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SAGAING REGION

A Snapshot of Child Wellbeing

BASIC INFORMATION

Area: 94,621.07 sq. km

Total population: 5,132,058


Rural: 4,279,001 Urban: 774,452 0-14 years: 1,364,387

Languages: Myanmar

Administrative divisions: 8 Districts, 37 Townships, 226 Wards,


1,760 Village Tracts, 6,128 Villages

Capital: Sagaing

Main economic activities: Agriculture, Forestry, Mining, Industry

SOCIO-ECONOMIC CONTEXT
Located in northwestern Myanmar, Sagaing Region is bordered by
India to the north, Kachin and Shan States and Mandalay Region to
the east, Mandalay and Magway Regions to the south and Chin
State and India to the west.
Sagaing Region is the primary producer of wheat in Myanmar
and is also home to range of industries.
Partly located in the Dry Zone of Myanmar, water scarcity is a
major concern in some parts of the Region.
On social development indicators, Sagaing Region generally
fares comparably or slightly better than the national average,
and the estimated poverty rate for the Region (15 per cent) is
one of the lowest among all states and regions in Myanmar.

CHILD WELLBEING
Children have basic needs, such as adequate nutrition Underweight 23
and healthcare, that if unmet could result in long-term
consequences, including limitations on their physical and
cognitive development and consequently on opportunities Not immunized (DPT3) 1
and wellbeing in adulthood.
Their experience of poverty is multidimensional and depri- Not using improved water
13
vation in any of the key dimensions (i.e. nutrition, health, source
education, care and protection, water, sanitation and
Not using improved
income) compromises their wellbeing. sanitation
9

A sizeable proportion of children in Sagaing Region con-


tinue to have some of their most basic needs unmet. The Not completing primary
40
chart depicts the extent of deprivation in the Region using school on time
a selected indicator for each key dimension. For example,
deprivation in nutrition is illustrated by about a quarter Birth not registered 46
(23 per cent) of children in the Region being underweight.
How children in Sagaing Region fare (compared to the Living below poverty line 15
average Myanmar child) in each of the key dimensions of
wellbeing is examined more closely on the following pag-
es. A table on the last page presents data on a slightly 0 10 20 30 40 50%
wider range of child wellbeing indicators.
Sources: MICS 2009-2010; IHLCA 2009-2010

1
NUTRITION 80%
Good nutrition is a cornerstone for survival, health and development. Well- Sagaing National Average
nourished children perform better in school, grow into healthy adults and in turn
give their children a better start in life. 60
Given the optimum start in life, all children have the potential to develop within
the same range of height and weight. This means that differences in children's 39
growth to age five are more dependent on nutrition, feeding practices, environ- 40 35
ment and health care than on genetics or ethnicity.
23 23
According to all three standard measures of malnutrition (underweight, stunting 20
and wasting), children in Sagaing Region are about as likely to be malnourished 8
7
as the average Myanmar child. The prevalence of stunting (or low height-for-
age) is alarmingly high with 39 per cent of children being stunted. Stunting is a
0
consequence of chronic malnutrition and can have irreversible damage on brain
development. If not addressed in the first two years of life, stunting diminishes Underweight Stunting Wasting
the ability of children to learn and earn throughout their lives. Source: MICS 2009-2010

98 HEALTH
Sagaing 100
100% Significant reductions in maternal and child mortality can be achieved
National Average through a few simple health interventions, including giving birth in a health
80 facility (or at least in the presence of a skilled birth attendant), timely im-
munization against some of the main childhood illnesses, and adequate
58 management of diarrhoea including oral rehydration therapy (ORT) etc.
60
Children in Sagaing Region are more likely than the average Myanmar child
36 to be born in a health facility (about 58 per cent are), where life-saving ob-
40
stetric care would be available for mother and child in case of complica-
tions during birth.
20
Immunization rates appear high and comparable to the national average
0 but the remote location of many communities, especially in the northern
Births in Immunization
townships of Lashi, Lahe and Namyun, does make delivering vaccines to
health facility (DPT3) all children in the Region a daunting task.
Source: MICS 2009-2010

HIV 100%
87 Sagaing
Elimination of mother-to-child transmission of HIV is a key component of the 82
global response to HIV for young children. In high-income countries, mother-to- 80
National
child transmission of HIV has been virtually eliminated. Steady expansion of HIV Average
testing, particularly of pregnant women, and provision of the most effective an- 60 51
tiretroviral treatment (ART) offers hope that mother-to-child transmission can be
virtually eliminated in low- and middle-income countries as well. 40 31
The Myanmar National Strategic Plan on AIDS 2011-2015 includes prevention 20 10
of mother-to-child transmission (PMTCT) as a priority and various related indica- 2
tors are regularly monitored. Among those reached by the public health system, 0
fewer than a third of pregnant women in Sagaing Region are likely to be tested
HIV-testing ART for HIV-testing
for HIV and receive the test result. The vast majority (87 per cent) of those iden-
for PMTCT for
tified as HIV-positive in the Region are likely, however, to receive ART for PMTCT.
pregnant infants
But only 2 per cent of infants born to women identified as HIV-positive in the
women
Region are tested for HIV within the prescribed 2 months after birth.
Source: National AIDS Programme, 2012

100 % WATER
87 Sagaing According to the Multiple Indicator Cluster Survey (MICS), about 13 per
82
80 cent of households in Sagaing Region are not using improved water
National Average sources. However, the Knowledge Attitudes and Practices (KAP) Survey on
60 Water and Sanitation conducted in 2011 in 24 townships nationwide, in-
cluding 2 from Sagaing, suggests that the water and sanitation situation in
the country is by and large much worse than indicated by the MICS. For
40
example, almost 27 per cent of households in Homalin township of Saga-
ing Region were found to be using unimproved water sources.
20
7 Lack of access to safe drinking water is a major contributor to diarrhoea
3
0 prevalence, with 80 per cent of child deaths due to diarrheal disease glob-
Access to improved Diarrhoea prevalence ally being attributed to poor drinking water, lack of sanitation and poor
water sources among children hygiene. Prevalence of diarrhoea among children aged 0-59 months in
among households Myanmar has increased from about 4 per cent in 2003 to almost 7 per
cent in 2009-2010. In Sagaing, diarrhoea prevalence stands at 3 per cent.
Source: MICS 2009-2010

2
SANITATION
According to the Multiple Indicator Cluster Survey (MICS), about 9 per 100% Sagaing
91
cent of households in Sagaing Region are not using improved sanita- 85
National Average
tion and 6 per cent are practicing open defecation. 80
However, as earlier mentioned, the 2011 KAP Survey on Water and
Sanitation revealed that the water and sanitation situation may actually 60
be much worse than indicated by the MICS, especially in some areas.
For example, as many as 17 per cent of households were found to not 40
be using improved latrines in Homalin township of Sagaing.
Improved sanitation can reduce diarrheal disease by more than a third, 20
and can significantly lessen the adverse health impacts of other disor- 6 7
ders responsible for death and disease among millions of children. 0
Investment in hygiene promotion, sanitation and water services is also Access to improved Open defecation
among the most cost-effective ways of reducing child mortality. sanitation
Source: MICS 2009-2010

94 EDUCATION
100%
Sagaing 88 Myanmar generally lags behind other countries in the region on education
indicators due to decades of underinvestment in the education sector.
80 National
Pre-school attendance among children aged 3-5 years is quite low with
Average 61
54 less than a quarter of all children attending pre-school in the country as a
60
whole. Sagaing Region fares even worse on this indicator, with only about
14 per cent of children aged 3-5 attending pre-school. Adequate intellec-
40 tual and social stimulation in early childhood, as provided in pre-school, is
23 important for a child developing to his or her full potential. And children
20 14 who attend pre-school tend to do much better in primary school.
The primary school enrollment rate in Sagaing is slightly higher than the
0 national average, as is the primary school completion rate. However,
Pre-school Primary school Primary school about 39 per cent of children attending primary school in the Region are
attendance enrolment completion still not completing their schooling on time.
Source: MICS 2009-2010; IHLCA 2009-2010

CARE AND PROTECTION 100%


Quality data on the most salient child protection issues in Myanmar, Sagaing
such as children living in out-of-home residential care, children living 80 72
and working on the street and children in hazardous forms of work, is National
currently unavailable. It is expected that with the population census Average
60 54
and Demographic Health Survey in 2014-2015, relevant data will be
collected and analyzed.
40
Currently available indicators include proportion of births registered
and proportion of children not living with a biological parent. Almost
20
half (46 per cent) of all births in Sagaing Region are not registered. 5
5
Unregistered children are not only deprived of their basic right to a
legal identity but are also more vulnerable to exploitation. With re- 0
gard to children not living with a biological parent, the situation in Births registered Children not living with
Sagaing is similar to the national average (about 5 per cent). a biological parent
Source: MICS 2009-2010

INCOME
80% Poverty incidence
While income alone is not sufficient to ensure a childs wellbeing, it often
enables families to have better access to quality education, health care,
60 water and sanitation.

40 Income poverty data are not as yet available in Myanmar.

26 However, the Integrated Household Living Conditions Assessment (IHLCA)


20 allowed estimation of monetary poverty, as measured by consumption
15
expenditure on food and non-food items. According to this measure, about
15 per cent of the population was estimated to be living below the poverty
0 line in Sagaing Region. This is lower than the poverty estimate of 26 per
Sagaing National Average cent for the country as a whole.

Source: IHLCA 2009-2010

3
TABLE OF INDICATORS FOR SAGAING REGION
N ational Highest Low est
IN DIC ATOR Sagaing
Average Incidence Incidence
Un derwei ght : % of children aged 0-59 months who measured below -2 SD 37. 4 13.0
22.5 22.6
international reference weight for age Rakhine Kachin
St u n t i n g : % of children aged 0-59 months who measured below -2 SD 58.0 24
38.6 35.1
N UTRITION

international reference height for age Chin Yangon


Was t i n g : % of children aged 0-59 months who measured below -2 SD 10.8 2.3
7 7.9
international reference weight for height Rakhine Kayah
E xc l u s i vel y breas t f ed: % of children aged 0-5 months who are 47 1.3
28.9 23.6
exclusively breastfed Mon Rakhine
Vi t am i n A s u ppl em en t at i on : % of children 5-59 months who never 13.1 6.4
8.3 10.6
received vitamin A Chin Bago West
An t e-n at al c are vi s i t s : % of pregnant women receiving ANC one or more 99.6 75.6
98.4 93.1
times during pregnancy Mon Chin
An t e-n at al c are qu al i t y : % of pregnant women who had urine specimen 91.2 16.2
C HILD HEALTH

46.9 56.9
M ATERN AL &

taken Mon Chin


Bi rt hs i n heal t h f ac i l i t y : % of ever married women aged 15-49 who 68.9 5.6
57.7 36.2
delivered in health facility Yangon Chin
Im m u n i zat i on : % of children aged 12-23 months who received DPT3 100.0 91.0
99.5 97.8
vaccinations Mon Chin
O RT Us e Rat e: % of children aged 0-59 months who had diarrhoea in the 90.2 47.2
[*] 66.3
last two weeks and received ORT Thanintharyi Kachin
H IV-t es t i n g f or pregn an t wom en : % of women attending ANC who 98.2 12.1
30.9 51
tested for HIV and received the result Kayah Chin
ART f or P M TCT : % of HIV-positive pregnant women who received
102.2 35.7
HIV

antiretroviral drugs to reduce the risk of mother-to-child transmission 86.8 82


Magway Shan South
during pregnancy, delivery and breastfeeding
H IV-t es t i n g f or i n f an t s : % of infants born to HIV-positive women 42.4 1.1
1.7 9.5
receiving a virological test for HIV within 2 months of birth Shan South Magway
92.5 51.1
Im proved wat er : % of households using improved water sources 86.6 82.3
Yangon Kayin
SAN ITATION

D i arrhoea preval en c e: % of children who had diarrhoea in the last two 13.1 2.5
W ATER &

2.5 6.7
weeks Chin Sagaing
Im proved s an i t at i on : % of households with access to sanitary means of 93.8 48.0
90.9 84.6
excreta disposal Yangon Rakhine
40.7 0.3
O pen def ec at i on : % of households practicing open defecation 6.2 7
Rakhine Yangon
E arl y c hi l dhood edu c at i on : % of children aged 36-59 months currently 60.7 5.4
13.9 22.9
EDUC ATION

attending early childhood education Kayah Rakhine


96.3 71.4
P ri m ary s c hool en rol m en t : Net Enrolment Rate in Primary School 94.1 87.7
Kayah Rakhine
72.3 31.7
P ri m ary s c hool c om pl et i on : Net Primary School Completion Rate 60.5 54.2
Thanintharyi Rakhine

Bi rt h regi s t rat i on : % of children aged 0-59 months whose births are 95.2 24.4
PROTEC TION

54.2 72.4
registered Yangon Chin
C HILD

P aren t al c are: % children aged 0-17 years in households not living with a 18.7 1.3
4.5 5.4
biological parent Mon Rakhine
IN C OM E

73.3 11.4
P overt y i n c i den c e: % of population who are poor 15.1 25.6
Chin Kayah

An asterisk indicates fewer than 25 unweighted cases.

NOTES
All data presented herein, except on the following indicators, comes from the Multiple Indicator Cluster Survey 2009-2010.
Area and Population: Health Management Information System (HMIS) Township Profiles 2011
Administrative divisions: 2012 MIMU P-Codes Release V (based on the 25 February 2011 Gazette issued by the Ministry of Home
Affairs with UN/NGO field office updates on the number of villages)
Poverty Incidence and Primary School Net Enrolment Rate: Integrated Household Living Conditions Assessment 2009-2010
HIV-testing for pregnant women, ART for PMTCT and HIV-testing for infants: Myanmar National AIDS Programme 2012 (This is pro-
gramme data, and unlike the data on the other indicators, is likely not representative at the state/regional level.)
The map was developed by the Myanmar Information Management Unit (MIMU) upon request by UNICEF.