Parmar Parveen Kaur, Barina Charlene C, Low Sharon, Tun Kyaw Thura, Otterness Conrad, Mhote Pue P, Htoo Saw Nay, Kyaw Saw Win, Lwin Nai Aye, Maung Cynthia, Moo Naw Merry, Oo Eh Kalu Shwe, Reh Daniel, Mon Nai Chay, Singh Nakul, Goyal Ravi, Richards Adam K
Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, 02118, United States of America.
Community Partners International, Mae Sot, Thailand; University of Washington, Seattle, Washington, United States of America.
PLoS One. 2015 May 13;10(5):e0121212. doi: 10.1371/journal.pone.0121212. eCollection 2015.
Myanmar transitioned to a nominally civilian parliamentary government in March 2011. Qualitative reports suggest that exposure to violence and displacement has declined while international assistance for health services has increased. An assessment of the impact of these changes on the health and human rights situation has not been published.
Five community-based organizations conducted household surveys using two-stage cluster sampling in five states in eastern Myanmar from July 2013-September 2013. Data was collected from 6, 178 households on demographics, mortality, health outcomes, water and sanitation, food security and nutrition, malaria, and human rights violations (HRV). Among children aged 6-59 months screened, the prevalence of global acute malnutrition (representing moderate or severe malnutrition) was 11.3% (8.0-14.7). A total of 250 deaths occurred during the year prior to the survey. Infant deaths accounted for 64 of these (IMR 94.2; 95% CI 66.5-133.5) and there were 94 child deaths (U5MR 141.9; 95% CI 94.8-189.0). 10.7% of households (95% CI 7.0-14.5) experienced at least one HRV in the past year, while four percent reported 2 or more HRVs. Household exposure to one or more HRVs was associated with moderate-severe malnutrition among children (14.9 vs. 6.8%; prevalence ratio 2.2, 95% CI 1.2-4.2). Household exposure to HRVs was associated with self-reported fair or poor health status among respondents (PR 1.3; 95% CI 1.1-1.5).
This large survey of health and human rights demonstrates that two years after political transition, vulnerable populations of eastern Myanmar are less likely to experience human rights violations compared to previous surveys. However, access to health services remains constrained, and risk of disease and death remains higher than the country as a whole. Efforts to address these poor health indicators should prioritize support for populations that remain outside the scope of most formal government and donor programs.
2011年3月，缅甸过渡到名义上的文职议会政府。定性报告表明，暴力和流离失所现象有所减少，而对卫生服务的国际援助有所增加。尚未发表对这些变化对健康和人权状况影响的评估。
2013年7月至9月，五个社区组织在缅甸东部五个邦采用两阶段整群抽样法进行了家庭调查。从6178户家庭收集了有关人口统计学、死亡率、健康结果、水和卫生设施、粮食安全与营养、疟疾以及侵犯人权行为（HRV）的数据。在筛查的6至59个月大的儿童中，全球急性营养不良（代表中度或重度营养不良）的患病率为11.3%（8.0 - 14.7）。在调查前一年共发生了250例死亡。其中婴儿死亡64例（婴儿死亡率94.2；95%置信区间66.5 - 133.5），儿童死亡94例（五岁以下儿童死亡率141.9；95%置信区间94.8 - 189.0）。10.7%的家庭（95%置信区间7.0 - 14.5）在过去一年中至少经历了一次侵犯人权行为，而4%的家庭报告有2次或更多次侵犯人权行为。家庭遭受一次或多次侵犯人权行为与儿童中度至重度营养不良相关（14.9%对6.8%；患病率比2.2，95%置信区间1.2 - 4.2）。家庭遭受侵犯人权行为与受访者自我报告的健康状况为一般或较差相关（患病率比1.3；95%置信区间1.1 - 1.5）。
这项关于健康和人权的大型调查表明，政治过渡两年后，与之前的调查相比，缅甸东部的弱势群体遭受侵犯人权行为的可能性较小。然而，获得卫生服务仍然受到限制，疾病和死亡风险仍然高于全国整体水平。应对这些不良健康指标的努力应优先支持那些仍处于大多数正规政府和捐助项目范围之外的人群。
