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Dougherty K, Creber RM, Zawtha B, Benda NC. Community Health Recommendations Driven by mHealth Population Surveillance Data Amongst Burmese Displaced People in Eastern India: A Pilot Usability Assessment of a Mobile Health Application for Data Collection. AMIA ... ANNUAL SYMPOSIUM PROCEEDINGS. AMIA SYMPOSIUM 2024; 2023:933-941. [PMID: 38222406 PMCID: PMC10785942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
With recent increases in armed conflict and forced migration, refugee health has become a growing priority amongst those who work in global health. Refugees and forced migrants, also known as displaced persons, face barriers to accessing health services and are often at an increased risk for adverse health outcomes, such as sexual violence, infectious diseases, poor maternal outcomes, and mental health concerns. Mobile health (mHealth) applications have been shown to increase access and improve health outcomes among refugee populations. Our study aims to evaluate the feasibility of using a novel mHealth application to conduct population health surveillance data collection amongst a population of Myanmar citizens who have been forced to relocate to eastern India. The data collected in a low-resource setting through the mHealth application will be used to identify priority areas for intervention which will assist in the development of a tailored intervention plan that best suits our population.
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Saw HW, Owens V, Morales SA, Rodriguez N, Kern C, Bach RL. Population mental health in Burma after 2021 military coup: online non-probability survey. BJPsych Open 2023; 9:e156. [PMID: 37575042 PMCID: PMC10594092 DOI: 10.1192/bjo.2023.550] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 07/04/2023] [Accepted: 07/12/2023] [Indexed: 08/15/2023] Open
Abstract
BACKGROUND Humanitarian crises and armed conflicts lead to a greater prevalence of poor population mental health. Following the 1 February 2021 military coup in Burma, the country's civilians have faced humanitarian crises that have probably caused rising rates of mental disorders. However, a dearth of data has prevented researchers from assessing the extent of the problem empirically. AIMS To better understand prevalence of depressive and anxiety disorders among the Burmese adult population after the February 2021 military coup. METHOD We fielded an online non-probability survey of 7720 Burmese adults aged 18 and older during October 2021 and asked mental health and demographic questions. We used the Patient Health Questionnaire-4 to measure probable depression and anxiety in respondents. We also estimated logistic regressions to assess variations in probable depression and anxiety across demographic subgroups and by level of trust in various media sources, including those operated by the Burmese military establishment. RESULTS We found consistently high rates of probable anxiety and depression combined (60.71%), probable depression (61%) and probable anxiety (58%) in the sample overall, as well as across demographic subgroups. Respondents who 'mostly' or 'completely' trusted military-affiliated media sources (about 3% of the sample) were significantly less likely than respondents who did not trust these sources to report symptoms of anxiety and depression (AOR = 0.574; 95% CI 0.370-0.889), depression (AOR = 0.590; 95% CI 0.383-0.908) or anxiety (AOR = 0.609; 95% CI 0.390-0.951). CONCLUSIONS The widespread symptoms of anxiety and depression we observed demonstrate the need for both continuous surveillance of the current situation and humanitarian interventions to address mental health needs in Burma.
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Affiliation(s)
- Htay-Wah Saw
- Michigan Program in Survey and Data Science, University of Michigan, Ann Arbor, USA
| | | | - Stephanie A. Morales
- Michigan Program in Survey and Data Science, University of Michigan, Ann Arbor, USA
| | - Nicolas Rodriguez
- Michigan Program in Survey and Data Science, University of Michigan, Ann Arbor, USA
| | | | - Ruben L. Bach
- Mannheim Centre for European Social Research (MZES), University of Mannheim, Mannheim, Germany
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Akhter-Khan SC, Wai KM, Drewelies J. Loneliness in Myanmar's older population: A mixed-methods investigation. J Cross Cult Gerontol 2022; 37:315-337. [PMID: 36301411 PMCID: PMC9643263 DOI: 10.1007/s10823-022-09459-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2022] [Indexed: 01/31/2023]
Abstract
OBJECTIVES Little is known about loneliness in lower- and middle-income countries. This study investigates loneliness in the older population of Myanmar using a mixed-methods approach. METHODS To identify predictors of loneliness, hierarchical regression models were used to analyze data from the Myanmar Aging Survey 2012 (N = 3,618, 57% women). In a mixed-methods sequential explanatory design, quantitative data were integrated with qualitative data from semi-structured interviews with older adults in Myanmar in 2019. RESULTS The prevalence of loneliness varied by between-person characteristics. Health impairments, lower income, being widowed, not having children, and living with fewer household members were each associated with loneliness. Qualitative findings suggested that the physical presence of family members was especially protective against loneliness. Religion had mixed associations with loneliness, depending on the type of religious practice, demographic characteristics, health status, and community engagement. DISCUSSION The findings contribute to a better understanding of individuals' experiences of loneliness and may inform the design of interventions to prevent loneliness in Myanmar and globally.
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Affiliation(s)
- Samia C. Akhter-Khan
- Department of Health Service & Population Research, King’s College London, London, UK
| | | | - Johanna Drewelies
- Department of Psychology, Humboldt University of Berlin, Berlin, Germany ,Lise Meitner Group for Environmental Neuroscience, Max-Planck-Institute for Human Development, Berlin, Germany
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Marthoenis, Htay MNN, Arafat SMY. Quality of online news reporting of suicidal behavior in Myanmar: Adherence to the World Health Organization reporting guidelines. Indian J Psychiatry 2021; 63:597-600. [PMID: 35136259 PMCID: PMC8793717 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_285_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 10/04/2021] [Accepted: 10/13/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Media reporting of suicide has an essential role in the suicidal behavior of the general population. AIMS The aim of this study is to assess the quality of online news reports of suicidal behavior in Myanmar against the World Health Organization (WHO) reporting guidelines. METHODS We performed a content analysis of all available suicide-related news reports published in vernacular online newspapers of Myanmar. RESULTS A total of 285 reports were analyzed, consisting of 87.4% suicides and 12.6% nonfatal suicidal attempts. Potentially, harmful information reported in the text includes the methods of suicide (100%), the word or term in Burmese related to suicide (89.5%), the name of the person (56.5%), life event (50.5%), and photo or suicidal person (17.9%). Meanwhile, helpful information such as prevention programs and the contact information for suicide services to the readers have been infrequently reported. CONCLUSION The study found that the newspaper reporting of suicide in Myanmar is grossly nonadherent to the WHO media guidelines.
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Affiliation(s)
- Marthoenis
- Department of Psychiatry and Mental Health Nursing, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Mila Nu Nu Htay
- Department of Community Medicine, Melaka-Manipal Medical College, Manipal Academy of Higher Education, Melaka, Malaysia
| | - S M Yasir Arafat
- Department of Psychiatry, Enam Medical College and Hospital, Savar Union, Bangladesh
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Cho SM, Saw YM, Saw TN, Than TM, Khaing M, Khine AT, Kariya T, Soe PP, Oo S, Hamajima N. Prevalence and risk factors of anxiety and depression among the community-dwelling elderly in Nay Pyi Taw Union Territory, Myanmar. Sci Rep 2021; 11:9763. [PMID: 33963225 PMCID: PMC8105404 DOI: 10.1038/s41598-021-88621-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 04/07/2021] [Indexed: 12/02/2022] Open
Abstract
Providing elderly mental healthcare in Myanmar is challenging due to the growing elderly population and limited health resources. To understand common mental health problems among Myanmar elderly, this study explored the prevalence and risk factors of anxiety and depression among the elderly in the Nay Pyi Taw Union Territory, Myanmar. A cross-sectional study was conducted among 655 elderly by face-to-face interviews with a pretested questionnaire. Descriptive analysis and multiple logistic regression analyses were performed. The prevalence of anxiety and depression were 39.4% (33.5% for males and 42.4% for females) and 35.6% (33.0% for males and 36.9% for females), respectively. The adjusted odds ratio of having anxiety was significant for having low education level, having comorbidity, having BMI < 21.3, poor dental health, no social participation, and having no one to consult regarding personal problems, while that of having depression was significant for having comorbidity, having BMI < 21.3, poor vision, and having no one to consult regarding personal problems. The reported prevalence of anxiety and depression indicate the demand for mental healthcare services among Myanmar elderly. Myanmar needs to improve its elderly care, mental healthcare, and social security system to reflect the actual needs of its increasing elderly population. Screening for anxiety and depression among elderly with comorbidities should be promoted. Raising community awareness of mental health, encouraging social participation, and supportive counselling are also essential in combating anxiety and depression among Myanmar elderly.
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Affiliation(s)
- Su Myat Cho
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
- Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan.
| | - Thu Nandar Saw
- Department of Community and Global Health, The University of Tokyo, 5th Floor, Medical Bldg. No. 3, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Thet Mon Than
- Medical Care Division, Department of Medical Services, Ministry of Health and Sports, Office No. 4, Nay Pyi Taw, 15011, Nay Pyi Taw Union Territory, Myanmar
| | - Moe Khaing
- Medical Care Division, Department of Medical Services, Ministry of Health and Sports, Office No. 4, Nay Pyi Taw, 15011, Nay Pyi Taw Union Territory, Myanmar
| | - Aye Thazin Khine
- Planning Unit, Department of Public Health, Ministry of Health and Sports, Office No. 47, Nay Pyi Taw, 15011, Nay Pyi Taw Union Territory, Myanmar
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
- Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Pa Pa Soe
- Department of Preventative and Social Medicine, University of Medicine, 30th Street, Between 73rd & 74th Streets, Mandalay, Myanmar
| | - San Oo
- Department of Neurology, Yangon General Hospital, Bo Gyoke Road, Lanmadaw Township 11131, Yangon, Myanmar
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
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Than MW, Zaw NT, Minn K, Saw YM, Kiriya J, Jimba M, Win HH, Shibanuma A. Assessing depressive symptoms among people living with HIV in Yangon city, Myanmar: Does being a member of self-help group matter? PLoS One 2021; 16:e0248807. [PMID: 33735312 PMCID: PMC7971502 DOI: 10.1371/journal.pone.0248807] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 03/07/2021] [Indexed: 12/12/2022] Open
Abstract
Background While self-help groups have been formed among people living with HIV, few studies have been conducted to assess the role of self-help groups in mitigating depressive symptoms. This study investigated the association between self-help group membership and depressive symptoms among people living with HIV in Yangon, Myanmar. Methods In this cross-sectional study, data were collected from people living with HIV at three antiretroviral therapy clinics in 2017. Multiple logistic regression analyses were carried out to examine the associations between having self-help group membership and depressive symptoms. Three ART clinics were purposively selected based on the recommendation from the National AIDS Program in Myanmar. At these clinics, people living with HIV were recruited by a convenience sampling method. Results Among people living with HIV recruited in this study (n = 464), 201 (43.3%) were members of a self-help group. The membership was not associated with having depressive symptoms (adjusted odds ratio [AOR] 1.59, 95% confidence interval [CI] 0.98–2.59). Factors associated with having depressive symptoms were female (AOR 3.70, 95% CI 1.54–8.88) and lack of social support (AOR 0.97, 95% CI 0.96–0.98) among self-help group members, and female (AOR 3.47, 95% CI 1.70–7.09), lack of social support (AOR 0.98, 95% CI 0.97–0.99), and internalized stigma (AOR 1.28, 95% 1.08–1.53) among non-members. Conclusions This study did not find evidence on the association between membership in self-help groups and depressive symptoms among people living with HIV. Social support was a protective factor against depressive symptoms both self-help group members and non-members, although the level of social support was lower among members than non-members. The activities of self-help groups and care provided by the ART clinics should be strengthened to address mental health problems among people living with HIV in the study site.
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Affiliation(s)
- Myat Wint Than
- Department of Community and Global Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | | | - Kyi Minn
- Myanmar Health and Development Consortium, Yangon, Myanmar
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Junko Kiriya
- Department of Community and Global Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Masamine Jimba
- Department of Community and Global Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Hla Hla Win
- Department of Preventive and Social Medicine, University of Medicine 1, Yangon, Myanmar
| | - Akira Shibanuma
- Department of Community and Global Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
- * E-mail:
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Sasaki Y, Shobugawa Y, Nozaki I, Takagi D, Nagamine Y, Funato M, Chihara Y, Shirakura Y, Lwin KT, Zin PE, Bo TZ, Sone T, Win HH. Association between depressive symptoms and objective/subjective socioeconomic status among older adults of two regions in Myanmar. PLoS One 2021; 16:e0245489. [PMID: 33507963 PMCID: PMC7842968 DOI: 10.1371/journal.pone.0245489] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 01/03/2021] [Indexed: 12/20/2022] Open
Abstract
Low objective socioeconomic status (SES) has been correlated with poor physical and mental health among older adults. Some studies suggest that subjective SES is also important for ensuring sound physical and mental health among older adults. However, few studies have been conducted on the impact of both objective and subjective SES on mental health among older adults. This study examines whether objective or subjective SES is associated with depressive symptoms in older adults in Myanmar. This cross-sectional study, conducted between September and December, 2018, used a multistage sampling method to recruit participants from two regions of Myanmar, for face-to-face interviews. The Geriatric Depression Scale (GDS) was used to evaluate the depressive symptoms. Participants were classified as having no depressive symptom (GDS score <5) and having depressive symptoms (GDS score ≥5). Objective and subjective SES were assessed using the wealth index and asking participants a multiple-choice question about their current financial situation, respectively. The relationship between objective/subjective SES and depressive symptoms was examined using a multivariable logistic regression analysis. The mean age of the 1,186 participants aged 60 years and above was 69.7 (SD: 7.3), and 706 (59.5%) were female. Among them, 265 (22.3%) had depressive symptoms. After adjusting for objective SES and other covariates, only low subjective SES was positively associated with depressive symptoms (adjusted odds ratio, AOR: 4.18, 95% confidence interval, CI: 2.98-5.87). This association was stronger among participants in the rural areas (urban areas, AOR: 2.10, 95% CI: 1.08-4.05; rural areas, AOR: 5.65, 95% CI: 3.69-8.64). Subjective SES has a stronger association with depressive symptoms than objective SES, among older adults of the two regions in Myanmar, especially in the rural areas. Interventions for depression in older adults should consider regional differences in the context of subjective SES by reducing socioeconomic disparities among the communities.
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Affiliation(s)
- Yuri Sasaki
- National Institute of Public Health, Wako, Japan
- * E-mail:
| | - Yugo Shobugawa
- Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Ikuma Nozaki
- National Center for Global Health and Medicine, Tokyo, Japan
| | | | | | - Masafumi Funato
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Yuki Chihara
- Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yuki Shirakura
- Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | | | - Poe Ei Zin
- University of Medicine 1, Yangon, Myanmar
| | | | | | - Hla Hla Win
- University of Medicine 1, Yangon, Myanmar
- University of Public Health, Yangon, Myanmar
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Lakin DP, Win KS, Aung H, Soe KNC, Kyi B, Marcell AV, Tol WA, Bass JK. Masculinity and mental health treatment initiation for former political prisoners in Yangon, Myanmar - a qualitative investigation. BMC Public Health 2021; 21:211. [PMID: 33494730 PMCID: PMC7836164 DOI: 10.1186/s12889-021-10249-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 12/20/2020] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Men living in low- and middle-income countries are unlikely to seek mental health care, where poor healthcare infrastructure, differences in illness conceptualization, and stigma can impact treatment seeking. Vulnerable groups, such as former political prisoners, are more likely than others to experience potentially traumatic events that may lead to negative mental health outcomes. To improve the likelihood of successful engagement of vulnerable men in psychotherapy, it is necessary to identify factors that influence treatment adherence, and to better understand men's attitudes surrounding decisions to seek and initiate care. The purpose of this investigation was to explore themes of masculinity, treatment seeking, and differences between male former political prisoners who accepted and declined therapy in an urban low-income context. METHODS We conducted a qualitative, interview-based investigation with 30 former political prisoners in Yangon, Myanmar who were eligible to receive mental health counseling provided by the non-governmental organization (NGO), Assistance Association for Political Prisoners. Men were initially screened using a composite questionnaire with items related to depression, anxiety, and posttraumatic stress symptom severity. After screening, if potential clients were identified as having probable mental health problems, they were asked if they would like to participate in a multi-session cognitive behavioral therapy program. Semi-structured, open-ended interviews were conducted with 15 participants who accepted and 15 participants who declined therapy. Interviews were transcribed and translated by local partners and thematically coded by the authors. We used thematic analysis to identify and explore differences in treatment-seeking attitudes between men who accepted and men who declined the intervention. RESULTS Men described that being a community leader, self-reliance, morality, and honesty were defining characteristics of masculinity. A focus on self-correction often led to declining psychotherapy. A general lack of familiarity with psychological therapy and how it differed from locally available treatments (e.g. astrologists) was connected to stigma regarding mental health treatment. CONCLUSIONS Masculinity was described in similar terms by both groups of participants. The interpretation of masculine qualities within the context of help-seeking (e.g. self-reliance as refusing help from others versus listening to others and applying that guidance) was a driving factor behind men's decision to enter psychotherapy.
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Affiliation(s)
- Daniel P. Lakin
- grid.21107.350000 0001 2171 9311Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Suite 780, Baltimore, MD 21205 USA
| | - Kyaw Soe Win
- Assistance Association for Political Prisoners, No. 75 Oakthaphayar Street, 33 Extension Ward, North Dagon Township, Yangon, Myanmar
| | - Htin Aung
- Assistance Association for Political Prisoners, No. 75 Oakthaphayar Street, 33 Extension Ward, North Dagon Township, Yangon, Myanmar
| | - Khin Nyein Chan Soe
- Assistance Association for Political Prisoners, No. 75 Oakthaphayar Street, 33 Extension Ward, North Dagon Township, Yangon, Myanmar
| | - Bo Kyi
- Assistance Association for Political Prisoners, No. 75 Oakthaphayar Street, 33 Extension Ward, North Dagon Township, Yangon, Myanmar
| | - Arik V. Marcell
- grid.21107.350000 0001 2171 9311Johns Hopkins University School of Medicine, 200 N Wolfe Street, Baltimore, MD 21287 USA
| | - Wietse A. Tol
- grid.21107.350000 0001 2171 9311Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Suite 780, Baltimore, MD 21205 USA
| | - Judith K. Bass
- grid.21107.350000 0001 2171 9311Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Suite 780, Baltimore, MD 21205 USA
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Akhter-Khan SC, Wai KM. Can COVID-19 Move Myanmar in the Right Direction? Perspectives on Older People, Mental Health, and Local Organizations. Am J Geriatr Psychiatry 2020; 28:921-923. [PMID: 32631750 PMCID: PMC7291977 DOI: 10.1016/j.jagp.2020.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 05/04/2020] [Accepted: 06/08/2020] [Indexed: 11/17/2022]
Abstract
• Mental Health in Myanmar needs more attention, funding, and research. • Older people's mental health in Myanmar is exacerbated by economic and social effects of COVID-19. • Local community organizations are the main source of care for older people, yet in urgent need for financial support.
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Affiliation(s)
- Samia C. Akhter-Khan
- Department of Psychology (SCAK), Humboldt University of Berlin, Berlin, Germany,Department of Psychology and Neuroscience (SCAK), Duke University, Durham, NC,Send correspondence and reprint requests to Samia C. Akhter-Khan B.Sc., Department of Psychology, Humboldt University of Berlin, Berlin, Germany.
| | - Khin Myo Wai
- Enlightened Myanmar Research Foundation (KMW), Yangon, Myanmar
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