About Us

12:33 AM Unknown 1 Comments

Contact Information

12:25 AM Unknown 0 Comments

Partners' Links

12:20 AM Unknown 0 Comments

Quality of Life of the Elderly People in Einme Township Irrawaddy Division, Myanmar

12:15 AM Unknown 0 Comments

Quality of Life of the Elderly People in Einme Township
Irrawaddy Division, Myanmar
Myo Myint Naing* Sutham Nanthamongkolchai** Chokchai Munsawaengsub**
*Medical officer, Medicines Sans Frontieres-Holland ,Myanmar
**Department of Family Health, Faculty of Public Health, Mahidol University, Bangkok,Thailand
4
ARTICLE INFO
Article history :
Received July 2010
Received in revised form September 2010
Accepted October 2010
Available online January 2011
Keywords:
Quality of life
Elderly people
Self-esteem
Family relationship
Corresponding Author:
Nanthamongkolchai S,
Department of Family Health,
Faculty of Public Health,
Mahidol University,
Bangkok 10400,Thailand.
Email : phsnt@mahidol.ac.th
Asia J Public Health 2010; 1(2):4-10
ABSTRACT
Objective: To study the quality of life of the elderly people in Einme Township, Irrawaddy Division, Myanmar, and factors related. Materials and Methods: A cross-sectional survey was conducted among 209 elderly aged 60 and over, who lived in Einme Township, Irrawaddy Division, Myanmar. Data were collected by using structured interview questionnaire from February 1 to 21, 2010. Statistics used for data analysis were frequency, percentage, mean, standard deviation, Pearson product moment correlation coefficient, and Multiple regression analysis. Results: The majority of the elderly people (80.9%) had a moderate level of quality of life, followed by high level(17.2%) and low level(1.9%). The factors that were statistically significantly related to the quality of life of elderly were education level, current illness, self-esteem, family income, family relationship and social support. In addition, self-esteem and family relationship could significantly predict the quality of life of elderly by 53.3%. Self-esteem had the highest predictive power of quality of life. Conclusion: The factors related to quality of life of elderly people were self-esteem and family relationship. To promote quality of life of the elderly, responsible organizations should establish activities that enhance elderly self-esteem and promote good family relationship.
INTRODUCTION
Quality of life is essential. Improving the quality of life is now a common aim of international development. However, enjoyment in life and a sense of purpose and happiness can still elude elderly people, making these important problems that need to be solved, especially in one’s advanced years1. It is not easy growing old and most times, depression attacks elderly people, and especially they tend to feel helpless and inactive after retirement, with their role as primary provider having finished. So, they are more negative and sensitive and rely on others, so they should be cared for to achieve a good quality of life.
The quality of life of elderly people has become relevant with the demographic shift towards an aging society. There are indications that concepts and concerns related to quality of life in elderly people are different from the general population. The majority of the elderly people evaluate their quality of life positively on the basis of social contacts, dependency, health, material circumstances and social comparisons.
Asia Journal of Public Health, July-December 2010 Vol.1 No. 2
5
Adaptation and resilience might play a part in maintaining a good quality of life. With all other influences controlled, ageing does not influence quality of life negatively, and a long period of good quality of life is possible2. Therefore, the maintenance and improvement of the quality of life become important issues. The proportion of elderly people (aged 60 or over) in the world population3 has increased, and also, in Asia4, the size and proportion of the elderly population was 281 million and 8.2% respectively. This means that 52% of the world’s elderly populations are living in Asian countries. In developing countries, including Asia, the elderly populations are increasing rapidly. These demographic changes are a direct result of the success of socio-economic development that has led to a decline in mortality rates at all ages and a reduction in fertility. However, an aged population might be expected to suffer with the problems of dependency and disability leading to an increased burden of disease. Myanmar5 has also emerged as a nation with an ageing population, and the proportion of elderly people over 60 has gradually increased from 6.4% in 1980-81 to 8.3% in 2005-06. Einme is a sub-urban area in the Myaungmya District, Irrawaddy division. The district is a deltaic tract, bordering south on the sea and traversed by many tidal creeks. The occupations of rice cultivation and fishing engage practically all the inhabitants of the district.
According to a report from Help Age International6, 2008, dependency ratio of the total older people in delta region, was 51.8% with the highest dependency ratio found in the poorest, female, old-old group. Also, 6.8% of the elderly live alone. The highest percentage of loneliness was found in the poorest male, old-old group. 59.8% of the elderly have no means of earning a living and 82% do not own property. 63.2% of the elderly are classified as the poorest of the poor. 29.2% are considered poor and only 7.7% are moderately self-sustainable. The highest percentage of the poorest was found in the oldest female group. Moreover, the study of the health status and quality of life of Thai elderly by Assantachai P and Maranetra N7 show that 61.4 % had a good quality of life and 38.6% had a low quality of life. The factors associated with a low quality of life were not living with the spouse, poor financial status, no regular exercise, sleeping or hearing difficulty, suffering from joint pain or diabetes mellitus, and history of a fall within the last 6 months. It is obvious that the elderly have faced both physical and mental problems and resulting bad health that led to negative mind and lower quality of life. Thus, it is no longer possible to ignore the commencing ageing phenomenon in Myanmar and therefore, it is vital to anticipate the requirements of the old age group in Myanmar in order to plan appropriate policies to address their growing needs and to support their quality of life.
In Myanmar, there is no specific policy for elderly people such as compulsory welfare services for the elderly or health insurance coverage, and there is still low awareness of the special needs for elderly people and staff working in the homes for the aged who have yet to understand the basics of care for the elderly (daily physical activity, minor illnesses and social support). Cooperation between health staff and social welfare staff is still weak regarding services at the homes for the aged5. So, the researcher was interested in studying quality of life of the elderly people in Einme Township, as well as factors affecting the quality of life of elderly people in Einme Township. The researcher also believes that the results derived from the study will be beneficial to public health sectors and other related organizations for conducting an effective plan and aid management to help and take care of elderly people in future.
MATERIALS AND METHODS
The research was a cross-sectional survey on quality of life of the elderly people with a sample group of 209 elderly people both male and female, aged 60 years and over. Data were collected from February 1 to 21, 2010 by the researchers and village health volunteers. The sample groups were selected by simple random sampling from 6 villages of Einme Township, and were made up of those who had been living in the selected village at least 1 year. The research instrument was an interview questionnaire, developed by the researcher and consisted of 6 parts. Part 1 employed general characteristics of elderly people such as age, sex, education level, marital status, family type, occupation of the old aged, family income and any chronic diseases that they had and included 9 questions. Part 2 was to determine the instrumental activities of daily living by using Barthel ADL index, 8 which was used for measuring the functional status and included 10 questions. Part 3 evaluated family relationships and examined feeling and opinion of elderly people towards family relations such as, love and care, interaction among family members, respect among family members, unity among family members, and relaxation among family members. The family relationships included 10 questions and were developed by the researchers by reviewing the family relationships in later life by Smith S9. Part 4 determined the social support by reviewing the work of Cobb S10. The set of questionnaires included 10 items relating to social
Asia Journal of Public Health, July-December 2010 Vol.1 No. 2
6
support from family and relatives or friends. Part 5 assessed self-esteem by using quick self-esteem assessment and included 11 questions. Part 6 evaluated the quality of life by using WHOQOL-BREF11 assessment form to provide a quality of life assessment that looks at domain level profiles. It had a total of 26 questions.
This structured questionnaire was assessed for content validity by three experts. Also, the tested interview questionnaire was then tested for reliability by doing a pretest in the pilot study among 30 elderly people with similar characteristics to those of the study population. The results were analyzed by calculating the Cronbach’s Alpha Coefficient of each set. The reliability results were as follows: questionnaire for family relationship was 0.88, social support was 0.78, self-esteem was 0.88, and quality of life was 0.97. The data were analyzed by descriptive statistics in terms of frequency, percentage, mean, standard deviation and applied to show the general characteristics of elderly people. Chi-square test and Pearson product moment correlation coefficient were used to determine the factors that were related to the quality of life of elderly people and stepwise multiple regressions were also applied to predict the factors that influence the quality of life of elderly people. A p-value of less than 0.05 was set
to consider as statistically significant.
Ethical Approval
The research proposal was approved by the Research Ethics Committee, Faculty of Public Health, Mahidol University, Bangkok Thailand: Ref. No MUPH2010-027.
RESULTS
The total sample of 209 elderly people showed that males made up 48.8% of the group and females 51.2%. The age was between 60 and 96 years with the median age of 69 years (SD = .8.2 years). More than half of them (51.2%) were between 60 and 69 years, followed by 35.4% who were between 70 and 79 years and 13.4% who were more than 80 years. The majority (70.3%) had a primary school education and 22.5%,and 7.2% had no education, and secondary school respectively. More than half, 55%, were married, 27.8% were single and 14.8% were divorced. Among them, 52.6% of the respondents lived with nuclear family members and 47.4% lived with their extended family. About half (55.5%) had no occupation in contrast with 44.5% who had an occupation. There were many farmers, 40.3% of respondents (Table 1).
Table1. Number and percentage of elderly people classified by general characteristics (n=209)
Personal characteristics
No.
%
Gender
Male
102
48.8
Female
107
51.2
age (Years)
60 - 69
107
51.2
70 - 79
74
35.4
80 and above
28
13.4
Median = 69, Minimum = 60, Maximum = 96,
Mean = 69.4, S.D.=8.2
Education level
Primary school
147
70.3
None at all
47
22.5
Secondary school
15
7.2
Marital status:
Married
115
55.0
Single
58
27.8
Widowed
31
14.8
Divorced
3
1.4
Separated
2
1.0
Family type
Nuclear
110
52.6
Extended
99
47.4
Occupation of elderly people:
No occupation
116
55.5
Occupation present
93
44.5
Farmer
84
40.2
Shop
5
2.4
Carpenter
1
0.5
Merchant
1
0.5
Bus driver
1
0.5
Vender
1
0.5
Current illness
With current illness
120
57.4
Without current illness
89
42.6
Chronic diseases
Without chronic disease
158
75.6
With chronic disease
51
24.4
Heart disease and
Hypertension
38
18.2
Diabetes
9
4.3
Cancer
1
0.5
Others
3
1.4
Health condition (Activities of Daily Living)
Just need some help
204
97.6
Need help at moderate level
2
1.0
Need help from other
2
1.0
Totally need help from other
1
0.5
Asia Journal of Public Health, July-December 2010 Vol.1 No. 2
7
Table1. Number and percentage of elderly people classified by general characteristics (n=209) (cont.)
Personal characteristics
No.
%
Family income: (in Kyats)
<10,000
117
56.0
10,000 – 30,000
53
25.4
> 30,000
39
18.7
Median = 10000, Minimum = 1000, Maximum = 300000, Mean = 21665.07, S.D. = 28951.1
Self-esteem
Low level (11-19)
5
2.4
Moderate level (20-26)
143
68.4
High level (27-33)
61
29.2
Family relationship
Low level (10-17)
26
12.4
Moderate level (18-23)
113
54.1
High level (24-30)
70
33.5
Social support
Low level (10-17)
22
10.5
Moderate level (18-23)
143
68.4
High level (24-30)
44
21.1
Almost half of the respondents (42.6%) were healthy now and 57.4% had some current illness. 75.6% of the elderly people were free of chronic diseases and 24.4% had chronic diseases, with the common diseases of hypertension and heart disease afflicting 18.2% of the respondents. Regarding the health condition (activities of daily living) of the 209 elderly people, the majority of the respondents, 97.6%, could perform tasks themselves and just needed some help (Table 1).
Most of the respondents (68.4%) had a moderate level of self-esteem, 29.2% had a high level and only 2.4% had a low level. The results showed that more than half of the elderly people had an income of less than 10000 Myanmar Kyats per month, and 25.4% earned between 10000 and 30000 Kyats monthly. The rest (18.7%) had an income of more than 30000 Kyats per month. The median income per month was 10000 Kyats (SD.28951.1), with the lowest being 1000 Kyats and highest 300000 Kyats (Table 1).
Among the 209 elderly people, 54.1% had a moderate level of family relationship, 33.5% had a high level and 12.4% a low level of family relationship. As for the level of social support in the group, 68.4% had a moderate level of social support, followed by 21.1% and 10.5% with high level and low level of social support respectively (Table 1).
Quality of life of the elderly people
This study indicated that the majority of the elderly people, that is 80.9% had a moderate level of quality of life. 17.2% had a high level of quality of life and only 1.9% showed a low level of quality of life (Table 2).
Table 2. Number and Percentage of the quality of life of elderly people (n = 209)
Quality of life
No.
%
Low level (26-60)
4
1.9
Moderate level (61-95)
169
80.9
High level (96-130)
36
17.2
Correlation between personal factors, family factors and social factors, and quality of life of the elderly people
In testing the relationship between the factors and quality of life of the elderly people by using Chi-square and Pearson’s Correlation Coefficient, the results revealed that education level, current illness, self-esteem, family income, family relationship and social support were significantly correlated with the quality of life of the elderly people in the study at a statistically significant level (p-value) of <0.05. However, sex, marital status, and occupation of elderly people, family type, age and health condition (activities of daily living) were not associated with the quality of life of elderly people (p-value >0.05) (Table 3,4).
Factors influencing the quality of life of elderly people
Using stepwise multiple regression analysis, self-esteem and family relationship were found to be the factors that had power to predict the quality of life of elderly people in the study. These two factors could predict 53.3% of the quality of life of the subjects. The factor that best predicted the quality of life of the elderly people was self-esteem (Beta = 0.574), followed by family relationship (Beta = 0.226). Therefore, quality of life of elderly people = 16.180 + 0.574 self-esteem + 0.226 family relationship (Table 5).
DISCUSSION
In this study, it was found that a majority (80.9%) of the elderly had a moderate level of quality of life, followed by 17.2% having a high level. Most of the elderly had a moderate level of quality of life because Myanmar is a developing country and the majority of people live in rural areas, and the socioeconomic status was not very high. In the study, even though most of the elderly

Health Care Update on Myanmar’s Irrawaddy Delta

12:08 AM Unknown 0 Comments

While at least a million severely affected people in the Irrawaddy Delta are trying to scrape together proper shelter and supplies of food, health care workers in the Irrawaddy Division are bracing for potentially deadly disease outbreaks. Many survivors of Cyclone Nargis are, no doubt, still seeking care for injuries suffered during the storm as well as sicknesses brought on by days of exposure to the torrential rains of the monsoon season. Health care services in the Irrawaddy Delta have been pieced together from the remnants of staff from local township hospitals along with Ministry of Health staff, staff from Yangon General Hospital and other hospitals, local healthcare workers from NGOs and international teams of doctors from around the region. While medical teams from NGOs and regional countries continue to stream into the country, the entire health care system of Yangon and the Irrawaddy is no doubt undergoing serious strain.
Take for example Yangon General Hospital’s staff of roughly 278 doctors and over 400 nurses (as per figures from the Yangon City website). The hospital’s cardiac and cancer wards were reportedly destroyed in the storm, with roofs covering other sections of the hospital being damaged. In addition to handling the afflicted among Yangon‘s population of 5 to 6 million people,
Yangon General’s doctors and nurses have reportedly been dispatched to Mawlamyinegyun, Laputta, Bogale, and Pyapun Townships to supplement local medical staff there. Below we have compiled information from a variety of sources to give an overall view of the provision of health care in the delta, moving geographically from East to West:
Dedaye:
Part of the Chinese team reportedly operates in Dedaye township. The township hospital is reportedly being used although its roof was blown away and all eight rural health centers and 20 sub-centers were badly damaged.
Pyapon:
The district hospital staff has been supplemented by specialists and nurses from Yangon General Hospital. Part of the team of Indian doctors and Medics is also operating there.
Bogale:
A “health cluster” of U.N. and international NGOs has set up an operations center in the Bogale area. The township hospital is being run by local hospital staff along with a team from Yangon General Hospital, consisting of two general surgeons, two orthopedic surgeons, two physicians, two pediatricians, two obstetrics and gynecologists, two anesthetists and six nurses from the Intensive Care Unit and Operation Theatre. The rest of the Indian team of doctors and medics is also operating there.
Other groups of doctors have visited and worked in the area on their own volition:
(Edit: Update) On the International Organization for MIgration’s relief facility in Bogale:
The hub, which was opened this week with the approval of the Ministry of Health, will also serve as a base for IOM medical teams assessing health needs in the areas worst affected by the cyclone. Yesterday a third IOM assessment team comprising seven doctors and two nurses left Yangon for the delta.
Mawlamyinegyun:
The township hospital staff has been supplemented by specialists and nurses from Yangon General Hospital. Mobile teams are also operating in shelters around the township.
Laputta:
The UN-NGO health cluster operates an operations center in the township (a third Irrawaddy operations center is in Bassein). At the township hospital, local staff are being supported by 17 medical specialists and nine nurses from Yangon General Hospital. The three rural health centers in Laputta are also functioning.
Merlin, which had been supporting and supplying local clinics in the area for some time prior to the cyclone, has teams operating in the township and has also acquired a cruiser donated by Pandaw River Cruises. The 180ft boat began operating May 21st as a mobile clinic in the Pyamalaw River and will start clinic operations along the river between the river’s mouth (near the Southwestern tip of the delta) and Laputta Township. Merlin also has another boat to supply this boat and its other operations in Laputta. The NGO has also set up clinics in camps that surround the region
Médecins Sans Frontières (Doctors Without Borders) also has a base and 4 fixed clinics operating in the township. As of May 17 they reportedly had 106 staff working in the township.
(Editor’s note: We will follow up on this report later this week with details on the Yangon healthcare situation.)

Project Photos in Wide Horizons

9:44 PM Unknown 0 Comments

SAW PROJECT

9:37 PM Unknown 0 Comments

Background

Problem	Project	Implementation
1.      Lack of activities at the weekend for forty five unparented children who live in SAW Safe House. 2.      No volunteer to conduct activities for the children. 3.      Not enough playing materials at SAW Safe House. 4.      Staff are very busy to play with children. 5.      Old materials are broken because no one take care of playing materials. 6.      They fight each other about the game. 7.      They are bully and misunderstand each other. 8.      Every week two children got injuries for every week. ( head and leg injuries) 9.      Children have lack of problem solve this game because they don’t have any book to read in SAW Safe House. 10.  Five children claim that they feel bored and miserable because of no activity. 11.  Children are playing dangerous games such as follow each other and catching by running Quantitative : ·         Forty children aged between 6 to 13. ·         Twenty children want to read books. ·         Once a week training for four weeks. ·         Two staff will manage the materials for sustainability. ·         Seven full- time staff. ·         Eighty three children in total age between one to eighteen years old.	Goal: To introduce more productive weekend activities for unpatented children in SAW Safe House which they can self-organize. Objective: ·         Provide dual-language books (Thai to Eng.) for children aged between six to thirteen years old who live in SAW Safe House to improve their comprehension in school in Feb 2016. ·         Provide sufficient sports and educational playing materials that are safe in Feb 2016 for children aged between 6 to 13 years old who live in SAW Safe House to improve their Physical and mental abilities while having fun. ·         Conduct four sessions of play and education activities over one month for two hours per session every weekend for 45 unparented children aged between six to thirteen years old in SAW Safe House in 13 Feb to 5 March 2016. Impact: ·         Children will be less bully and will encourage each other to play a safer games. ·         They will get new games material and story books. ·         They can develop their physical and mental abilities. ·         They will be able to promote team work with good relationship between each other. ·         They will improve in problem solving skills. Proposed Materials: Game materials and duals language book Thai to English and English to Thai	Eight students from WH conducted activities with books and playing materials on 20, 21, 27 February and 5 March 2016 with 29 children in the SAW Safe House. There are materials that we provided to SAW Safe House. ·         4 types of books ·         19 types of games ·         5 types of exercise playing materials

Type	Quantity	Name
Books	4 pieces	Dual-language story books
	12 pieces	Dual-language comic books
	3 pieces	Dual-language picture dictionary
	2 pieces	Dual-language posters
Games	5 sets	Problem solving game (Domino)
	1 set	Problem solving game (Block)
	3 sets	Critical thinking (Creative shape of toy)
	4 sets	Problem solving game (Four connect)
	2 sets	Board game (Mix up - words)
	5 sets	Board game (Snake and ladders)
	4 sets	Problem solving game (jigsaw)
	3 sets	Educational game (Flash cards-words)
	3 sets	Educational game (Time telling-clock)
	1 piece	Educational game (Time telling game)
	3 pieces	Critical thinking game (Magic)
	2pieces	Critical thinking game (Magic cube)
	2sets	Problem solving game (Bolin)
	2 sets	Critical thinking game (Bingo)
	1 set	Educational game (Spendy game)
	1 set	Problem solving game(Monopoly)
	1 piece	Critical thinking game (Football toy)
	4 pieces	Mathematic game (Circle Arrow)
	1 set	Bracelet
Exercise materials	3 pieces	Hula hoop
	5 pieces	Balls
	2 pieces	Sort balls
	4 pieces	Jumping rope
	1 pair	Black board and chalk box (for drawing pictures and calculating Math)

Figure 1 all playing materials and books that we, organizers, provided to SAW Safe House.

Finding

Figure 2 children are voting their favorite games.

Plans and Expectations

Evaluation Questions and Methodology

 

Contact details