Migration patterns & their associations with health and human rights in eastern Myanmar after political transition: results of a population-based survey using multistaged household cluster sampling

Parveen K Parmar¹, Charlene Barina^{2

3}, Sharon Low^{2

4}, Kyaw Thura Tun², Conrad Otterness^{2

5}, Pue P Mhote^{6

7}, Saw Nay Htoo⁶, Saw Win Kyaw⁸, Nai Aye Lwin^{6

8

9}, Cynthia Maung^{6

8

9}, Naw Merry Moo^{7

10}, Eh Kalu Shwee Oo¹⁰, Daniel Reh¹¹, Nai Chay Mon¹², Xinkai Zhou¹³, Adam K Richards^{2

14}

Affiliations

¹ 1Division of Global Emergency Medicine, Department of Emergency Medicine, University of Southern California, 1975 Zonal Ave, Los Angeles, CA 90033 USA.
² Community Partners International, 2550 Ninth St. Suite 111, Berkeley, CA 94710 USA.
³ Present Address: Clinton Health Access Initiative, Hanoi, Vietnam.
⁴ International organization for Migration, Mogadishu, Somalia.
⁵ 4Present Address: Washington State Department of Health, Tumwater, USA.
⁶ Burma Medical Association (BMA), Mae Sot, Thailand.
⁷ Health Information Systems Information Group (HISWG), Mae Sot, Thailand.
⁸ Back Pack Health Worker Team, Mae Sot, Thailand.
⁹ Mae Tao Clinic, Mae Sot, Thailand.
¹⁰ Karen Department of Health and Welfare, Hpa-An, Myanmar.
¹¹ Karenni Mobile Health Committee (KnMHC), Mae Hong Son, Thailand.
¹² Mon National Health Committee (MNHC), Sangkhlaburi, Thailand.
¹³ 12Department of Medicine, Statistics Core, David Geffen School of Medicine at University of California, Los Angeles, USA.
¹⁴ 13Division of General Internal Medicine and Health Services Research, University of California, Los Angeles, USA.

PMID: 31061675
PMCID: PMC6486977
DOI: 10.1186/s13031-019-0193-1

Migration patterns & their associations with health and human rights in eastern Myanmar after political transition: results of a population-based survey using multistaged household cluster sampling

Parveen K Parmar et al. Confl Health. 2019.

. 2019 Apr 27:13:15.

doi: 10.1186/s13031-019-0193-1. eCollection 2019.

Authors

Affiliations

¹ 1Division of Global Emergency Medicine, Department of Emergency Medicine, University of Southern California, 1975 Zonal Ave, Los Angeles, CA 90033 USA.
² Community Partners International, 2550 Ninth St. Suite 111, Berkeley, CA 94710 USA.
³ Present Address: Clinton Health Access Initiative, Hanoi, Vietnam.
⁴ International organization for Migration, Mogadishu, Somalia.
⁵ 4Present Address: Washington State Department of Health, Tumwater, USA.
⁶ Burma Medical Association (BMA), Mae Sot, Thailand.
⁷ Health Information Systems Information Group (HISWG), Mae Sot, Thailand.
⁸ Back Pack Health Worker Team, Mae Sot, Thailand.
⁹ Mae Tao Clinic, Mae Sot, Thailand.
¹⁰ Karen Department of Health and Welfare, Hpa-An, Myanmar.
¹¹ Karenni Mobile Health Committee (KnMHC), Mae Hong Son, Thailand.
¹² Mon National Health Committee (MNHC), Sangkhlaburi, Thailand.
¹³ 12Department of Medicine, Statistics Core, David Geffen School of Medicine at University of California, Los Angeles, USA.
¹⁴ 13Division of General Internal Medicine and Health Services Research, University of California, Los Angeles, USA.

PMID: 31061675
PMCID: PMC6486977
DOI: 10.1186/s13031-019-0193-1

Abstract

Background: Myanmar transitioned to a nominally civilian government in March 2011. It is unclear how, if at all, this political change has impacted migration at the household level.

Methods: We present household-level in- and out-migration data gathered during the Eastern Burma Retrospective Mortality Survey (EBRMS) conducted in 2013. Household level in-and out-migration information within the previous year was gathered via a cross-sectional, retrospective, multi-stage population-based cluster randomized survey conducted in eastern Myanmar. Univariate, bivariate and regression analyses were conducted.

Results: We conducted a cross-sectional survey of 6620 households across Eastern Myanmar between July and September of 2013. Out-migration outstripped in-migration more than 6:1 overall during the year prior to the survey - for international migration this ratio was 29:1. Most in-migrants had moved to their present location in the study area from other areas in Myanmar (87%). Only 11.3% (27 individuals) had returned from another country (Thailand). Those who migrated out of eastern Myanmar during the previous year were more likely to be male (55.2%), and three times more likely to be between the ages of 15-25 (49.5%) than non-migrants. The primary reason cited for a return to the household was family (26.3%) followed by work (23.2%). The primary reason cited for migrating out of the household was for education (46.4%) followed by work (40.2%). Respondents from households that reported out-migration in the past year were more likely to screen positive for depressive symptoms than households with no migration (PR 1.85; 95% CI 1.16, 2.97). Women in households with in-migration were more likely to be malnourished and had a higher unmet need for contraception. Forced labor, one subset of human rights violations experienced by this population, was reported by more in-migrant (8%) than out-migrant households (2.2%), though this finding did not reach statistical significance.

Conclusions: These analyses suggest that opportunities for employment and education are the primary drivers of migration out of the household, despite an overall improvement in stability and decrease in prevalence of human rights violations found by EBRMS 2013. Additionally, migration into and out of households in eastern Myanmar is associated with changes in health outcomes.

Keywords: Health; Human rights; Migration; Myanmar.

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Conflict of interest statement

PP and AKR serve on the Board of Directors of Community Partners International, and as members of the Community Partners International Health Advisory Team.Each head of household provided informed verbal consent. The Institutional Review Boards at the University of California Los Angeles and Partners HealthCare provided ethical review and approved the study protocol, including the verbal consent process.Not applicable.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.