheet

Wa Raw Data- Excel spreadsheet

survey report by dr akm version 2

Documents