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Background: Auxiliary Midwives (AMWs) are community health volunteers supporting the work of midwives, especially maternal and child health services in hard to-reach areas in Myanmar. This paper assessed the contributions of AMW to maternal and child health services, factors influencing their productivity and their willingness to serve the community.Method: The study applied quantitative cross-sectional survey using census method. Total of 1,185 AMWs belonging to three batches: trained prior to 2000, between 2000 and 2011, and in 2012, from 21 townships of 17 states and regions in Myanmar participated in the study. Multiple logit regression was used to examine the impact of age, marital status, education, domicile, recruitment pattern and 'batch of training', on AMW's confidence level in providing care, and their intention to serve the community more than 5 years.Results: All AMWs were able to provide essential maternal and child health services including antenatal care, normal delivery and post-natal care. They could identify and refer high-risk pregnancies to larger health facilities for proper management. On average, 9 deliveries, 11 antenatal and 9 postnatal cases were performed by an AMW during the six months prior to this study. AMWs had a comparative advantage for longer service in hard-to-reach villages where they lived, spoke the same dialect as the locals, understood the socio-cultural dimensions, and were well accepted by the community. Despite these contributions, 90 % of the respondents expressed receiving no adequate supervision, refresher training, replenishment of the AMW kits and transportation cost. AMWs in the elder age group are significantly more confident in taking care of the patients than those in the younger groups. Over 90 % of the respondents intended to stay more than five years in the community. The confidence in catering services appeared to have significant association with a longer period of stay in AMW jobs as evidenced by the odds ratio of 3.5, compared to those reporting unconfident.Conclusions: Comprehensive support system and national policy are needed to sustain and strengthen the contributions of AMWs, in sharing the workload of midwives, particularly in hard-to-reach areas of Myanmar. [ABSTRACT FROM AUTHOR]

Background: To promote institutional delivery, the Government of India, through the Janani Suraksha Yojana (JSY) program, gives monetary reward to all pregnant women who give birth at the government or private health center. Despite providing cash assistance, a higher number of women are still preferring delivering at home. Therefore, this study sought to determine the prevalence of home births and identifying the factors influencing women's choice of home deliveries.Methods: Data from the National Family Health Survey (NFHS) conducted during 2005-06 and 2015-16 were used in the study. The respondents were women 15-49 years; a sample of 36,850 and 190,898 women in 2005-06 and 2015-16 respectively were included in the study. Multivariate logistic regression was used to determine the factors influencing home delivery. Income-related inequality in home delivery was quantified by the concentration index (CI) and the concentration curve (CC), and decomposition analysis was used to examine the inequality in the prevalence of home deliveries.Results: The prevalence of home deliveries has reduced from 58.5% in 2005-06 to 18.9% in 2015-16. The odds of delivering babies at home were lower among women who had full ANC in 2005-06 [AOR: 0.34; CI: 0.28-0.41] and in 2015-16 [AOR: 0.41; CI: 0.38-0.45] and were higher among women with four or higher parity in 2005-06 [AOR: 1.70; CI: 1.49-1.92] and in 2015-19 [AOR: 2.16; CI: 2.03-2.30]. Furthermore, the odds of delivering babies at home were higher among rural women and were lower among women with higher education. It was found that the value of CI increased from - 0.25 to - 0.39 from 2005-06 to 2015-16; this depicts that women delivering babies at home got more concentrated among women from lower socio-economic status.Conclusion: There is a need to promote institutional deliveries, particular focus to be given to poor women, women with higher parity, uneducated women, and rural women. ANC is the most concurring contact point for mothers to get relevant information about the risks and complications they may encounter during delivery. Therefore, effort should be directed to provide full ANC. Targeted interventions are called for to bring improvements in rural areas. [ABSTRACT FROM AUTHOR]