Myanmar

OVERVIEW

Myanmar is a country that is undergoing massive transitions, including in the sphere of women's health care. You can obtain many forms of contraception (birth control), including pills, injectables and IUDs. While emergency contraception (the morning after pill) seems to require a prescription, this does not seem to be strongly enforced, at least in Yangon, and local women report being able to buy the pill without a prescription at pharmacies. While there are places to get STI tests, and there are no travel/residency restrictions tied to STI status, there are not many resources available for treating STIs. Regarding menstrual products, pads are most commonly available, although you cna find tampons at Market Place locations. Currently, Myanmar has no national HPV vaccination program or a PrEP program. Maternity leave is given to women (12 weeks and 66.7% of wages covered). Abortion is generally illegal, except for cases when the pregnancy endangers the life of the woman. While an underground abortion network exists in Myanmar, there are many unsafe providers and it is recommended that one exercises extreme caution if they wish to obtain an abortion.

Contraception (Birth Control)

General Note: There are many types of contraceptives, also known as "birth control," including IUDs, oral contraceptives, patches, shots, and condoms, etc. If you would like to view a full list, click here.

Laws & Social Stigmas

In Myanmar, you can obtain birth control. According to a 2015 study, 52% of women in Myanmar (who are married or in unions) use any form of contraception, including traditional methods like the rhythm method or withdrawal. The number of women using modern methods of contraception is about 40%. The most common modern methods are injectables (29.4%), the pill (12.3%), female sterilization (3.8%) and the IUD (2.2%). In 2013, UNFPA reported that one in four women in Myanmar do not have their family planning needs met. However, this number may have improved since 2013.

While women in cities like Yangon and Mandalay have easy access to contraception, village women of Myanmar face additional hurdles. It is commonly believed that contraception goes against God's wishes and promotes promiscuity. Furthermore, sex education is not taught in Burmese schools, and sex before marriage is taboo. If a woman is having sex before marriage, the social stigma attached to her choices may discourage her from seeking out contraception. Village women often live in isolated environments that do not have easy access to nearby towns, and some dirt paths were washed away in past storms.

In 2015, Myanmar introduced a family law that has been criticized as targeting Muslim minorities. According the law, signed by President Thein Sein, Myanmar's state or regional governments can now request a presidential order, which gives local authorities the power to "organize" when women have children (i.e. they can enforce gaps of 36 months between births). This legislation was driven by nationalist Buddhist monks who fear a growing Muslim population. Among the parties that have expressed concern about the bill are the UN High Commissioner for Human Rights.

What to Get & Where to Get It

• Some of the birth control pills you can expect to see are Marvelon, Marvelon 28 and Microgynon ED, Exluton and Preme.
• If you want contraceptive injectables, you can find Contracep, Depo-Provera, Megestron and Norignon.
• If you want a contraceptive implant, you can find Jadelle.
• We're not sure about which IUDs are available. However, you can probably get an IUD device and insertion procedure at Marie Stopes.

Recommended pharmacies:

• Golden Valley Citymart - recommended by a Yangon local
• International SOS Clinic Pharmacy - should carry more international brands and staff speak many languages, including English, French, Japanese, and Burmese.

Emergency Contraception (Morning After Pill)

Important Notes: Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC as soon as possible after unprotected sex. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click here and here.

Laws & Social Stigmas

In Yangon, you can purchase emergency contraception (the morning after pill) without a prescription. Technically, you need a prescription to obtain emergency contraception (the morning after pill) in Myanmar. However, this law is not universally enforced and pharmacists don't always ask for prescriptions.

What to Get & Where to Get It

• In Myanmar, you can find EC at pharmacies and social marketing programs (e.g. PSI, DKT, MSI and PSIA). Some of the dedicated emergency contraception you can expect to see is Duet, ECee2, Pill 72, Postinor, Postinor-2 and Pregnon. For these brands, you should take 2 pills within 120 hours after unprotected sex.
• If you can't access dedicated emergency contraception, you can use some oral contraceptives (birth control pills) as replacement EC. To do, remember that, in 28-day packs, only the first 21 pills can be used. You can take FMP (take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later). You can also take Anna, Microgynon or Microgynon 30 ED (for all of these brands, take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later).
• For more information on EC options in Myanmar, you can visit the Princeton EC website.
• You can also get an IUD, which can prevent a pregnancy for up to 5 days after unprotected sex.

Costs

"The price of EC ranges from 593.4 kyats to 2900 kyats ($0.60 - $2.93), as of 2014."

Sexually Transmitted Infections (STIs/STDs)

Important Notes - Learn about PEP and PrEP: If you think that you've been recently exposed to HIV (i.e. within 72 hours), seek out PEP (Post-Exposure Prophylaxis). It's a month-long treatment to prevent HIV infection after exposure, and it may be available in your city. Take PEP as soon as possible. For more information, click here. If you are at risk of HIV exposure, seek out PrEP (Pre-Exposure Prophylaxis). It's a daily oral pill that can prevent HIV infection before exposure. To learn more about PrEP, click here.

Laws & Social Stigmas

In Myanmar, there no known travel or residency restrictions related to STI status. You will not be asked for a medical certificate before entering the country. There are 210,000 people living with HIV (.7% of the population), as of February 2017.

Regarding HPV, as reported by HPV Information Centre, " Cervical cancer ranks as the 2nd most frequent cancer among women in Myanmar and the 1st most frequent cancer among women between 15 and 44 years of age. Data is not yet available on the HPV burden in the general population of Myanmar. However, in South-Eastern Asia, the region Myanmar belongs to, about 3.0% of women in the general population are estimated to harbour cervical HPV-16/18 infection at a given time, and 71.6% of invasive cervical cancers are attributed to HPVs 16 or 18."

More information:

• 'Myanmar's neglected HIV/AIDS patients' - Al Jazeera Video Report from 2012

Testing Facilities

Visit the city pages, like the Yangon page, for local recommendations.

Support

According to HIVTravel, "Medical facilities are poor. There is no appropriate treatment for foreigners living with HIV/AIDS."

• AIDS Healthcare Foundation Myanmar: "In 2014, AHF Myanmar’s first clinic opened in Yangon in collaboration with the Ministry of Health. AHF Myanmar provides HIV/AIDS related services at Mingaladon Hospital and Waibagi Specialist Hospital and provides ART drugs, laboratory services, and data and information management. AHF Myanmar also supported capacity building of hospital staff and organized advocacy meetings with parliamentarians for increased community testing and early treatment strategy." Address: No.1356, Bo Min Yaung Road, (34) Ward, Dagon Mothit (North), Yangon, Myanmar. Contact: Dr. Win Oo, Title: Country Program Manager, Tel:+95 9 731 81175, +95 1 581039, Fax: +95 1 581039, Email: win.oo@aidshealth.org.
• UNAIDS Myanmar: Contact: Eamonn Murphy, UNAIDS Country Director. Telephone: +95 1 25 23 61. Fax: +95 1 22 92 80. Email: MURPHYE@UNAIDS.ORG
• United Nations Development Programme (UNDP) - HIV/AIDS - Project: 6 Natmauk Road, Yangoon / Myanmar, Phone: +951 542 910-19, Fax: +951 292 739.
• Top Project Myanmar: This organization is almost entirely run by sex workers. Helps sex workers manage their STIs. Read an article about it here.

Medications & Vaccines

What to Get & Where to Get It

• There are no known providers of PrEP in Myanmar.
• There is no nationwide HPV vaccination program in Myanmar, according to a 2016 report. However, you may be able to get the vaccination at a hospital.

Menstruation

Note: In addition to pads and tampons, you can also use menstrual cups and menstrual underwear for your period. To learn more about menstrual cups, click here. To learn more about menstrual underwear, click here.

Laws & Social Stigmas

Some girls in Myanmar experience shame regarding their periods and generally do not talk about menstruation.

“The biological fact of the matter is that all women menstruate, yet the necessary conversations on this subject have yet to be had in many areas of Myanmar. This lack of awareness has left women at the bottom of the social, political and economic hierarchies which has led to adverse effects in national development. Without proper resources on menstruation that any man or woman can access, an uncomfortable paradigm will linger that fails to connect female hygiene and gender equality.” - Maghen Quadrini from local women’s rights organisation Akhaya

What to Get & Where to Get It

In Myanmar, pads are easier to find than tampons. Local women say that you can find tampons at Market Place in Golden Valley and Market Place at Myanmar Plaza (mini-tampons and regular-sized tampons) in Yangon. While menstrual cups are not widely available, you may be able to purchase Lunette from liveloveluna and have it shipped to Myanmar. There are no official sellers of most major menstrual cup brands (that we know of) in Myanmar, such as DivaCup, MoonCup, LadyCup, etc.

Gynecological Exams

What to Get & Where to Get It

While wealthy women often leave the country for medical care, the majority of Burmese women do not have this luxury. We are still researching what are the best options for women in Myanmar, including the most affordable ones. For local recommendations, visit the city pages, like the Yangon page.

Pregnancy

Laws & Social Stigmas

In Myanmar, women get 12 weeks of maternity leave with 66.7% of wages covered. Men get six days of "casual leave" to assist spouses.

Abortion

Important Note: There are two main types of abortions: medical (also known as the "abortion pill") and surgical (also known as "in-clinic"). For medical abortions, you take a pill to induce abortion. For surgical abortions, a procedure is performed to induce abortion. For general information about medical and surgical abortions, click here.

Laws & Social Stigmas

In Myanmar, abortion is generally illegal. It is only permitted when the woman's life is endangered by the pregnancy. According to the Myanmar Penal Code, "whoever voluntarily causes a woman with child to miscarry" can face up to three years in prison and/or a fine, if the woman consents to the abortion. If the woman does not consent to the abortion, that person can receive up to ten years in prison and/or a fine

Despite the strict abortion laws in Myanmar, there is an underground abortion network, where many women receive unsafe abortions. In fact, 10% of all maternal deaths in Myanmar are due to unsafe abortions. According to a report from IPAS in Myanmar, "Studies indicate that each year more than 246,000 women with unintended pregnancies resort to unsafe practices and unqualified practitioners for induced abortions. Women who undergo unsafe procedures are likely to delay seeking help for complications, resulting in greater complications and higher costs for women and the public health system."

What to Get & Where to Get It

• You can potentially get the "abortion pill" by mail. Check out this link for details.
• You can legally obtain an abortion on request in Vietnam, Cambodia and India, among many other countries in the region.

Costs

If you are pregnant and considering getting an abortion outside Myanmar, you will need to consider the following costs: transportation to the country where you will be obtaining an abortion, hotel or accommodation costs in that country, cost of the abortion in the country and the total amount of days you may need to be in the country both before and after the abortion.

Advocacy & Counseling

List of Additional Resources

• Women's Organizations Network of Myanmar: Contact Address hide (ဆက္သြယ္ရန္လိပ္စာ), Building 11, Room 3(A), 2nd Floor, Sen Yeik Nyein 2 Street, Kamaryurt Township. Telephone: 09 430 23325. Contact Email (ဆက္သြယ္ရန္အီးေမးလ္လိပ္စာ). Email: won.myanmar@gmail.com