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The recent census results highlight the gap in access to education and family planning options for women living in rural areas, say human rights and non-governmental organisations.
Married women in Chin State give birth to nine children on average, compared to four in Rangoon, according to the 2014 Myanmar Population and Housing Census Thematic Report on Fertility and Nuptiality.
Chin human rights activist Cheery Zahau believes that the high fertility rate in Chin State is linked to the low high-school completion rate in her region.
She says that the government needs to invest in education to give more women opportunities. “I have been strongly advocating for a long time that the education system needs to be decentralised,” she said in a telephone interview with DVB on Thursday. “The central government says if you have 500 people you get a high school, but in Chin State there are so many small villages so they just need one or two teachers–not one teacher per subject.”
The adolescent fertility rate is 33 births annually per 1,000 women aged 15-19, with regional highs in Shan and Chin states. A lack of awareness and access to contraception are some of the factors contributing to the high fertility rate.
“Looking at the high adolescent rate–these are exactly the things we want to be avoiding. Girls have a right to complete their education,” said Janet E. Jackson, the United Nations Population Fund (UNFPA) representative for Burma, noting that births by very young women are also of concern as they can often result in health problems for both mother and child.
Jackson advocates a multi-sectored approach with investments in education and health. “It’s about being able to complete education, and encourage and support girls in their secondary education and beyond to prepare them for adulthood and a career.”
The census data raises other issues that need to be addressed–such as options for unwanted pregnancies, and the country’s high maternal mortality rate.
Jackson points to the fertility surveys data — 24 percent of maternal mortality incidents in the year before the April 2014 census were among 15- 24 year olds. “All of these were preventable,” she said.
On a positive note, more information and choices for contraception are slowly being put on the table for women in Burma.
“One of the biggest barriers is access, and about presenting comprehensive information and services to young people so if they want counselling or certain situations they can do so and link to health providers,” explained the UNFPA representative.
UNFPA is working in collaboration with the Ministry of Health and Sports to introduce sex education in schools. In addition, 70 health centres nationwide are promoting ‘youth corners’ where young people can have a quiet space to access information and talk together. They are also rolling out a new programme that will provide US$1 million worth of implant contraceptives, part of $2.6 million to be directed towards reproductive health-related supplies.
Although investment in healthcare is still lacking in isolated areas such as Chin State, a few small improvements have been noted since 2011. “There’s been some progress such as mini-clinics set up in each township but there they do not always have a regular doctor, only a nurse,” said Cheery Zahau.
Thang Khan Tuang of Chin Natural Resource Watch echoed the sentiment that coordinated development in the region is inadequate. “It’s not just a lack of services but also, in my opinion, because Chin people are still using agriculture systems from the 19th century,” she told DVB. “Young people have no technical support or new job opportunities—so this cycle of poverty just goes round again and again.”
A lack of knowledge about healthcare contributes to inadequate nutrition in women, which can in turn affect the well-being of young mothers. “In Chin State, they have enough vegetables but they don’t know how to utilise them with other supplements such as milk. This is resulting in high malnutrition rates,” said Cheery Zahau.
Another influence on the high birth rate is culture and religion. The majority of Chins are Christians; contraception is still frowned upon according to their faith, said Cheery Zahau.
Notwithstanding these crucial issues, other indicators gleaned from the 2014 census suggest a progressive trend in Burmese women’s sense of independence.
For example, the average age for a woman’s first marriage has risen from 21.3 years in 1973 to 23.6. Burma also has the second highest ratio in the Southeast Asian region of women who never marry. It is more than four times higher than in Laos, and more than double that of Vietnam and Cambodia.
“It may be linked to women becoming more independent at ages of 35 to 45, and not wanting to have a family,” suggested Nan Htwe, the programme co-ordinator of Akhaya Women, an organisation that provides support for women to challenge gender stereotypes.