Reproductive, Maternal, and Child Health
PATH is actively working to improve the health of mothers and children in Myanmar. PATH’s history in Myanmar began with a project on neonatal care, which has subsequently expanded to a number of projects that support maternal and child health, and empower women with access to quality reproductive health care and family planning services.
Improving neonatal care
PATH’s work in Myanmar began in 2012 with a project to improve community-based neonatal care. Many women in Myanmar deliver their babies at home, with midwives as their most common birth attendants. Infant mortality rates are high compared to other countries in the region at 40 deaths per every 1,000 births according to recently released Demographic Health Survey.
From June 2012 through May 2013, PATH partnered with multiple organizations to design and deliver a training on essential newborn care for midwives and rural communities. These trainings were conducted in conjunction with the Maternal and Child Health division of the Ministry of Health, Divisional Health, Township Health departments, and the Burnet Institute.
The project built on PATH’s expertise in implementing Helping Babies Breathe (HBB) initiatives in resource-limited settings. Through this project, PATH improved the knowledge and capacity of neonatal care and nutrition department and township heads, midwives, health workers, and mothers in communities in both semi-urban and rural communities in Yangon. The trained persons serve a collective population of 500,000 with an estimated 10,000 pregnant women per year. They also now have access to life saving commodities provided through the project.
Preventing cervical cancer
In Myanmar, cervical cancer is the 1st most common female cancer in women aged 15 to 44 years. PATH is working to stop the spread of this disease through new and easy methods, such as visual inspection with acetic acid (VIA), which involves swabbing the cervix with vinegar (5% acetic acid) and looking for areas that turn white. This indicates they are likely to be precancerous or cancerous, which the provider can treat on the spot using cryotherapy. This screen and treat approach is easy to teach and implement in low-resources settings, making it viable for scale-up nationwide.
In 2014, PATH implemented a train-the-trainer course with obstetricians and gynecologists in three townships in the Mandalay region. Through a training-of-trainers course and the provision of commodities (pelvic models and cryotherapy instruments), PATH led a training of trainers for obstetricians and gynecologists. These trained health staff then trained 40 Basic Health Staff in two districts of the project townships, designated by the Ministry of Health, to conduct the screenings.
By establishing services in two pilot districts, the regional and national governments now have an opportunity to evaluate the feasibility, acceptability, and affordability of a screen-and-treat approach based on VIA and cryotherapy. PATH is seeking additional funding to scale up this project and apply lessons learned and evidence generated from this approach to the development of national cervical cancer screening and treatment policy and guidelines.
Ensuring quality family planning services
Approximately one fourth of women of childbearing age in Myanmar (nearly 1.8 million women) would like to practice what is locally referred to as birth spacing, but they do not have access to contraception. Limited availability and financial constraints lead to unwanted pregnancies and unsafe abortions, a leading cause of maternal deaths. At the 2013 International Conference on Family Planning in Addis Ababa, Myanmar officials publicly vowed to halve unmet need for contraception and raise the contraceptive prevalence rate from 40 percent to 60 percent.
PATH is supporting this transformation with analysis to inform a total market approach to family planning. This approach seeks to ensure that people who have the ability to pay for family planning access the services they need through the private sector (for-profit businesses and nonprofit organizations) so that limited public-sector (government) resources can be effectively targeted to those who cannot afford services. The goal is to ensure that the needs of the total population are met. To explore the viability of this approach, PATH has met with local stakeholders, developed a landscape analysis, and convened government officials and public- and private-sector leaders in this field.