Multimorbidity and health seeking behaviours among older people in Myanmar: A community survey

Background: The world population is aging very rapidly and the impact is more severe in developing countries because of insufficient resources and low awareness of the challenges faced by older people. This study aimed to explore multimorbidity of older people in Myanmar and their health seeking behaviours. Methods: A community-based cross-sectional study was conducted in both urban and rural areas of Bago Region and Mon State during October 2016. A multistage sampling method was used to select 4,859 people aged 60 years and older. Participants were interviewed face-to-face using a questionnaire. Multinominal logistic regression was used to analyse data. Results: More than half of the study participants (57.9%) reported at least one chronic condition in the last year and 33.2% reported two or more conditions (multimorbidity). The common conditions were hypertension (67.3%), arthritis (24.7%), arrhythmia (14.7%), coronary heart disease (13.8%) and diabetes (13.7%). A majority (61.7%) of participants with a chronic condition took western medicine. Older people usually saw a doctor (60.2%) or health assistant (21.9%) at a nearby clinic or rural health center; 1.6% reported seeing uncredentialed medical persons. Factors associated with multimorbidity were being female (adjusted Prevalence Ratio (aPR) = 2.14, 95% confidence interval (CI) 1.63–2.82) and having fair (aPR = 2.20, 95% CI 1.59–3.04) or poor self-reported health (aPR = 3.93, 95% CI 2.79–5.52). Those with less than middle school education (aPR = 0.50, 95% CI 0.25–0.99) and those living in rural areas (aPR = 0.78, 95% CI 0.62–0.98) were less likely to have multimorbidity. Older people in rural areas had less access to health care than their urban counterparts. Conclusion: Chronic conditions are common among older people in Myanmar, with higher prevalence in women and in urban areas. The lower prevalence of chronic conditions in those who live in rural areas may be related to living a more traditional lifestyle.