Analysis of Reproductive Health Stakeholders in Myanmar
Executive Summary
Reproductive Health Stakeholder Analysis Myanmar was done in 2001 and identified over 50 agencies and organizations. However, many agencies and organizations were working with primary focus on HIV/AIDS. Primary data collection focused on 4 areas of RH – birth spacing; maternal and obstetric care; RTI/STI programmes; and ARH activities.
This is the second attempt, after five years, to update the information on reproductive health stakeholders in Myanmar. In this analysis, only those organizations that have activities with primary objectives of addressing the reproductive health issues are included. This analysis is undertaken with the objective of updating the information on reproductive health activities - the Minimum Essential Package of Reproductive Health Interventions according to the Life Cycle Approach - implementing by stakeholders.
Five semi-structured, self-administered questionnaires were sent to 54 stakeholders and received replies from 39 stakeholders (72.2%). Among the responding stakeholders, 17 stakeholders have no reproductive health programme and 2 organizations are implementing HIV/AIDS programme only.
Non-governmental organizations started implementing reproductive health activities as early as 1991 by local NGO and 1993 by International NGOs and more and more NGOs coming into play. All the States/Divisions are covered by one or more stakeholders giving that MMCWA provides RH services in all States and Divisions. The number of stakeholders in State/Division ranges from one in Kayah state to 12 in Yangon division. Northern Shan state has 11 stakeholders and Mandalay and Ayeyarwady divisions have 9 stakeholders each. Among the organizations, MMCWA covers all states/divisions and UNFPA implements in 15, JOICFP in 11, PSI in 10 and MMA in 8 states/divisiosn.
Out of 18 organizations, 14 are involved in ‘Adolescent reproductive health’ and ‘RTI/STI/HIV/AIDS’. Thirteen organizations (72.2%) provide/support ‘Antenatl care’. Twelve organizations promote ‘Men’s role in/and reproductive health’. Nine organizations supported ‘Postnatal care’. ‘Birth spacing and contraceptive services’ are provided by 11 organizations. Nine organizations support for ‘Neonatal care’ and ‘Postnatal care’. ‘Delivery care’ is delivered by 7 organizations. Only 4 organizations take care of ‘Post-abortion care’. ‘Post menopausal reproductive health’ and ‘Gynaecological cancers’ are supported by one organization. There is no organization addressing the area of ‘Subfertility’.
The number of RH interventions implemented by each organization ranges from 2 interventions (MdM, PSI, YWCA) to 11 interventions (MMCWA). MMCWA engages in all minimum essential package of RH interventions. Malteser implements 9 interventions and AMI, Merlin and UNFPA provide 8 interventions each.
There is a wide variety of target population, from newborn to youth, adolescents and married men and women, high risk groups to general community and service providers.
Fifteen organizations conducted training, both technical and management support training for improving the skills of the service providers and the quality of services provided to targeted groups as well. Types of trainings could be grouped into 8 groups: - (1) Training of AMW/TBA; (2) Reproductive health; (3) Birth spacing, contraceptives, family planning; (4) Safe motherhood, neonatal care and women and child development; (5) STI/HIV/AIDS; (6) Male involvement; (7) Supporting skills development; and (8) Project management. There were 21 research studies conducted by seven organizations. The number of research study conducted by each organization ranged from 1 to 6 studies. The research areas comprises of KABP of Sexual and Reproductive Health of young people (15 – 24 years), RH services facility assessment / Infrastructure and quality of services, Knowledge and performance of Trained personnel, Behavioural study on male involvement, KPC survey / Formative research, Safe motherhood, PMCT, Anaemia in pregnancy, Antenatal care, and KAP study of Youth-to- Youth peer education for Reproductive Health.
There seems to be a strong collaboration among the key players. Almost all the stakeholders were in close cooperation with Department of Health in delivering the RH services. UNFPA was cited by 11 organizations - 2 LNGOs and 9 INGOs - as an implementing partner in reproductive health. Reproductive health activities and geographical coverage are similar in some cases between stakeholders because information was received from both donor and implementer.
Most of the organizations showed their interest in reproductive health in Myanmar. Over half of the organizations expressed that their organizations gave priority to reproductive health in a strong manner. The organizations’ interest in health promotion and improved quality and access to services were high (60%). Majority of the organizations were of great interest in partnership and net-working (53.3%), capacity building (73.3%) and sustainability (80%). However, there was necessity to enhance more networking and advocacy to build a closer relationship with public services and other implementing partners with common goal. Most of the organizations expressed their opinions on gaps between capacity of their staff and performance in reproductive health.
Two-thirds of the organizations plan to expand/scale up their RH activities and the rest are going to continue their activities. The planned expansion/scaling up activities include birth spacing, male involvement, training, advanced care, quality care, comprehensive sexual reproductive health counseling, emergency obstetric care and expansion in geographical coverage and more support to public health facilities. CONTENTS
Executive summary
1. Introduction 1
2. Objectives 1
3. Methodology 2
4. Limitations 4
5. Study Period 4
6. Profile of organizations 4
7. Geographical coverage by stakeholders 5
8. Minimum essential package of reproductive health interventions 7 8.1 Reproductive health activities by stakeholders 7 8.2 Sub-component activities of each RH interventions 7 8.2.1 Adolescent reproductive health 8 8.2.2 Birth spacing and contraceptive services 8 8.2.3 RTI/STI/HIV/AIDS 9 8.2.4 Antenatal care 9 8.2.5 Delivery care 9 8.2.6 Neonatal care 10 8.2 7 Postnatal care 10 8.2.8 Post-abortion care 10 8.2 9 Gynaecological cancers 10 8.2.10 Postmenopausal reproductive health 10 8.2.11 Men’s role in/and reproductive health 10 8.3 Target population 11 8.4 Implementing partners 12 8.5 Future plan 13
9. Capacity Building 13
10. Research 17
11. Opinions, perceptions and attitudes on organization performance 18
12. Conclusions 21
References 22
Annexes Annex A : Profile of organizations Annex B-1 : Geographical coverage of reproductive health interventions Annex B-2 : Township coverage of reproductive health interventions Annex B-3 : Minimum essential reproductive health interventions Annex C : Capacity building Annex D : Research studies Annex E : Opinion, perceptions and attitudes Annex F : Questionnaires ABBREVIATION
AIDS : Acquired Immno Deficiency Syndrome AMW : Auxiliary Midwife ARH : Adolescent Reproductive Health BCC : Behavioural Change Communication BHS : Basic Health Services CBO : Community Based Organization CHEB : Central Health Education Bureau CSG : Community Support Group DHP : Department of Health Planning DOH : Department of Health DU : Drug User EC : European Commission ECHO : European Commission for Humanitarian Organization FBO : Faith-based Organization FRHS : Fertility and Reproductive Health Survey GO : Government Organization HIV : Human Immuno-deficiency Virus HRM : High Risk Men INGO : International Non-Governmental Organization KABP : Knowledge, Attitude, Behaviour, Practice LNGO : Local (National) Non-Governmental Organization MANA : Myanmar Anti Narcotic Association MCH : Maternal and Child Health MCHWSA : Medical Christian Health Workers Services Association MNA : Myanmar Nurses Association MOH : Ministry of Health MSM : Men having sex with men MWAF : Myanmar Women Affairs Federation MWRA : Myanmar Women of Reproductive Age NAP : National AIDS Programme NGO : Non-Governmental Organization PH : Public Health PMCT/PMTCT : Prevention of Mother to Child Transmission PPFA-International : Planned Parenthood Federation of America-International RH : Reproductive Health RHC : Rural Health Center RTI : Reproductive Tract Infection SDC : Swiss Development Committee SRH : Sexual Reproductive Health STI : Sexually Transmitted Infection SW : Sex Worker TBA : Traditional Birth Attendant THD : Township Health Department ToT : Training of Trainer TMO : Township Medical Officer VCCT : Voluntary Confidential Counselling and Testing VHV : Village Health Volunteer
ABBREVIATION OF ORGANIZATIONS/STAKEHOLDERS
AFXB : Association of Francois-Xavier-Bagnoud AMDA : Association of Medical Doctors of Asia AMI : Aide Medicale International CARE : Cooperation Assistance Relief Everywhere JICA : Japan International Cooperation Agency JOICFP : Japanese Organization for International Cooperation in Family Planning Malteser : Malteser International MdM : Medicins du Monde MMA : Myanmar Medical Association MMCWA : Myanar Maternal and Child Welfare Association MRCS : Myanmar Red Cross Society MSI : Marie Stopes International PSI : Population Services International SC : Save the Children UNFPA : United Nations Population Fund WV : World Vision YWCA : National Young Women Christian Association
RH Stakeholders Analysis
ANALYSIS OF REPRODUCTIVE STAKEHOLDERS IN MYANMAR
1. Introduction
1.1 Background
Myanmar is the largest country in mainland South-East Asia with a total land area of 676,578 square kilometers lying between 09° 32′ N and 28° 31′ N latitudes and 92° 10′ E and 101° 11′ E longitudes. The population of Myanmar in 2005-2006 is estimated at 55.4 million with a growth rate of 2.02 percent. About 70 percent of the population resides in the rural areas. The country is administratively into 14 States and Divisions. These States and Divisions are subdivided into 65 districts, 325 townships, 59 sub-townships, 2759 wards, 13723 village tracts, and 64976 villages.1
1.2 Reproductive Health Stakeholders in Myanmar
Reproductive Stakeholder Analysis was conducted in 2001 2. Health Stakeholders Report Myanmar, published in 2003, included ‘reproductive health’ as one of the health areas selected for analysis 3. The Directory of International Non Governmental Organizations published yearly also contained information of organizations working in reproductive health 4, 5.
Reproductive Health Stakeholder Analysis Myanmar (2001) identified 51 agencies and organizations – 12 government ministries, 17 local NGOs and Community Groups, 7 UN agencies, 15 INGOs, and donors. Primary data collection focused on 4 areas of RH – birth spacing; maternal and obstetric care; RTI/STI programmes; and ARH activities. Additional HIV/AIDS activities were taken from a similar stakeholder analysis with a specific focus on HIV/AIDS. Almost all of the stakeholders have RTI/STI/HIV/AIDS related activities, but most focus on HIV/AIDS. 14 organizations are involved in Birth spacing and contraception; 15 in obstetric care; and 15 in ARH. Data were organized briefly according to Agency, Activity, Information and education, Health staff training, RTI/STI supplies and/or services, Condom promotion and distribution, Care, compassion and other treatment for PLWHA, and Location.
In the Health Stakeholder Report Myanmar (2003), 45 stakeholders interviewed included RH in their current or planned health activities. Of these only 18 have significant RH programming or commitments. The activities were grouped into 5 groups: birth spacing; RTIs and HIV/AIDS; Obstetrics; ARH and Cancers, Infertility and Menopause. Twenty organizations worked on birth spacing; nearly all involved in RTI/HIV/AIDS and most focused on STI and/or HIV/AIDS; 21 worked on obstetrics; 14 on ARH; and 2 on Cancer/Infertility/Menopause. Fourteen organizations had Newborn care components.
There were 65 agencies and organizations, including 12 government ministries, listed as RH stakeholders in the Five-Year Strategic Plan for Reproductive Health in Myanmar, 2004-2008 6.
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2. Objectives
This report was undertaken with the objectives of: • updating the information on reproductive health activities implementing by stakeholders with reference to the Minimum Essential Package of Reproductive Health Interventions according to the Life Cycle Approach; • highlighting the situation of capacity building and research in reproductive health service delivery; and • illustrating organizational relationships for developing stakeholder alliances; so that opportunities to mobilize their support for a particular goal could be identified and to be able to ensure targeted programming maximizing the effectiveness and efficiency of implementation in terms of resource allocation.
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3. Methodology
3.1 Data collection
Stakeholders were identified by reviewing relevant documents 2, 3, 4, 5, 6 and informed them about the analysis process with an introductory letter. Five structured and self-administered questionnaires were developed and finalized with the comments and inputs from the Department of Health. (Annex F)
FORM A: Profile of the Organization FORM B: Current activities on Reproductive Health FORM C: Information on Capacity building in Reproductive Health FORM D: Information on Research in Reproductive Health FORM E: Opinions, perceptions and attitudes on organization performance in RH
Reproductive health activities were categorized according to the “Minimum Essential Package of Reproductive Health Interventions According to the Life Cycle Approach” – Adolescent reproductive health, Birth spacing and contraceptive services, RTI/STI/HIV/AIDS, Antenatal care, Delivery care, Neonatal care, Postnatal care, Post-abortion care, Gynaecological cancers, Postmenopausal reproductive health, and Men’s role in/and reproductive health. Sub-fertility was included as an additional intervention.
The questionnaires were e-mailed / postal mailed to the following 54 stakeholders (4 Government organizations, 7 UN agencies, 24 INGOs, 2 International Red Cross Movement Organizations, and 17 LNGOs) and followed up by telephone and personal contact.
Government Organizations Department of Health Department of Health Planning Department of Medical Research (Lower Myanmar) Ministry of Sports
UN Agencies UNDP UNAIDS UNICEF UNFPA UNHCR UNOPS WHO
International NGOs Action contre la Faim Adventist Development and Relief Agency Association Francois-Xavier Bagnoud Association of Medical Doctors of Asia Aide Medicale Internationale Artsen Zonder Grenzen CARE International in Myanmar COMPASS Research HOPE International Development Agency International HIV/AIDS Alliance Myanmar Japan International Cooperation Agency Myanmar Office
3 RH Stakeholders Analysis Japanese Organization for International Cooperation in Family Planning Malteser International Merlin Marie Stopes International Medicins du Monde Medicins Sans Frontieres –Switzerland PARTNERS Myanmar Progetto Continenti Population Services International Save the Children (combined SC-UK, SC-US and SC-J) Stromme Foundation World Concern World Vision
International Red Cross Movement Organizations International Federation of Red Cross and Red Crescent Societies Danish Red Cross
Local NGOs Asho Chin Baptist Conference Kayin Baptist Convention Karuna Myanmar Social Services Myanmar Christian Health Workers’ Services Association Muslim Free Dispensary and Medical Relief Society Myanmar Baptist Convention Myanmar Council of Churches Myanmar Health Assistant Association Myanmar Maternal and Child Welfare Association Myanmar Medical Association Myanmar Nurses Association Myanmar Red Cross Society National Council of Young Men’s Christian Association National Young Women’s Christian Association Pyi Gyi Khin Pwo Karen Baptist Conference Salvation Army
3.2 Data analysis
Out of 54 organizations contacted, at the end of September, 2006, 39 organizations (72.2%) replied, out of which 17 organizations responded that they have no RH programme. Two organizations that implement HIV/AIDS activities like condom promotion, VCCT for HIV, HIV/AIDS prevention without reproductive health objective were not included in the analysis.
Organizational profiles were prepared with information on organization’s brief history and mission; areas of expertise, activities including training and research, locations, target groups, staff strength, implementing partners and future plan in RH.
Reproductive health activities were analyzed in terms of geographical coverage - State/Division and Townships, and by target groups.
4 RH Stakeholders Analysis Information on capacity building on RH was grouped into 8 categories; - Reproductive health, ARH, Birth spacing/contraceptives/family planning, Safe motherhood, Neonatal care, STI/HIV/AIDS, Male involvement, and Project management.
Since DOH and MMCWA provides RH services in all townships in the country, these two organizations were not included in the detail tabulation of geographical location of activities.
Research studies conducted by the organizations were grouped according to the research areas and the key findings were highlighted.
Opinions, perceptions and attitudes on organization performance in reproductive health and expectations and suggestions of the organizations were analyzed in the light of: - interests, plan, and scope of the organization; organization efforts in implementation and management decision making, monitoring and supervision; organization power; gaps and constraints; and expectations and suggestions - while maintaining the anonymity of organizations. Altogether 16 organizations responded to this section.
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4. Limitations
Stakeholders can be defined as actors who have an interest in the issue under consideration, who are affected by the issue, or who – because of their position – have or could have an active or passive influence on the decision-making and implementation processes 7. This analysis included exclusively organizations that implement reproductive health activities and other actors were not included. Moreover, this study was conducted in the light of management and project implementation aspects.
The list of stakeholders was prepared based on existing information available but may not be an exhaustive list.
Data were collected by e-mailing and postal mailing the structured and self administered questionnaires and no attempt has been made to verify the answers although some cross-check was done between questionnaires.
5. Study Period
The study period is scheduled from August 2006 to September 2006.
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6. Profile of organizations
MMCWA was the first NGO that involved in RH activities as early as 1991 and its mission was dedicated to promote health and wellbeing of mother and children. Like MMCWA, 5 organizations – AFXB, AMDA, JOICFP, MSI, WV – implemented RH activities since they began their activities in Myanmar. Among the organizations, the number of staff engaged in RH activities ranged from 5 (JICA) to over 7,000 (MMCWA). The number of RH interventions out of the minimum essential package implemented by each organization varied from 2 (PSI, YWCA) to 11 (MMCWA), majority of the organizations (27.8%) delivering 5 RH interventions. Fifteen organizations provided trainings and 7 organizations conducted research studies in RH. (Annex A)
Table 1: Summary of Profiles of Organizations
Stakeholders Year began in Year began RH No. of staff in RH RH Training Research Myanmar Interventions* 1.AFXB 1993 1993 14 3 x 2.AMDA 1995 1995 15 7 x 3.AMI 2002 2005 20 8 x 4.CARE 1996 2002 31 3 x x 5.JICA 1981 1998 5 4 x x 6.JOICFP 2000 2000 22 6 x x 7.Malteser 2001 2004 60 10 x 8.MdM 1994 2002 3 9.Merlin 2005 82 8 x x 10.MMA 1949 1999 20 3 x 26 central; 50 x 106 11.MMCWA 1991 1991 project tsps.; 20 x non- 11 x x project tsps. 12.MRCS 1920 2000 48 3 x x 13.MSI 1998 1998 380 4 x 14.PSI 1994 2001 24 2 x 15.SC 1995 1999 97 6 x x 16.UNFPA 1973 1996 10 UNFPA + 9 DOH 8 x 17.WV 1993 1993 32 5 18.YWCA 1900 1998 2 * Minimum essential package of RH interventions according to the life cycle approach DOH started since 1948. WHO provides support since 1950s.3
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7. Geographical Coverage by stakeholders
7.1 State/Division Coverage
All the States/Divisions are covered by one or more stakeholders given that MMCWA provides RH services in all States and Divisions. The number of stakeholders in State/Division ranges from one in Kayah state to 12 in Yangon division. Northern Shan state has 11 stakeholders and Mandalay and Ayeyarwady divisions have 9 stakeholders each. Eight organizations work in Mon state, 7 each in Bago and Magway divisions, and 5 each in Rakhine state, Sagaing and Tanintharyi divisions. (Annex B-1)
Table 2: Number of stakeholder operating in each Stats/Division
State/Division Stakeholders Total Kachin 1. MdM 2. MMCWA 3. UNFPA 3 Kayah 1. MMCWA 1 Kayin 1. MMCWA 2. PSI 3. SC 4. UNFPA 4 Chin 1. MMCWA 2. UNFPA 2 Mon 1. AFXB 2. JOICFP 3. MMA 4. MMCWA 5. MSI 6. PSI 7. SC 8. UNFPA 8 Rakhine 1. AMI 2. JOICFP 3. Malteser 4. MMCWA 5. UNFPA 5 Shan (S) 1. JOICFP 2. MMCWA 3. PSI 4. UNFPA 4 Shan (N) 1. AMDA 2. AMI 3. CARE 4. JICA 5. JOICFP 6. Malteser 7. MMA 8. MMCWA 9. 11 PSI 10. SC 11. UNFPA Shan (E) 1. MMCWA 2. UNFPA 3. WV 3 Bago 1. JOICFP 2. MMA 3. MMCWA 4. MRCS 5. MSI 6. PSI 7. UNFPA 7 Sagaing 1. JOICFP 2. MMA 3. MMCWA 4. PSI 5. UNFPA 5 Tanintharyi 1. JOICFP 2. MMCWA 3. SC 4. UNFPA 5. WV 5 Magway 1. AMDA 2. JOICFP 3. MMA 4. MMCWA 5. PSI 6. SC 7. UNFPA 7 Mandalay 1. AMDA 2. CARE 3. JOICFP 4. MMA 5. MMCWA 6. MSI 7. PSI 8. UNFPA 9. WV 9 Yangon 1. AFXB 2. AMI 3. JOICFP 4. MdM 5. MMA 6. MMCWA 7. MRCS 8. MSI 9. PSI 12 10. UNFPA 11. WV 12. YWCA Ayeyarwady 1. JOICFP 2. Merlin 3. MMA 4. MMCWA 5. MRCS 6. MSI 7. PSI 8. UNFPA 9. WV 9
In terms of state/division coverage, MMCWA covers all states/divisions, UNFPA implements in 15 states/divisions, JOICFP supports in 11 states/divisions, PSI provides services in 10 states/divisions and MMA operates in 8 states/divisions. (Table 3)
7.2 Townships coverage in each State/Division
For townships coverage, the most extensive covering organizations in descending order are MMCWA (all townships), PSI (116 townships), UNFPA (114 townships), MMA (45 townships) and JOICFP (27 townships). AFXB renders services in 20 townships in Yangon and Mon, SC implements in 15 townships of 5 states/divisions, WV delivers services in 13 townships in 5 states/divisions, MSI performs for 12 townships in 4 states/divisions, and MdM carries out activities in 11 townships. DOH delivers RG services in all townships in all states/divisions. WHO provides support to the MOH in implementation of Myanmar five-year strategic plan for RH.
Table 3: Number of townships stakeholders engaging in RH services in States/Divisions
Stakeholder Number of townships in each State/Division KCN KYA KYN Chin Mon RKN Shan Shan Shan Bago SGN TTY MGW MDY YGN AYE Total N S E 1.AFXB 4 16 20 2.AMDA 1 1 1 3 3.AMI 1 3 3 7 8 RH Stakeholders Analysis
4.CARE 1 2 3 5.JICA 2 2 6.JOICFP 1 1 1 1 4 2 1 4 4 3 5 27 7.Malteser 1 3 4 8.MdM 3 8 11 9.Merlin 1 1 10.MMA 3 1 9 5 7 7 9 4 45 11.MMCWA Covers all townships in all states/divisions 325 12.MRCS 2 2 1 5 13.MSI 2 1 6 2 1 12 14.PSI 2 8 6 4 20 10 9 17 32 8 116 15.SC 3 6 4 1 1 15 16.UNFPA 2 2 2 5 5 5 3 1 21 11 4 13 12 14 14 114 17.WV 2 3 3 3 2 13 18.YWCA 5 5
KCN = Kachin; KYA = Kayah; Kyn = Kayin; RKN = Rakhine; SGN = Sagaing; MGW = Magway; MDY = Mandalay; YGN = Yangon; AYE = Ayeyarwady
Moreover, the number of townships covered by each organization varied according to the RH intervention. MMCWA implements ARH, Birth spacing and contraceptive services, RTI/STI/HIV/AIDS and Delivery care in all townships in all states/divisions. In areas of ‘neonatal care’, ‘postnatal care’ and ‘post-abortion care’ it operates through 91 maternity homes. For PMCT it provides services in Mandalay division only. UNFPA supports activities in 15 states/divisions covering 114 townships in general and 41 townships for ‘promotion of sexual and reproductive information for young people’, 35 townships for ‘youth-friendly clinics/centres’, 30 townships for ‘condom promotion’ and ‘diagnosis and treatment of reproductive tract infections including STIs’, 22 townships for ‘PMCT’ and 2 townships for ‘men’s role in/and reproductive health’. (Annex B-2)
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8. Minimum essential package of reproductive health interventions
8.1 Reproductive health activities by stakeholders
Out of 18 responding organizations, 14 (77.8%) are involved in ‘Adolescent reproductive health’ and ‘RTI/STI/HIV/AIDS’. Thirteen organizations (72.2%) provide/support ‘Antental care’. Twelve organizations (66.7%) promote ‘Men’s role in/and reproductive health’. ‘Birth spacing and contraceptive services’ are provided by 11 organizations. Nine organizations support for ‘Neonatal care’ and ‘Postnatal care’. ‘Delivery care’ is delivered by 7 organizations. Only 4 organizations take care of ‘Post-abortion care’. ‘Post menopausal reproductive health’ and ‘Gynaecological cancers’ are supported by one organization.
Table 4: Stakeholders involved in each reproductive health intervention
MINIMUM ESSENTIAL REPRODUCTIVE HEALTH INTERVENTIONS Stakeholders ARH BSC RTI/STI/ ANC DC NC PNC PAC GCA PMRH MRH Total HIV/AIDS 1.AFXB x x x 3 2.AMDA x x x x x x x 7 3.AMI x x x x x x x x 8 4.CARE x x x 3 5.JICA x x x x 4 6.JOICFP x x x x x x 6 7.Malteser x x x x x x x x x 9 8.MdM x x 2 9.Merlin x x x x x x x x 8 10.MMA x x x 3 11.MMCWA x x x x x x x x x x x 11 12.MRCS x x x 3 13.MSI x x x x 4 14.PSI x x 2 15.SC x x x x x x 6 16.UNFPA x x x x x x x x 8 17.WV x x x x x x 6 18.YWCA x x 2 14 11 14 13 7 9 9 4 1 1 12 DOH delivers all interventions including ‘subfertility’. WHO provides supports to the MOH in implementation of Myanmar five-year strategic plan for RH.
The number of RH interventions implemented by each organization ranges from 2 interventions (MdM, PSI, YWCA) to 11 interventions (MMCWA). MMCWA engages in all minimum essential package of RH interventions. Malteser implements 9 interventions and AMI, Merlin and UNFPA provide 8 interventions each.
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8.2 Sub-component Activities for each Reproductive Health Interventions
Table 5 shows the number of sub-component activities implemented by each organization. In general, all organizations do not implement all sub-component activities for each RH intervention, except some organizations deliver all components in ‘Adolescent reproductive health’, ‘Neonatal care’, ‘Post-natal care’, ‘Post-menopausal RH’ and ‘Men’s role in/and RH.
Table 5: Stakeholders involved in sub-component activities of reproductive health intervention
MINIMUM ESSENTIAL REPRODUCTIVE HEALTH INTERVENTIONS Stakeholders (No. sub-component activities) ARH BSC RTI/STI/ ANC DC NC PNC PAC GCA PMRH MRH (2) (5) HIV/AIDS (10) (7) (7) (11) (4) (2) (1) (3) (5) 1.AFXB 1 3 2 2.AMDA 1 2 2 8 1 2 1 3.AMI 1 2 5 6 2 5 7 2 4.CARE 2 1 2 5.JICA 8 1 7 4 6.JOICFP 2 8 1 7 7 1 7.Malteser 1 1 3 7 2 6 6 2 1 8.MdM 2 4 9.Merlin 1 1 1 6 2 7 7 2 10.MMA 4 2 3 11.MMCWA 1 2 5 9 5 7 11 2 1 1 1 12.MRCS 1 1 1 13.MSI 2 5 3 1 14.PSI 1 4 15.SC 2 2 3 4 4 3 16.UNFPA 2 3 3 5 5 3 2 2 17.WV 1 2 3 1 2 3 18.YWCA 3 2 DOH delivers all interventions including ‘subfertility’. WHO provides supports to the MOH in implementation of Myanmar five-year strategic plan for RH.
Provision/Supporting of the organizations towards implementation of sub-components for each reproductive health intervention are analyzed in terms of geographical coverage. In view of the fact that MMCWA makes available all reproductive health interventions in all states/divisions, unless specific information is mentioned, the analysis is done for other organizations. The number of states/divisions and townships are calculated exclusively without MMCWA. (Annex B-3)
8.2.1 Adolescent Reproductive Health
Fourteen organizations (77.8%) are working on Adolescent Reproductive Health. Thirteen organizations “provide sexual and reproductive health information” in 101 townships in 13 states/divisions (MMCWA involves only in “provision of sexual and reproductive health information” in all 325 townships of all states/divisions.) and 5 organizations run “youth- friendly clinics/centers” in 39 townships in 11 states/divisions.
8.2.2 Birth Spacing and Contraceptive Services
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Altogether11 organizations (61.1 %) provide “Birth spacing and Contraceptive Services”. Out of which, two organizations (PSI & MSI) work for “emergency contraception” in 10 states/divisions for 118 townships and PSI accounts for 116 townships in 8 states/divisions. Ten organizations deliver “oral contraception” in 15 states/divisions covering 184 townships, and major contribution is from UNFPA that supports activities in 112 townships in 14 states/divisions through Department of Health. Seven organizations make available “monthly and/or three monthly injectables” in 182 townships of 15 states/divisions (UNFPA provides support in 112 townships). MMCWA makes available “oral contraception” and “monthly and/or three monthly injectables” in all townships in all stats/divisions. Five organizations support for “IUDs” in 14 states/divisions totally 138 townships including 112 townships by UNFPA. Two organizations (MSI & YWCA) supports for “sterilization” in 5 states/divisions covering 17 townships.
8.2.3 RTI/STI/HIV/AIDS
Altogether 14 organizations (77. %) are carrying out RTI/STI/HIV/AIDS activities. MMCWA provides all services in all states/divisions in 325 townships, but for “PMTCT” MMCWA implements in Mandalay division only. Apart from MMCWA, 13 organizations are involved in “condom promotion” in 129 townships of 14 states/divisions. Nine organizations provide “diagnosis and treatment of RTIs (including STIs)” in 13 states/divisions concentrating in 101 townships. “Voluntary counseling and testing for HIV” is supported by 7 organizations covering 75 townships in 11 states/divisions. “PMTCT” service is rendered by 5 organizations in 57 townships of 10 states/divisions and 2 organizations work for “syphilis screening and treatment” in 14 townships of Yangon division and Kachin state. Most of the activities were concentrated on HIV/AIDS and to a lesser extent on STIs.
8.2.4 Antenatal Care
Twelve organizations render antenatal care services. MMCWA provides all services except “treatment of intestinal parasites” in 325 townships in all states/divisions. Seven organizations carry out for “preparation of birth plans” in 13 states/divisions in 116 townships. “Immunization against tetanus” is provided by 7 organizations in 28 townships of 10 states/divisions. Six organizations “detect and treat hypertensive disorders in pregnancy” in 124 townships (14 states/divisions). “Detection and treatment of malaria” is made available in 7 townships of 5 states/divisions by 5 organizations. Eleven organizations give “advice on early detection of complications and danger signs of pregnancy” to target populations of 127 townships in 14 states/divisions. Ten organizations “provide iron/folate supplement” to pregnant mothers of 123 townships in 14 states/divisions. In 19 townships of 8 states/divisions, 6 organizations “detect and treat anaemia”. Four organizations support for “syphilis screening and treatment” in 113 townships, and in 8 townships, 4 organizations “treat intestinal parasites”. “VCCT for HIV” is offer by 3 organizations. MMCWA supports ‘VCCT for HIV’ only in Mandalay division. MMA conducts counseling only. UNFPA supports in 5 sub-components (“preparation of birth plans”; “detection and treatment of hypertensive disorders in pregnancy”; “advice on early detection of complications and danger signs”; provision of iron/folate supplement; and “syphilis screening and treatment” in 112 townships in 14 states/divisions.
8.2.5 Delivery Care
Delivery care is implemented by 7 organizations. MMCWA delivers the services through 91 maternity homes situated in all states/divisions. Six organizations help to promote “clean delivery practices” in 14 states/divisions covering 117 townships. Four organizations promote “routine placenta examination” in 115 townships. “Administration of oxytocic drugs in the third stage of labour” and “Administration of oral and/or parenteral antibiotics” is executed by
12 RH Stakeholders Analysis MMCWA in 91 maternity homes. UNFPA also supports for “Administration of oxytocic drugs in the third stage of labour” and “administration of anticonvulsants to treat pre-eclampsia and eclampsia” in collaboration with DOH. Three organizations support the “use of the partograph”. None of the responding organization performs “surgery”. Among the townships covered, UNFPA accountable for 112 townships in 14 states/divisions.
8.2.6 Neonatal Care
Seven organizations implement neonatal care. MMCWA covers all components of neonatal care in 91 maternity homes in all states/divisions. In addition to MMCWA, 5 organizations work for “prevention and management of hypothermia” in 10 townships, “prevention and management of infections”, “umbilical cord care” and “early detection and management of neonatal jaundice” in 8 townships. “Immediate initiation of breast feeding” and “promotion of exclusive breast feeding” are promoted by 6 organizations in 10 townships and 7 townships respectively. Three organizations support for “resuscitation of newborn” in 3 townships.
8.2.7 Postnatal Care
Nine organizations provide/support for postnatal care. MMCWA carries out all sub-components except “detection and treatment of anaemia” and “immunization against tetanus” in 91 maternity homes. UNFPA helps to ‘provide iron/folate supplement’, ‘detect and treat anaemia’ and ensure ‘through review at 6 weeks postpartum’ in 112 townships. Six organizations deliver “birth spacing plans services” in 24 townships. Five organizations provide “iron/folate supplement” in 119 townships and “postnatal care within first 6 weeks” in 116 townships and ensure that “thorough review at 6 weeks postpartum” is carry out in 8 townships. In 116 townships, “detection and treatment of anaemia” is executed by 5 organizations. Three organizations each operate in “early detection and management of puerperal complications” (7 townships) and “detection and treatment of malaria” (5 townships). Four organizations support for “immunization against tetanus”. “VCCT for HIV” in Mandalay division and “syphilis screening” in all townships is made available by MMCWA.
8.2.8 Post-abortion Care
Post-abortion care services are carried out by 4 organizations. MMCWA and UNFPA support in provision of “Post-abortion birth spacing” and “counseling on birth spacing for post-abortion clients” services in 91 maternity homes and in 112 townships respectively. Malteser renders ‘post-abortion birth-spacing services’ in Maungdaw. MRCS conducts “counseling on birth spacing for post-abortion clients” in 5 townships. “Prevention and management of sepsis, tetanus, injury, shock and haemorrahge” is conducted by Malteser in Maungdaw. None of the organization does “manual vacuum aspiration for management of incomplete abortion”.
8.2.9 Gynaecological Cancers
“Cervical cancer and breast cancer screening and treatment” services are provided by MMCWA in all states/divisions.
8.2.10 Postmenopausal Reproductive Health
Only one organization, MMCWA, provides “counseling, including life style and nutrition” as postmenopausal reproductive health in all states/divisions.
8.2.11 Men’s Role in/and Reproductive Health
13 RH Stakeholders Analysis Traditionally family planning and RH services have focused almost exclusively on women. Yet the health and attitudes of men often play a critical role in the health of women since men often hold decision-making power over matters as sexual relations and when and whether to have a child or even seek health care.
Twelve organizations are encouraging “men’s role in/and reproductive health”. All 12 organizations “promote awareness of STIs/HIV/AIDS”. MMCWA “promotes awareness of STIs/HIV/AIDS” in all states/divisions and the other 11 organizations in 75 townships. Eight organizations “promote men’s role in support of reproductive health” in 68 townships. Three organizations work in “promotion of community awareness about violence against women” in 57 townships. MMA is the major organization contributing for all 3 sub-components in 8 states/divisions covering altogether 45 townships.
14 RH Stakeholders Analysis
8.3 Target Population
There is a wide variety of target population, from newborn to youth, adolescents and married men and women, general community to high risk groups. Some organizations provide services through training service providers. (Annex B-3). This variation depends upon the RH activities performed by each organization.
Target population/beneficiaries addresses by stakeholders can be grouped into 8 categories: (1) Youth and adolescent – youth, out-of school youth, young people 10 – 24 years, youth from workplace, 15-24 years old, (2) Women & Children – women, women of reproductive age, reproductive women, married women, pregnant women, child bearing women, mothers, eligible couples, Neonates, (3) Men – married men, men of reproductive age, eligible couples, (4) High risk groups – SWs, clients, DUs, MSM, high risk men, high risk behaviour group, trishaw drivers, boat men, truck drivers, workers from transport sector, karaoke bars/hotel owners, (5) Uniform service personnel – military, police, prisons, (6) Patients – post-abortion cases, PLHAs, patients coming to RHC/mobile clinics, (7) Service providers – general practitioners, AMW, village health volunteers, peer educators, birth attendants and (8) General population – villagers.
There are organizations that express specific target group like ’15-24 years old youth’, ‘women of reproductive age from low income neighbourhood’. However, some organizations mention in a very vague way like ‘youth’, ‘women’, ‘all’.
Table 6: Target population addressed by organizations
Target population groups Organi- Youth & Women & Men High risk Uniform PLHAs Service General zation Adolescent Children group service / providers population personnel Patients AFXB Youth; Workers from Uniform PLHAs Youth from transportation service workplace personel AMDA Mothers; Village Female Reproductive health villagers; female; volunteers Villagers Pregnant women AMI Adolescents Women in MSM; Patients General reproductive Trishaw to RHC / population age; Pregnant drivers; Boat mobile women; Child men; High clinics bearing women; risk men; Neonates; <1 CSW children CARE 15-24 years JICA AMW JOICFP Youth Women of Men of AMW reproductive age reproductive age Malteser Youth Women; Men; Risk groups; Prisons; PLHA Peer General Children <5; Karaoke bars; Military; educators; population; Incarcerated Police Health population; care Bar/Hotel facilities; owners; Teachers Truck drivers MdM SWs; DUs Merlin Women of Men of reproductive age reproductive age MMA Pregnant women All MMCWA Young people Married women; Married men Post- Pregnant abortion women; cases 15 RH Stakeholders Analysis
Women of reproductive age; Newborns MRCS Adolescents; Youth (15-24 years & out- of school) MSI 10-24 years Women of Men SWs; Risk reproductive age behaviour from low group income neighbourhood; Women PSI Women of General reproductive age practi- tioners SC 15-24 years; 15-49 eligible 15-49 eligible Birth Out-of school couples; couples; attendants youth; Reproductive Reproductive General age women; age men; youth; Pregnant Husband of Adolescent mothers pregnant girls mothers UNFPA 15-24 years Women of Spouses; Men SWs & clients reproductive of age; Pregnant reproductive mothers; age Newborn WV Youth Women; Risk groups Mothers YWCA Women of All ages reproductive age
8.3.1 Number of target beneficiaries reached
There is a great variation in stating the number of beneficiaries reached by each organization for a particular sub-component of RH intervention in a township, from less than hundred to over 300,000. Moreover the number of beneficiaries reached was expressed collective in each state/division in some cases. However some organization mentioned the exact number of beneficiaries covered for each township. (Annex B-3)
16 RH Stakeholders Analysis
8.4 Implementing Partners
There seems to be a strong collaboration among the key players. Reproductive health activities and geographical coverage are similar in some cases because information was received from both donor and implementer. In some instances, there is no clear identification between donors and implementing partners.
Table 7: Implementing partners of organizations
Stakeholders Implementing Partners Public Sector UN agencies LNGO INGO Others AFXB DOH (NAP) UNAIDS, MRCS AZG, PSI, SDC UNICEF, MSI UNFPA, UNIAP AMDA DOH, NATALA UNFPA, UNDP, PSI JICA UNAIDS, WFP AMI DOH (township) UNFPA EC, ECHO, FHAM CARE DOH (NAP, RH, UNFPA MNA PSI, MSI PHC), THD, STI team JICA DOH (MCH, UNFPA, UNICEF JOICFP State/Township) JOICFP DOH (MCH, PH, UNFPA MMA JICA CHEB) Malteser UNFPA, UNHCR PSI, Health Unlimited MdM MdM Merlin DOH UNICEF MMA DOH (MCH, PH, UNFPA, WHO Ministry of CHEB) Industry - 2 MMCWA DOH, DOSF UNFPA MWAF, MMA, JOICFP, MRCS, MNA, IPPF MHA MRCS DOH (MCH/BS) UNFPA MMA PPFA- International MSI DOH (NAP, UNFPA MCH) PSI Private practitioners SC DOH UNFPA CBOs, MNA, PSI, MSI Literacy and cultural Association UNFPA DOH (MCH), WHO, UNAIDS, MMCWA, MSI, PSI, DHP WFP, UNODC, MMA, MRCS, CARE, AMI, UNHCR MANA Malteser WV MOH, THD CBO YWCA DOH MCHWSA
Almost all the stakeholders were in close cooperation with Department of Health in delivering the RH services. UNFPA was cited by 11 organizations - 2 LNGOs and 9 INGOs - as an implementing partner in reproductive health.
17 RH Stakeholders Analysis
8.5 Future plan
Two-thirds of the organizations expressed their plan to scale up RH activities in the future. The future expansion of activities include provision of more services in terms of contraceptives and condoms, expansion of more RH interventions such as advanced level ANC and PNC, basic emergency obstetric care, training, support to township health facilities, scaling up existing programme, continuation of the current programmes and quality improvement. Some organizations plan to improve the knowledge of communities and form mothers’ groups for sharing and caring. One organization will try to explore ways to sustain the activities. (Annex A)
18 RH Stakeholders Analysis
9. CAPACITY BUILDING IN REPRODUCTIVE HEALTH
9.1 Organizations and categories of training
Fifteen organizations (83%) conducted training, both technical and management support training for improving the skills of the service providers and the quality of services provided to targeted groups as well. Types of trainings could be grouped into 8 groups: - (1) Training of AMW/TBA; (2) Reproductive health; (3) Birth spacing, contraceptives, family planning; (4) Safe motherhood, neonatal care and women and child development; (5) STI/HIV/AIDS; (6) Male involvement; (7) Supporting skills development; and (8) Project management. (Annex C)
Four organizations supported training for AMWs and TBAs. Trainings for “RH” were provided by 4 organizations and for “ARH” by 6 organizations. Six organizations conducted trainings on “Birth Spacing, Contraceptives, Family Planning” and 5 organizations on “Safe Motherhood, Neonatal care, Women and Child Development. Six organizations carried out “STI/HIV/AIDS” trainings. Eight organizations (57 %) ran trainings promoting ‘male involvement’ in/and reproductive health. Six organizations trained their staff in ‘skill development’ such as communication, counseling, peer education, life skills and first aid to facilitate improving delivering services. Five organizations also provided trainings ensuring effective and efficient operation of project activities such as ‘project cycle management’, ‘monitoring and evaluation’, ‘management information system’.
Table 8: Capacity Building Activities by Stakeholders
Categories of Training Stakeholders AMW/ RH Birth Spacing, Safe RTI/STI/ Male Supporting Project TBA Contraception, motherhood, HIV/AIDS Involvement Skills Management Family Neonatal Development Planning Care, Women & Child Dev. 1.AFXB x x x 2.AMDA x x x x 3.AMI x x x 4.CARE x x x x 5.JICA x 6.JOICFP x x x x 7.Malteser x 8.MdM 9.Merlin x 10.MMA x 11.MMCWA x 12.MRCS x x x 13.MSI x x x 14.PSI x x 15.SC x x x x x 16.UNFPA x x x x 17.WV 18.YWCA
9.2 Topics/Subjects in training
Government training manual was used in AMW training and TBA training. Training in ‘Reproductive Health’ consists of anatomy and physiology of female genital organs, signs of pregnancy, antenatal- , natal-, and postnatal care, birth spacing, RTIs, female cancers, 19 RH Stakeholders Analysis HIV/AIDS, male involvement. MMA emphasizes on client-oriented quality care in antenatal care, new born care, contraception, post-abortion care, RTIs and VCCT.
‘Birth spacing and Family planning’ training gave emphasis on advantages of family planning, methods of contraception, advice on the importance of seeking medical advice.
Training on ‘Safe Motherhood’ included importance of ante-natal care, birth plan, early recognition of danger signs during pregnancy, post-natal care, exclusive breast feeding, family planning, immunization, iron supplementation. ‘Women Child Health Development’ stressed on IMCI and IMPAC. ‘Main topics of ‘Newborn care’ comprised of danger signs of newborn, care of newborn, resuscitation of birth asphyxia at community level, and breast feeding.
‘Male Involvement’ training dealt with gender and sexual health, men's role in RH, prevention of STI/HIV, antenatal care, delivery care, post-natal care, prevention of abortion and post-abortion care, birth spacing and reproductive tract cancer and infertility and sexual dysfunction.
Major topics in ‘Behavioural Change Communication (BCC)’ training consisted of health and health education concepts, health education methodology, effective communication, behavioural change communication, influence of behavior, counseling, adult learning.
‘Peer educators training’ taught on RH, gender and sex, birth spacing, STI/HIV/AIDS, abortion care, life skills for youth, BCC, interpersonal communication, and counselling.
The comprehensiveness of the training topics/subjects differed from organization to organization depending upon the category of trainees. It was also noted that very little attentions was paid to reproductive tract infections in ‘RTI/STI/HIV/AIDS’ training.
9.3 Trainees
The category of trainees varied from direct service providers like AMWs, TBAs, General Practitioners, and Basic Health Service to implementers like Project staff, Red Cross Volunteers, Community Support Groups, MMMCWA members, Village Health Teams, Peer Educators, Outreached Workers and to target groups like Youth, Out of school youth, and Workers.
9.4 Trainers
Trainers of 8 organizations were own organizations’ staff only and 7 organizations acquired assistance from DOH. Two organizations had international expert/consultant.
9.5 Training Manual
Training manuals were available from 12 organizations. ‘AMW training’, ‘TBA training’, ‘Safe motherhood’, ‘Family planning’, and “Women Child Health Development’ training employed DOH manuals. For other trainings, organizations prepared their own training manuals.
9.6 Duration of training
Regarding the duration of training, there was slight variation for the similar training.
Table 9: Capacity Building/Training in Reproductive Health
Training Trainee Duration Organization AMW/TBA Training AMW training AMWs 6 months AMI AMW Refresher training AMWs 3 days JICA 20 RH Stakeholders Analysis
TBA training (Basic) TBAs 2 weeks AMI TBA training (Refresher) TBAs 5 days AMI 3 days JOICFP 2 days Malteser Reproductive Health Reproductive health Outreached workers 3 days CARE Red Cross Volunteers 6 days MRCS RH/BCC ToT Members 5 days MMCWA Basic Health Staff 3 days JOICFP Community Support Group (CSG) 2 days JOICFP RH/BCC township training Members 5 days MMCWA RH/BCC ToT Refresher Basic Health Staff 2-3 days JOICFP RH/BCC CSG Refresher Community Support Group (CSG) 1 day JOICFP RH/BCC CSG Multiplier Community Support Group (CSG) 1 day JOICFP RH, Life skills training Youth 5 days JOICFP Promotion of RH General Practitioners 2 days MMA Clinical-oriented quality care in RH General Practitioners 5 days MMA RH training Workers from Industry (2) 1 day MMA Peer Educator training on RH Red Cross Volunteers 5 days MRCS ARH training Members MMCWA Out of school youth 1-2 days SC ARH and Safe motherhood Youth 4 days JOICFP Birth Spacing, Contraceptives, Family Planning
Birth spacing & contraceptive methods 3 days PSI Birth spacing, abortion Peer Group 1 1/2 hr AFXB Training on contraceptives Village Health Teams 1 day SC Family planning Health Educators, Nurses, Peer 1 day AMI educators Family planning services and STI MSIM center-in-charge 3 days MSI management Nurse 5 days MSI Insertion of IUD BHSs 2 days UNFPA Safe Motherhood, Neonatal care, Women and Child development
Safe motherhood Staff 2 days AMDA MWs, AMWs 3 days AMDA Health Educators, Nurses 1 day AMI Staff 3 days Merlin Village Health Teams, TBAs 2 days SC IMCI and Safe motherhood CHWs, AMWs 2 days Merlin Pregnancy, Childbirth, Postnatal and BHSs 5 days UNFPA Neonatal Care (PCPNC) Women & Child Health Development – ToT Staff (Merlin, DOH) 11 day Merlin Women & Child Health Development Staff (Merlin, DOH) 6 days Merlin Community-based Health Activities Staff 5 days New born care Village Health Teams, AMWs, 2 days SC TBAs Infant feeding Health Educators, Nurses, Peer 1 day AMI educators RTI/STI/HIV/AIDS HIV/AIDS/STI Peer Group 1 hr AFXB Volunteer 3 days AMDA HIV/AIDS Outreached workers 3 days CARE Village Health Teams, Youths 1 day SC STI 1 day PSI Peer Group ½ hr AFXB Peer educators 1 day MSI PMCT Village Health Teams, AMWs, 1 day SC TBAs, BHS Male Involvement Male Involvement Peer Group 1/2 hr AFXB, Increasing male involvement ToT General Practitioners 1 day JOICFP Multiplier training Male volunteers 1 day JOICFP 21 RH Stakeholders Analysis
Anti Human Trafficking Peer Group 1 hr AFXB, Supporting Skills Development
Counselling training Red Cross Volunteers 5 days MRCS RH Counselling BHSs 5 days UNFPA ARH Counselling BHSs 5 days UNFPA Communication and counselling Community Based Contributing 3 days MSI Agents Life Skills training Out of school youth 2 days SC Peer educators, Youth volunteers 2 days MSI First Aid Volunteers 2 days AMDA First Aid & Health Education VHV/MW/AMW 2 days AMDA Basic Health Knowledge Volunteers 5 days AMDA Peer education Outreached workers, Educators 3 days CARE Peer Educators induction Peer educators 3 days MSI Communication skills MSIM staff 2 days MSI Service provider training MSIM staff 3 days MSI Project Management RH Programme Management BHSs, TMOs 5 days UNFPA RH/BCC Management TMO, Health staff 2 days JOICFP Rural Health Management VHV 5 days AMDA Project Cycle Management Community, Basic Health Staff 3 days JOICFP Red Cross Volunteers 4 days MRCS Project Sustainability and Business Planning Red Cross Volunteers 3 days MRCS RH Management Information System BHSs, Statisticians 4 days UNFPA Gender and Design, Monitoring and Outreached workers 3 days CARE Evaluation Advocacy meeting Community, MWs ½ day JOICFP Advocacy training Local authorities 1 day JOICFP
9.7 Evaluation of training
Monitoring and evaluation findings were available from 8 organizations (53%) and there was an encouraging result of high retention of trainees in active role and improved knowledge and skills and even the impact like reduced abortion among teen age, increased in VCT among pregnant women, early recognition of danger signs, early referral, early initiation of breast feeding.
22 RH Stakeholders Analysis
10. RESEARCH
10.1 Number of research studies
There were 21 research studies conducted by seven organizations (CARE, JICA, JOICFP, Merlin, MMCWA, MRCS, SC). The number of research study conducted by each organization ranged from 1 (CARE) to 6 studies (JICA, MMCWA). (Annex D)
10.2 Areas of research
The research areas comprises of KABP of Sexual and RH of young people (15 – 24 years), RH services facility assessment / Infrastructure and quality of services, Knowledge and performance of Trained personnel, Behavioural study on male involvement, KPC survey / Formative research, Safe motherhood, PMCT, Anaemia in pregnancy, AN care, and KAP study of Youth- to-Youth peer education for RH. Studies were conducted in N-Shan, Kachin, Chin, Kayin and Mon states and Bago, Yangon, Ayeyarwady, Mandalay and Yangon Divisions.
Table 10: Research studies conducted by organization in relation to reproductive health
Organization Research Topic CARE A KABP Study on sexual and reproductive health of young people (15-24 years) JICA RH Services Facility Assessment JICA Midwifery-trained Personnel’s Performance for Antenatal Care JICA Midwifery-trained Personnel’s Ability Communication with Clients JICA Midwifery-trained Personnel’s Performance Delivery Care JICA Midwifery-trained Personnel’s Knowledge Obstetric Complications JICA Midwifery-trained Personnel’s Performance Postnatal Care JOICFP Baseline data collection and behavioural study on male involvement in RH JOICFP Health infrastructure and quality of RH services Qualitative study Baseline survey Part I Merlin KPC Survey Merlin Formative research MMCWA Anaemia in pregnancy MMCWA Safe motherhood MMCWA PMCT MMCWA AN care MRCS Rapid survey for Youth-to-Youth Peer Education for RH program in selected townships MRCS End-line survey for Youth-to-Youth Peer Education for RH Program in selected townships SC Behavioural surveillance survey SC Youth behavioural survey
10.3 Key findings
Key findings of some research studies were: Needs in health infrastructure for RH, Inadequate knowledge and practice of men on RH, Critical lack of awareness of maternal, newborn and child health issues among communities. One study found that young people knew more of RH than HIV/AIDS and STIs. However, there was a gap between knowledge and safer sex practices and attempts to prevent unwanted pregnancy among sexually active youth.
Study by Merlin in Laputta, Ayeyarwady division, found strong points and weak points in knowledge and practices: - a very small proportion of mothers knew 3 or more newborn and maternal-related danger signs; only a small proportion had knowledge about birth planning/preparedness; almost half of the mothers named one or more methods of modern family planning and sources for family planning supplies; only one-third of women who are not currently pregnant and do not want another child are using modern family planning method; vast majority of children are being delivered at home and only 25% are being delivered by a trained and skilled health professional; nearly half of the mothers initiated breastfeeding immediately 23 RH Stakeholders Analysis within first hour of delivery; a negligible proportion of mothers knew about exclusive breastfeeding and less than 10% were being exclusively breastfed; only about one third of mothers attended 2 or more ANC sessions during their most recent pregnancy; just over half of the mothers took iron/folic supplements in their recent pregnancy; a negligible proportion of mothers received adequate postpartum care; untrained TBAs are the first choice for assistance at delivery, followed by trained TBAs/AMWs.
One organization highlighted that traditional values and cultural norms and religious beliefs influence many behaviour related to health which can, at times, put lives at risk.
10.4 Reports
Reports are available only for 2 studies and reports of 2 studies are in the process of printing.
24 RH Stakeholders Analysis
11. OPINIONS, PERCEPTIONS, ATTITUDES ON ORGANIZATION PERFORMANCE
Altogether 16 out of 18 organizations implementing reproductive health activities in Myanmar responded to this section. By using stakeholder analysis as the methodological tool, it could be able to reveal the behavior, intentions, and interests at organizational level. By doing so, understanding towards participating organizations could be improved. Findings were collated as follows. (Annex E)
11.1 Interests, plan and scope of the organization in reproductive health
Most of the organizations showed their interest in reproductive health in Myanmar. Over half expressed that their organizations gave priority to reproductive health in a strong manner (56.3%). Moreover, baseline studies prior to project implementation were given high priority (66.7%). For capacity building, development of training curriculum is important. Over 70% of participating organization in this study revealed their great interest in training curriculum. The organizations’ interest in health promotion and improved quality and access to services were high (60%). Moreover, majority of the organizations were of great interest in partnership and net-working (53.3%), capacity building (73.3%) and sustainability (80%) of reproductive health activities in the country. Although the goal stated for reproductive health was perceived as strong (87.6%, moderate to high degree), some organizations (56.3%) thought that their target setting was not highly achievable (in a moderate degree) and their present scope was not so broad (40%). Generally speaking, organizations engaged were highly motivated and favorable for future reproductive health programs.
11.2 Organization efforts 11.2.1 Implementation of reproductive health activities
Nearly 50% of participating organizations felt that they were able to build a rapport with public services in reproductive health sector strongly. Although their opinions were high for building a rapport with other NGOs (42.9%), they felt that their links with faith-based organizations were only in a moderate degree (53.3%). Half of the organizations were greatly satisfied on open discussions made with donor agencies for planning RH activities. Moreover, they perceived advocacies to community members as highly adequate (40%) and other stakeholders as moderate (35.7%). Results indicated the necessity to enhance more networking and advocacies especially with faith-based organizations and also required to build a closer relationship with public services and other NGOs with common goals.
Even though the responding organizations provided their opinion on budgetary allocation varied from moderate to high (53.4%), capacity building of own staff and target audience and dissemination of reproductive health information/feed-back to other partners in Myanmar was felt as moderately adequate (73.3%, 53.3% and 56.3% respectively). Although the capacity building activities for own staff was adequate, further attempts should be focused on capacity building of target groups and strategies for information dissemination through existing networks.
25 RH Stakeholders Analysis
11.2.2 Management decision-making, monitoring and supervision of reproductive health activities
Compared to top-down decisions, bottom-up decisions were felt as more adequate for management of RH activities in their organizations (20% vs. 40% respectively). Decentralization in management decision-making of participating organizations was satisfactorily practiced. Most of the participating organizations felt that they have a good built-in monitoring system for reproductive health activities. But majority expressed that supervisions in implementation were less adequate.
11.3 Organization power, gaps and constraints in reproductive health activities One third of participating organizations (33.3%) provided an opinion that their influence on other partners in carrying out RH activities was moderate. Some 46.2% thought that their position in the past was moderately supportive of RH policy and plans in Myanmar also true at present (57%). But for future, 57% anticipated that they might be able to support RH policies and plans in Myanmar in high degree. This finding was in consistency with their strong opinions towards sustainability issues (80%) already stated in section 5.1.
Most of the organizations expressed their opinion on gaps between capacity of their staff and performances in RH as slight and gaps between targets and actual implementation were slight (80% vs. 60%). Those gaps were perceived as either due to problems in funds (moderate to high, 53.4%), problems in commodities (moderate to high, 56.2%) or other problems.
11.4 Expectations and suggestions by organizations
Twelve out of 16 organizations expressed their personal expectations and provided open suggestions to enhance reproductive health activities in Myanmar.
Priorities for future expansion were focused mostly upon adolescent reproductive health issues (ARH). The establishment of youth friendly clinics/centers, youth information centers was their major concern aiming to integrate with existing ARH services. Reflective learning approach intermingled with behavioral change communication (BCC) and community capacity building was to be practiced by one international NGO in their selected project areas for ARH. Further, youth friendly services will be promoted for improving sexual and reproductive health in terms of accessibility as well as quality.
For curative aspect, quality of care in their organization-linked clinics will be further improved. Moreover, there will be arrangements at such quality clinics to assemble diagnosis of HIV/AIDS and other sexually transmitted infections and appropriate treatment. Treatment of opportunistic infections and ante-retroviral therapy for HIV/AIDS will be practiced in forthcoming years by one organization. Besides, one local NGO will conduct training for capacity building of general practitioners as their priority. Voluntary confidential counseling and testing services to ensure
26 RH Stakeholders Analysis prevention of spread of HIV/AIDS and syndromic management services for STIs will also be expanded.
One organization revealed the plan to develop comprehensive sexual and reproductive health counseling and for integration of HIV/STIs and family planning services.
As for MCH services, one international NGO showed interest in: basic to comprehensive emergency obstetric care. Another INGO focused advanced antenatal care and post natal care, and advanced nutrition support to pregnant and lactating women and children under five years of age. Apart from that one INGO linked with one United Nations Agency to conduct community oriented ‘Healthy Mother Project’ and aimed at provision of quality reproductive health services.
One international NGO in collaboration with the United Nations Agency planned to strengthen community support groups, behavioral change communication, development and distribution of IEC materials and capacity building of basic health staff, community leaders and volunteers in RH activities.
Being targeted to special regions (WA region), one international NGO would like to provide training for auxiliary midwives (AMW) in remote areas and capacity building of local authorities. Monitoring and support were planned for women in Rakkhine State. Moreover, in Dala, medico social unit for those who were in reproductive age group was planned to establish and also planned to strengthen public health facilities at the same project area.
One international NGO put emphasis to plan increased supplies of contraceptive commodities (condoms, injectables, oral contraceptive pills etc.), train males to increase their involvement in reproductive health and improved capacity in negotiation and decision-making skills.
Major suggestions to improve resource mobilization were focused upon human resources such as RH volunteers, mobilization of funds for RH by respective donors, mobilization of other partners interested in RH issues, material support such as teaching materials, contraceptive commodities etc.
For cultural fitness the requirement to develop IEC materials in line with local culture was pointed out so as to improve acceptability, sense of ownership and process of behavior change.
For achievement of sustainable impact upon target audience, one national NGO would like to attract policy-makers and other partners through further advocacies. Creation of enabling environment and necessity of long term funding were also pointed out.
27 RH Stakeholders Analysis
12. Conclusions
This report presents the analysis of RH stakeholders currently working in Myanmar – Who is doing What, Where, for Whom and with Whom. There are 20 stakeholders with exclusive RH programmes compare to 18 in 20038. Moreover, this report includes organizations with exclusive reproductive health programmes only. The RH interventions are analysed according to the ‘Minimum essential package of reproductive health interventions’ according to the life cycle approach so that it is in consistent with the Myanmar five-year strategic plan for reproductive health and will ensure supporting its successful implementation.
Many organizations are concentrated in Yangon, Mandalay and Ayeyarwady divisions and Northern Shan and Mon states. Most of the organization (77.8%) provides sexual and reproductive health information and only one organization works on postmenopausal reproductive health. However, it is encouraging to note that two-thirds of the organizations are promoting the men’s role in/and reproductive health. The number of organizations implementing sub-component activities of minimum intervention also varies widely. The reasons for this disparity need to be explored. Cross review between the reproductive health indicators and the stakeholder analysis will help in highlighting the priority area for implementation.
Detail information of the reproductive health interventions implementing by each organization in terms of geographical coverage – state/division and township, and sub-component activities of each reproductive health interventions in addition to training and research conducted by organizations are annexed so that it will serve as a quick reference for both implementers and funding agencies. Moreover, it will facilitate cooperation and coordination among players and consequently leading to maximizing the impact. Opinions, perceptions and attitudes on organization performance can throw some light in future planning.
28 RH Stakeholders Analysis
References
1. Ministry of Health, Health in Myanmar, 2006. 2. Population Council, Reproductive Health Stakeholder Analysis - Myanmar. 2001, Unpublished Report submitted to WHO: Yangon 3. UN Technical Working Group on Health, Myanmar. Health Stakeholder Report Myanmar. 2003 4. INGO, 2004. Directory of International Non-Governmental Organizations & Red Cross Movement Organizations Working in Myanmar. 5. INGO, 2005. Directory of International Non-Governmental Organizations & Red Cross Movement Organizations Working in Myanmar. 6. Department of Health, Five-Year Strategic Plan for Reproductive Health in Myanmar, 2004-2008. 7. Varvasovszky, Z. and Brugha, R. 2000. How to do (or not to do).. A stakeholder analysis. Health Policy and Planning; 15(3): 338-345. 8. UN TWG on Health, Health Stakeholder Report, Myanmar. 2003 9. WHO-SEARO, Detailed Workplans 2006-2007, Myanmar. 2005
29 Annex A
PROFILE OF ORGANIZATIONS
1. Association of Francois-Xavier-Bagnoud (AFXB) 2. Association of Medical Doctors of Asia (AMDA) 3. Aide Medicale International (AMI) 4. CARE International in Myanmar (CARE) 5. Department of Health (DOH) 6. Japan International Cooperation Agency (JICA) 7. Japanese Organization for International Cooperation in Family Planning (JOICFP) 8. Malteser International (Malteser) 9. Medicins du Monde (MdM) 10. Merlin 11. Myanmar Health Assistant Association (MHAA) 12. Myanmar Medical Association (MMA) 13. Myanmar Maternal and Child Welfare Association (MMCWA) 14. Myanmar Red Cross Society (MRCS) 15. Marie Stopes International (MSI) 16. Partners Myanmar 17. Population Services International (PSI) 18. Save the Children (SC) 19. United Nations Population Fund (UNFPA) 20. World Vision Myanmar (WV) 21. World Health Organization (WHO) 22. National Young Women Christian Association (YWCA)
Name of Organization: Association of Francois-Xavier-Bagnoud (AFXB)
General Background Year began in Myanmar: 1993
Mission: To fight poverty and AIDS and support the world’s orphans and vulnerable children left in the wake of the AIDS pandemic by advocating for their needs and by providing direct support to families and communities that care for them
Year began RH: 1993
Areas of expertise in RH: . HIV/AIDS . Anti-human trafficking linked to HIV/AIDS . Birth spacing . Male role in RH . Peer approach in RH . Youth & PLHA network
Number of staff in RH: 14
Activities: Adolescent reproductive health; STI/RTI/HIV/AIDS; Men’s role in/and reproductive health
Locations: Yangon Division (North Okkalapa; South Okkalapa; Dagon; Thaketa; Thingangyun; Mingaladon; Hlaingthaya; Shwepyitha; Kamayut; Tamwe; Mayangone; Hlaing; Kuauktan; Thanlyn; Hmawbi); Mon State (Mawlamyine; Kyaikhto; Kyaikmaraw; Paung)
Target Groups: Trainees from vocational centre; PLHAS; Youth from work place; Workers from transportation sector; uniform personnel
Capacity Building: . Birth spacing . Abortion . STIs . HIV/AIDS . Male involvement . Anti-human trafficking
Research: NA
Implementing partners: NAP
Future plan: Would like to expand: . Provision of injectables and oral contraceptives . Condom distribution . Training on male involvement . Training on negotiation and decision making skills
Name of Organization: Association of Medical Doctors of Asia (AMDA)
General Background Year began in Myanmar: 1995
Mission: A global network of partnership for peace through projects with ‘sogo-fujo’ (or mutual assistance) spirit under local initiatives.
Year began in RH: 1995 (as part of primary health care and maternal and child health projects)
Areas of expertise in RH: Maternal and child health; Birth spacing; Ante and post-natal care; maternal and child nutrition; health education; awareness raising of STIs; Supplementary vitamins support; Condom promotion
Number of staff in RH: 15
Activities: ARH; BS & Contraceptives; STI/RTI/HIV/AIDS; Prenatal Care; Neonatal Care; Post-natal Care; Men’s RH
Locations: Shan - N (Laokai); Mandalay (Meiktila, Nyaung U); Magwe (Pakoku)
Target Groups & Number: Female villagers; Village health volunteers; mothers; Reproductive female; Villagers; Pregnant women
Capacity Building: . STI/HIV/AIDS . Safe motherhood . First aid
Research: NA
Implementing partners: Department of Health; NATALA; PSI; UNFPA; UNDP; UNAIDS; WFP; JICA
Future plan: All of the components above will be implemented in the dry zone as well as in Kokang areas, especially under the primary health care and maternal and child health care settings.
Name of Organization: Aide Medicale International (AMI)
General Background Year began in Myanmar: July 2002 Mission: 1. To get closer to the most helpless without any discrimination 2. To go where others do not 3. To teach them how to live without us
Year began in RH: March 2005 in Wa special region 2 January 2006 in Dala township
Areas of expertise in RH: . Prenatal care (care of pregnant mother, TT immunization, provision of iron and folate supplements) . Delivery care (clean delivery practices, referral of at-risk pregnancy, support health infrastructure) . Birth spacing and contraceptives (oral and injectable contraceptives and condoms) . Postnatal care
Number of staff in RH: 20 including 3 expatriates
Activities: ARH; BS & Contraceptives; STI/RTI/HIV/AIDS; Prenatal care; Delivery care; Neonatal care; Post-natal care; Men’s reproductive health
Locations: Shan-N (Mong Pawk, Wein Kao, Mong Maw); Rakhine (Buthidaung); Yangon (Dala, Twante, Seikkyi)
Target Groups : Adolescents; Women in reproductive age; General population; MSM; High risk men; SW; Patients; Pregnant women; Neonates; Child bearing women; Under 1 children
Capacity Building: . Safe motherhood . Family planning . Infant feeding . AMW training . TBA training
Research: NA
Implementing partners: UNFPA, UNHCR, UNICEF, UNAIDS, DOH, EC, FHAM, ECHO
Future plan: In Dala: - support of public health facilities (Township hospital, RHC, UHC, MCH ward) for the provision of RH in terms of medical supplies (essential drugs, equipment), logistics (rehabilitation of buildings) and organization of trainings for nurses, midwives, AMW and doctors - youth friendly corner
In Northern Rakhine state: - to organize the training of AMW with DOH - Rakhine state in order to replace TBA
Name of Organization: CARE International in Myanmar (CARE)
General Background Year began in Myanmar: June 1996
Mission: To serve individuals and families in the poorest communities in the world. Drawing strength from our global diversity, resources and experience, we promote innovative solutions and are advocates for global responsibility. We facilitate lasting change by: . strengthening capacity for self-help . providing economic opportunity . delivering relief in emergencies . influencing policy decisions at all levels . addressing discrimination in all forms
Year began in RH: 2002
Areas of expertise in RH: . Behavioural change intervention with reflective learning approach to youth . Capacity building to service providers for youth friendly services for SRH . Enhancing social and policy environment that enables the target communities to support youth to improve SRH in sustainable manner
Number of staff in RH: 31 including 24 outreach workers
Activities: Adolescent reproductive health; STI/RTI/HIV/AIDS; Men's role in RH
Locations: Mandalay (Aung Myay Tha Zan, N|Maha Aung Myay) Shan-N (Muse)
Target Groups: 15-24 years both male and female
Capacity Building: . Reproductive health . HIV/AIDS . Gender and Design, Monitoring and Evaluation . Peer education
Research: . A KABPP Study on Sexual and Reproductive Health of Young People
Implementing Partners: DOH (NAP, RH, PHC), PSI, MSI, UNFPA, MNA
Future plan: scaling up the existing programme
Name of Organization: Department of Health (DOH)
General Background Year began in Myanmar :1948
Goal: To attain a better quality of life by improving reproductive status of women and men, including adolescents through effective and appropriate reproductive health programmes undertaken in a life-cycle approach
General objectives: • To provide appropriate information about reproductive health and the prevention of common reproductive health problems • To ensure that quality integrated reproductive health services are provided in an appropriate, accessible, and affordable manner • To promote utilization of reproductive health services through promotion of a client-centred approach to service provision
Year began Reproductive Health :1996
Strategic Approach • Improving health workers’ skills • Improving the health system • Improving family and community practices • Improving the enabling environment • Improving the evidence base for decision making
A. Safe motherhood: In Myanmar, intense efforts have been put to improve maternal, newborn and child health services through various activities, with particular emphasis on essential obstetrics care.
B. Adolescent Reproductive Health: The Ministry is engaged in small-scale peer education and information provision activities and is strengthening the reproductive health component of the school health programme.
C. Birth Spacing and Post Abortion Care: Oral and injectable contraceptives, condoms, and IUDs have been available and are now provided in 112 project townships. Pre- and in- service training on birth spacing and contraceptives provision, distribution of commodities and information materials are provided. Since abortion and its complications have taken a large share of maternal morbidity and mortality, management of post abortion care has been operationalised with heightened interest on preventive aspect nation wide.
D. STI/RTI/HIV/AIDS: Basic health staffs in all townships provide services for the management of RTIs and STIs. Diagnosis and treatment of STIs is also provided through 40 AIDS/STD Teams. The NAP also provides VCCT and PMTCT services, 100% condom use.
E. Antenatal care, delivery care, postnatal care and post-abortion care: Virtually all antenatal care, many deliveries, and post-natal care are provided at all level of health care delivery system. Most of the treatment of obstetric and abortion-related complications is provided at all hospitals.
F. Gynaecological cancer: Obstetric and gynaecological care is provided at all levels. Menopausal clinics and cervical cancer screening services are providing in selected urban tertiary hospitals. G. Subfertility: Counselling and basic treatment is available at township hospitals and more comprehensive services are available at some tertiary-level hospitals.
H. Men’s Role in/and RH: Paternal responsibility and involvement is highlighted in training manuals for basic health staff and health volunteers. Gender advocacy has been conducted in states and divisions.
The collaboration between RH programmes and other related key public health programmes such as immunization, nutrition, malaria has been strengthened.
Name of Organization: Japan International Cooperation Agency (JICA)
General Background Year began in Myanmar: 1981
Mission: We, as a bridge between the people of Japan and developing countries, will advance international cooperation through the sharing of knowledge and experience and will work to build a more peaceful and prosperous world.
Year began in RH: 1998
Areas of expertise in RH: . Midwifery education & training . Advocacy . Essential medical equipment supply . Community mobilization
Number of staff in RH: 5
Activities: Prenatal care; Delivery care; Neonatal care; Postnatal care
Locations: Shan state (North) – Kyaukme, Naungcho
Target Groups: AMW
Capacity Building: AMW refresher training
Research: . RH Services Facility Assessment (2005) . Midwifery-trained Personnel’s Performance for Antenatal Care (2005) . Midwifery-trained Personnel’s Ability Communication with Clients (2005) . Midwifery-trained Personnel’s Performance Delivery Care (2005) . Midwifery-trained Personnel’s Performance Postnatal Care (2005)
Implementing partners: DOH
Future plan: Implementation of current technical cooperation project in reproductive health, namely “Community-Oriented Reproductive Health Project 2005-2010” entrusted to JOICFP
Name of Organization: Japanese Organization for International Cooperation in Family Planning (JOICFP)
General Background Year began in Myanmar: 2000
Mission: To enable individuals to make their own choices regarding reproductive health and rights while ensuring access to quality services and appropriate information
Year began in RH: 2000
Areas of expertise in RH: . Behaviour Change Communication . Safe Motherhood . Birth spacing . Adolescent Sexual and Reproductive Health . Male Involvement for RH
Number of staff in RH: 12 local + 10 international (long-term and short-term)
Activities: Adolescent reproductive health; Prenatal care; Delivery care; Neonatal care; Postnatal care; Men's role in/and RH
Locations: Yangon (Kungyangone; Thongwa; Dala); Bago (Daik-U; Oktwin; Gyobingauk; Pyay); Ayeyarwady (Zalun; Yekyi; Nyaungdon; Myanaung; Hinthada); Mandalay (Singaing; Myittha; Nahtogyi; Wundwin); Magwe (Aunglan; Taungdwingyi; Yenangyaung; Chauk); Sagaing (Myaung, Monywe); Shan (Lashio, Pindaya); Rakhine (Ponnagyun); Tanintharyi (Dawei); Mon (Kyaikhto)
Target Groups: Youth; Women of reproductive age
Capacity Building: . Project Cycle management . AMW refresher training . Youth training – BCC, Life Skills . Community Support Group training . RH/BCC Management training . Training for increasing male involvement in RH
Research: . Baseline Data Collection and Behavioural Study on Male Involvement in RH (2005) . Health Infrastructure and Quality of RH Services Qualitative Study Baseline Survey Part I (2005)
Implementing partners: DOH (MCH section, CHEB); MMA; UNFPA; JICA
Future plan: Executed project funded by UNFPA . Information, Education for Behavioural Change (2002 Sep- 2006 Dec) . Increasing male involvement for RH through effective BCC strategies (2004-2007) and expected to continue (2007-2010) . DOH/JICA/JOICFP Community Oriented Reproductive Health Project (2005 Feb-2010 Jan)
Name of Organization: Malteser International
General Background Year began in Myanmar: 2001
Mission: . Provide relief to major emergencies in the world, especially in the health sector . Implement rehabilitation measures and link relief, rehabilitation and development (LRRD) . Establish and promote primary health care delivery . Reduce the vulnerability and poverty of those afflicted . Care for refugees and returnees . Support and coordinate with local partner NGOs
Year began in RH: 2004
Areas of expertise in RH: Antenatal Care, Intrapartum and Postpartum Care; RH education and awareness including HIV/AIDS, VCCT, STI prevention, detection and treatment; family planning
Number of staff in RH: 60
Activities: ARH; BS & Contraception; STI/RTI/HIV/AIDS; Prenatal care; Delivery care; Neonatal care; Postnatal care; Post-abortion care; Men's RH
Locations: Shan-N (Pang Kham, Mong Pawk, Mong Maw); Rakhine (Maungdaw)
Target Groups: Youth; Risk groups; Women; Men; Peer educators; Health care facilities; Prisons; Military; Police; Karaoke bars; Drop-in centers; PLWHA; Truck drivers; Bar/Hotel owners
Capacity Building: Refresher training for TBAs
Research: NA
Implementing partners: UNHCR, PSI
Future plan: Will expand the following RH services: . birth spacing, . advanced level ANC and PNC, . advanced nutrition support to pregnant and lactating mothers and children under 3
Name of Organization: Medicins du Monde (MdM)
General Background Year began in Myanmar: 1994
Mission: To provide access to health care to vulnerable populations
Year began in RH: 2002
Areas of expertise in RH: STI and HIV and AIDS couselling, health education and medical care
Number of staff in RH:
Activities: Birth spacing and contraceptives; STI/RTI/HIV/AIDS
Locations: Yangon (Mayangone, Insein, N.Okkalapa, S.Okkalapa, Tamwe, Latha, N.Dagon, S.Dagon); Kachin (Myitkyina, Moegaung, Hopin)
Target Groups: SW; Drug users
Capacity Building: NA
Research: NA
Implementing Partners:
Future plan: same
Name of Organization: Merlin
General Background Year began in Myanmar: 2005
Mission: Merlin is the only specialist UK agency which responds worldwide with vital health care and medical relief for vulnerable people caught up in natural disasters, conflicts, disease and health system collapse.
Year began in RH:
Areas of expertise in RH: Integrated Management of Maternal and Child Illness (IMMCI)
Number of staff in RH: 82
Activities: Adolescent reproductive health; Birth spacing and contraceptives; STI/RTI/HIV/AIDS; Prenatal care; Delivery care; Neonatal care; Postnatal care; Men's role in/and reproductive health
Locations: Ayeyarwady Division (Laputta)
Target Groups: Men & women of reproductive age
Capacity Building: . Community-based Health Activities (local staff, DOH staff) . Women Child Health Development (local staff, DOH staff) . Safe Motherhood/Birth Preparedness (local staff) . CHW Basic and Refresher training (CHW)
Research: . Knowledge, Practice, Coverage Survey . Formative Research
Implementing partners: DOH, UNICEF
Future plan: same activities till June 2008 Will expand in: . Basic Emergency Obstetric Care (BEOC) . Comprehensive Emergency Obstetric Care
Name of Organization: Myanmar Health assistant association (MHAA)
General Background Year began in Myanmar: 1994
Mission: To help the public health problems to the Myanmar Community and prevention and control of contagious disease activities
Year began in RH: Not yet
Areas of expertise in RH:
Number of staff in RH:
Activities: . Condom promotion . VCCT for HIV
Locations: . Tanintharyi Division (Myeik, Kawthaung); Yangon (Thanlyn, Kyauktan); Mon (Thanbyuzayat)
Target groups: . Seafarers
Capacity building:
Research:
Implementing partners: NAP
Future plan:
Name of Organization: Myanmar Medical Association (MMA)
General Background Year began in Myanmar: 1949
Mission: . Promote and advance the Science of Medicine . To promote continuing medical education and medical research among the medical professions . To support the provision of health along with the National Health Care Program . To promote cooperation and foster a fraternal spirit among its members . To safeguard the honour and dignity of the medical profession . To maintain a high ethical standard among the medical profession . To promote international fraternization of the medical profession
Year began in RH: 1999
Areas of expertise in RH: . Client-oriented quality of care . Client-oriented communication and counseling . Contraception . Post abortion care . Antenatal care . New born care . Postnatal care . Reproductive tract infection . VCCT - STI and HIV/AIDS
Number of staff in RH: 20
Activities: STI/RTI/HIV/AIDS; Prenatal care; Men's role in/and reproductive health
Locations: 8 S/D 45 townships – Yangon (9); Bago (9); Sagaing (5); Ayeyarwady (4); Mandalay (7); Shan-N (1); Magwe (7); Mon (3)
Target Groups: Pregnant mothers; All
Capacity Building: . Workshop on role of GPs in promotion of RH . Training of GPs on RH . Training of workers from Ministry of Industry (2)
Research: NA
Implementing Partners: UNFPA, WHO, Ministry of Industry (2)
Future plan: . To improve knowledge and skills of general practitioners from all over the country on contraception, STI management, HIV prevention, ARH and identification of high-risk obstetric cases . To improve knowledge of communities on AN care, PN care, contraception and prevention of STI and HIV/AIDS
Name of Organization: Myanmar Maternal and Child Welfare Association (MMCWA)
General Background Year began in Myanmar: 1991
Mission: The MMCWA is a voluntary organization dedicated to serving the Myanmar Society in promoting the health and wellbeing of mother and children with the aim to improve the quality of life of people.
Year began in RH: 1991
Areas of expertise in RH: . Antenatal care, Natal care, Post natal care . New born care and early childhood care . Pubertal care . Menopausal care and Postmenopausal care . Prevention and care for unsafe abortion and unwanted pregnancy . Male involvement
Number of staff in RH: 26 at central level; 50 persons each in all 106 project townships; 20 persons each in non-project township
Activities: Adolescent reproductive health, Birth spacing and contraceptives, STI/RTI/HIV/AIDS, Prenatal care, Delivery care, Neonatal care, Postnatal care, Post-abortion care, Gynaecological cancer, Postmenopausal reproductive health, Men's reproductive health
Locations: All States and Divisions
Target Groups: Young people, Married women and men, Pregnant women, New born, Post-abortion case, Women of reproductive age
Capacity Building: . Central Training on RH, BCC, TOT . Township trainings . ARH training
Research: . Anaemia in pregnancy . Safe motherhood . PMCT . AN care
Implementing Partners: MWAF, MMA, MROS, MNA, MHA, JOICFP, WHO, UNFPA, UNAIDS, UNICEF
Future plan: Will expand on safe motherhood, new born care and male involvement
Name of Organization: Myanmar Red Cross Society (MRCS)
General Background Year began in Myanmar: 1920 (under India Red Cross) 1937 (Burma Red Cross)
Mission: Through its nation wide network of volunteers, MRCSD will work to promote a healthier and safer environment for the people of Myanmar giving priority to the most vulnerable communities and individuals. In time of distress and disaster, the MRCS will assist those affected and help them return to normal life.
Year began RH: October 2000
Areas of expertise in RH: . Peer education . Peer counseling . Outreach activities for high risk youth . Prevention of sexual reproductive health problems . Promoting sexual reproductive health problems
Number of staff in RH: 48
Activities: Adolescent reproductive health; STI/RTI/HIV/AIDS; Post- abortion care
Locations: Yangon Division (North Okkalapa; Shwepyitha); Bago Division (Daik-U, Phyu); Ayeyarwady Division (Maubin)
Target Groups: Adolescent; Youth (15-24 & out-of school)
Capacity Building: . Training of Trainers . Youth Peer Educators Training & Refresher Training . Peer Counselling Training . Project Cycle Management training . Project Sustainability Business Planning
Research: . Rapid Survey for Youth to Youth: Peer Education for RH Programme . End-line Survey for Youth to Youth: Peer Education for RH Programme
Implementing partners: MMA, DOH (MCH, BS section)
Future plan: . To promote the SRH for adolescent and youth . To sustain the SRH activities in project townships . To involve the skillful Red Cross volunteers for SRH activities . Will expand RH activities in new 6 townships . Youth friendly center for RH activities
Name of Organization: Marie Stopes International Myanmar (MSI)
General Background Year began in Myanmar: 1998
Mission: Right Choices Save Women. Providing Choices in Reproductive Health Care.
Year began in RH: 1998
Areas of expertise in RH: . Provision of full range of contraceptive services . Antenatal care . Treatment of Sexually Transmitted Infections . Reproductive Health Counselling . Gynaecological examination . Provision of sexual and reproductive health information and services to young people . Youth centers . Provision of HIV VCCT services . IEC activities about RH, various contraceptives available, promotion of safer sex behaviour
Number of staff in RH: 380 (319 not full time staff)
Activities: ARH; Birth spacing & contraceptives; STI/RTI/HIV/AIDS; Prenatal care
Locations: Mon (Mawlamyine, Thaton); Ayeyarwady (Pathein); Bago (Pyay); Mandalay (Pyigyitagun, AMTZ, CATZ, CNTZ, MHAM, Myingyan);Yangon (Thaketa, Thingangyun)
Target Groups: Women of Reproductive age; Children
Capacity Building: . Youth Peer Educators Induction Training . Communication Skills Training . Service Providers Training . Life Skills Training . STI Training . Training on Family Planning Services and STI Management . Training on Communication and Counselling
Research: NA
Implementing partners: UNFPA
Future plan: Scaling up Would like to expand the following: . Integration oh HIV/STI and family planning . Comprehensive SRH counseling . Treatment of Opportunistics Infections and Antiretrovial Therapy
Name of Organization: Partners Myanmar (Partners)
General Background Year began in Myanmar: 1998
Mission: PARTNERS is an international solidarity organization created in France in 1991. PARTNERS works with qualified volunteers who conduct development projects in poor areas which get little assistance from large international organizations. They work in close conjunction with the local population, whose involvement in designing and implementing the programmes is of paramount importance. Particular emphasis is placed on health, education and training, especially for the benefit of women and children. In Myanmar, PARTNERS has developed projects in water and sanitation, health education, HIV/AIDS prevention and child protection.
Year began in RH: 2004
Areas of expertise in RH: . Condom promotion . HIV/AIDS prevention . Capacity building
Number of staff in RH: 14
Activities: STI/RTI/HIV/AIDS
Locations: Yangon (Shwepyithar)
Target Groups: Women of Reproductive age; Children
Capacity Building: . HIV/AIDS prevention
Research: NA
Implementing partners: MRCS, MBCA, Karuna, Cholia Muslim Trust, Thingaha, MMA, PSI, BI, CBI, AZG, MdM, UNAIDS, UNDP, UNFPA, UNOPS, UNICEF
Future plan: FHAM project is to be completed by the end of November 2006. After this project, no other RH activities have been foreseen yet.
Name of Organization: Population Services International (PSI)
General Background
Year began in Myanmar: 1994
Mission: To empower low income and vulnerable people of Myanmar to lead healthier lives. We do this through social marketing – working with the private sector to promote healthy behaviour and ensure access to quality health products and services
Year began in RH: 2001
Areas of expertise in RH: . Development of training materials on RH, STI . Distribution of IEC materials on RH, STI . Provision of skill building training on RH and STI to private practitioners . Provision of IUD insertion skills to private practitioners . Monitoring of Sun Quality Health Network franchisees in provision of quality birth spacing products . Mystery client surveys on RH, STI services provision and sustainability of quality of care for RH, STI patients
Number of staff in RH: 24
Activities: Adolescent reproductive health; Birth spacing and contraceptives;
Locations: Yangon (32 tsp.); Mandalay (17 tsp.); Ayeyarwaddy (8 tsp.); Sagaing (10 tsp.); Bago (20 tsp.); Magwe (9 tsp.); Mon (8 tsp.); Kayin (2 tsp.); Shan-N (6 tsp.); Shan-S (4 tsp.)
Target Groups: Health care service providers; Women of reproductive age
Capacity Building: Skill building training on RH STI training
Research:
Implementing partners: Private practitioners
Future plan: . Expansion of Sun Quality Health Clinics up to a number of 1000 in 2008 . Provision of 1 million consultation on RH by 2008 . Strengthening of RH activities by improving quality of care and integration of adolescent reproductive health services, services for Voluntary Counselling and Testing for HIV into network . Branding of 10 Sun clinics as Youth Friendly Clinics by the end of December 2006
Name of Organization: Save the Children (SC)
General Background Year began in Myanmar: 1995
Mission: Save the Children fight for children's rights. It delivers immediate and lasting improvements to children's lives worldwide.
Year began in RH: 1999
Areas of expertise in RH: . Community mobilization and empowerment . Life skills training . Working in partnership with civil society groups . Partner Defined Quality
Number of staff in RH: 97
Activities: Adolescent reproductive health; Birth spacing & contraceptives; STI/RTI/HIV/AIDS; Prenatal care; Neonatal care; Men's role in/and RH
Locations: Tanintharyi (Launglone); Magway (Pakokku); Kayin (Phaan, Hlaingbwe, Kawkareik); Mon (Mawlamyine, Thaton, Kyaikmaraw, Paung, Mudon, Chaungzone); Shan-N (Theinni, Namkham, Namphatka, Muse)
Target Groups: Adolescent (15-24); Youth (15-24); Out-of school youth; Reproductive age group; Eligible couples; Pregnant mothers and their husbands; Birth attendants
Capacity Building: . Safe motherhood training . Prevention of HIV/AIDS . Training on contraceptives . PMCT . Newborn care . Life skill training . Life skill workshop on ARH
Research: . Behavioural Surveillance Survey (2002) . Youth Behaviour Survey (2004)
Implementing partners: CBO, MNA, Literacy and Cultural Association, MSI
Future plan: Plan to scale up community based RH and Adolescent Reproductive Health Programs
Name of Organization: United Nations Population Fund (UNFPA)
General Background Year began in Myanmar: 1973
Mission: Meeting the RH needs and improving the quality of life of the people of Myanmar through increased utilization of integrated, quality and gender-sensitive RH services by women, men and young people, as well as achieving behavioural changes towards healthy reproductive and sexual practices through appropriate reproductive health and HIV/AIDS information and counselling
Year began in RH: 1996
Areas of expertise in RH: . Antenatal care . Delivery care . Postnatal care . Birth spacing . ARH . SII/HIV/AIDS
Number of staff in RH: 10 (UNFPA) and 9 (DOH)
Activities: ARH; Birth spacing & contraceptives; STI/RTI/HIV/AIDS; Prenatal care; Delivery care; Postnatal care; Post-abortion care; Men’s RH
Locations: 14 states/divisions (112 townships) -Yangon (14); Bago (21); Ayeyarwady (14); Mandalay (12); Magwe (13); Sagaing (11); Shan-N (5); Shan-S (3); Shan-E (1); Rakhine (5); Tanintharyi (4); Mon (5); Kachin (2); Chin (2)
Target Groups: 15-24 years old; Women of Reproductive age; SW and clients; Pregnant mothers; Postnatal mothers; Men of reproductive age
Capacity Building: . Training on pregnancy, childbirth, postnatal and neonatal care . Training on insertion of IUD . Training on RH counseling . Training on ARH counseling . Training on RH Programme Management . Training on RH MIS . Training of statisticians on RH MIS
Research: NA
Implementing partners: DOH, MMCWA, MMA, MRCS, MANA, MSI, PSI, CARE, AMI, Malteser, WHO, UNAIDS, WFP, UNODC, UNHCR
Future plan: Scaling up to cover the whole country (2007 – 2010)
Name of Organization: World Vision Myanmar (WV)
General Background Year began in Myanmar: 1993
Mission: World Vision is a Christian organization and as an instrument of God, we will work with the poor and the marginalized to facilitate transformational development that will bring about abundant life through Jesus Christ
Year began in RH: 1993
Areas of expertise in RH: To increase access to AN, Delivery and PN care
Number of staff in RH: 32
Activities: Adolescent reproductive health; RTI/STI/HIV/AIDS; Prenatal care; Neonatal care; Postnatal care; Men’s RH
Locations: Yangon (Hlaingtharyar, S.Dagon, Hmawbi); Mandalay (Chanmyatharzi, Pyigyitagun, Amarapura); Ayeyarwady (Thabaung, Pathein); Shan-E (Kyaungton, Tachileik); Tanintharyi (Dawei, Myeik, Kawthaung)
Target Groups: Youth, Women, Risk group, Mothers
Capacity Building: NA
Research: NA
Implementing partners: DOH
Future plan: Strengthening of mother’s group for sharing and caring each other with RH issues
Name of Organization :World Health Organization (WHO)
General Background
Year Began in Myanmar: 1950
Mission: The attainment of the highest level of health by the people of Myanmar
• Providing technical support to the Ministry of Health in implementation of Myanmar five-year strategic plan for reproductive health: - Providing skilled care during pregnancy, delivery, new born, postnatal; - Providing sexual and reproductive health information, education and services for young people; - Providing of birth spacing and contraceptive services, and reproductive tract infections/sexually transmitted infections and services; - Providing post abortion care; - Providing menopausal care and screening and treatment of cervical and breast cancer; - Promoting men’s role in support of reproductive health; - Promotion of community awareness on the knowledge about: pregnancy, childbirth and newborn care, danger sign, role of family and community in birth preparation and referral, transportation in case of emergency.
• Supporting the Ministry of Health on implementation of gender and women’s health programme
• Providing support for reproductive health in Myanmar and strengthening linkages between WHO Myanmar and reproductive health partners.
• Strengthened monitoring and evaluation
Year Began in RH: 1950s
Area of Work (Ref: Detailed Wokplans 2006-2007):
1. Child and adolescent health 1.1 Interventions addressing young people’s health, including youth-friendly health services and partnerships, strengthened and expanded to 8 townships 1.2 Package of essential child and neonatal interventions promoted and implemented in phases in accordance with the country’s Five Year Strategic Plan on Child Health development 1.2.1 implementing all components of IMCI strategy in 6 districts; 1.2.2 implementing essential new born care in 6 districts; 1.2.3 research projects aiming to influence evidence-based newborn care and child survival conducted in 3 new districts; and 1.2.4 multi-sectoral partnership on child health development established and functional)
2. Making pregnancy safer Improved quality of, increased access to, and reduced delay in, antenatal, postpartum, neonatal, and post-abortion care, to reduce maternal and neonatal mortality 2.1 75 facilities with functioning neonatal care/500,000 population 2.2 40 townships implementing IMPAC 2.3 Improve provision of quality services for post-abortion care management and referral system for obstetrical emergencies in selected townships 2.4 Operational research on good self-care, family and community practices, and new born health problems
3. Reproductive health and research An essential package of RH interventions implemented in accordance with the strategic plan for RH in Myanmar (2004-2008) 3.1 capacity of RH care providers enhanced in 20 townships 3.2 management team monitored for post-training skills in 20 townships 3.3 research conducted to support implementation of RH strategic plan (2004- 2008)
4. Health system policies and service delivery 4.1 Strengthened delivery of nursing and midwifery services centered on quality, equity and efficiency, at community and health facility levels 4.1.1 25 hospitals/community health facilities implementing activities in support of total quality management in nursing and midwifery services 4.2 Improved managerial process at township and basic health services levels 4.2.1 training for management effectiveness programme in 12 townships 4.3 Quality of medical supply system, repair and maintenance enhanced 4.3.1 upgrading quality of storage facilities at Yangon central medical store with standby electricity back up system for 10 warehouses 4.3.2 83 hospitals covered by standard medico-social services 4.3.3 80 hospitals equipped with computerized medical record system
5. Gender, women and health Development of strategy for integrating gender equity into prgrammes, policy, and capacity building in the health sector 5.1 development/adaptation of WHO gender mainstreaming tools for health managers 5.2 2 field tests conducted with gender mainstreaming tools with RH management teams 5.3 implementation, monitoring and evaluation of gender mainstreaming tools
Implementing Partners: UNICEF, UNFPA, Ministry of Health, Ministry of Sport, MNA, Myanmar Nurses and Midwifery Councils, Packard Foundation
Name of Organization: National Young Women Christian Association (YWCA)
General Background Year began in Myanmar: 1900
Mission: Train a woman – build a nation.
Year began in RH: 1998
Areas of expertise in RH: . Family planning
Number of staff in RH: -
Activities: Birth spacing & contraceptives; Prenatal care
Locations: Yangon Division (N. Okkalapa, Insein, Hlaingtharyar, Hmawbi, Taikkyi)
Target Groups: Women of Reproductive age; All age (esp. children)
Capacity Building: NA
Research: NA
Implementing partners: MCHWSA (Medical Christian Health Workers Services Association), PSI
Future plan:
Annex B -1
GEOGRAPHICAL COVERAGE OF REPRODUCTIVE HEALTH ACTIVITIES BY STAKEHOLDERS
• Adolescent Reproductive Health
• Birth Spacing and Contraceptive Services
• RTI/STI/HIV/AIDS
• Antenatal Care
• Delivery Care
• Neonatal Care
• Postnatal Care
• Post-abortion Care
• Gynaecological Cancers
• Postmenopausal reproductive Health
• Men’s Role in/and Reproductive Health
Adolescent Reproductive Health
KCN KYA KYN CHN MON RKN SHN(N) SHN(S) SHN(E) BGO SGN TTY MGW MDY YGN AYW
Provision of sexual and reproductive health information for young people *
Org. SC AFXB JOICFP AMDA JOICFP WV JOICFP JOICFP JOICFP AMDA AMDA AFXB JOICFP JOICFP CARE MRCS SC JOICFP CARE AMI Merlin MSI JOICFP MSI WV SC JOICFP JOICFP MRCS SC SC UNFPA MSI MRCS MSI PSI MSI WV WV PSI UNFPA UNFPA WV UNFPA No. Tsp. 3 7 1 6 1 2 5 2 4 5 19 37 9 Youth-friendly clinics/centers Org. JOICFP JOICFP CARE JOICFP JOICFP JOICFP JOICFP JOICFP CARE JOICFP JOICFP MSI UNFPA Malteser UNFPA MSI UNFPA UNFPA UNFPA JOICFP MSI MSI SC JOICFP UNFPA MSI UNFPA UNFPA UNFPA UNFPA UNFPA No. Tsp. 3 1 3 1 5 2 1 4 8 5 6
* MMCWA covers all townships in all states/divisions
KCN = Kachin state KYA = Kayah state KYN = Kayin state CHN = Chin state MON = Mon state RKN = Rakhine state SHN (N) = Northern Shan state SHN (S) = Southern Shan state SHN (E) = Eastern Shan state BGO = Bago division SGN = Sagaing division TTY = Tanintharyi division MGW = Magway division MDY = Mandalay division YGN = Yangon division AYW = Ayeyarwady division
Birth Spacing and Contraceptive Services
KCN KYA KYN CHN MON RKN SHN(N) SHN(S) SHN(E) BGO SGN TTY MGW MDY YGN AYW
Emergency contraception Org. PSI PSI PSI PSI PSI PSI PSI PSI PSI PSI MSI MSI MSI MSI MSI No. Tsps. 2 8 6 4 20 10 9 18 32 9 Oral contraceptives *
Org. MdM PSI UNFPA MSI AMI AMDA PSI UNFPA MSI PSI SC AMDA AMDA MdM Merlin UNFPA PSI Malteser AMI UNFPA PSI UNFPA UNFPA PSI MSI MSI MSI UNFPA UNFPA PSI UNFPA SC PSI PSI PSI UNFPA UNFPA UNFPA UNFPA UNFPA No. Tsps. 4 2 2 9 5 10 5 1 27 15 5 18 24 37 20 Monthly and/or three monthly injectables *
Org. MdM PSI UNFPA MSI AMI AMDA PSI UNFPA MSI PSI UNFPA AMDA AMDA MdM MSI UNFPA PSI UNFPA AMI UNFPA PSI UNFPA PSI MSI MSI PSI UNFPA PSI UNFPA UNFPA PSI PSI UNFPA UNFPA UNFPA UNFPA No. Tsps. 4 2 2 9 5 10 5 1 27 15 4 17 24 37 20 IUDs
Org. UNFPA UNFPA MSI UNFPA UNFPA UNFPA UNFPA MSI UNFPA SC UNFPA MSI MSI MSI UNFPA UNFPA UNFPA PSI PSI UNFPA UNFPA UNFPA YWCA No. Tsps. 2 2 2 5 5 3 1 15 11 5 13 24 35 15 Sterilizations Org. MSI MSI MSI MSI MSI YWCA No. Tsps. 2 1 6 7 1
* MMCWA covers all townships in all states/divisions
RTI/STI/HIV/AIDS
KCN KYA KYN CHN MON RKN SHN(N) SHN(S) SHN(E) BGO SGN TTY MGW MDY YGN AYW
Condom promotion *
Org. MdM SC AFXB AMI AMDA UNFPA UNFPA MMA MMA SC AMDA AMDA AFXB Merlin UNFPA UNFPA MMA Malteser AMI WV MRCS UNFPA UNFPA MMA CARE AMI MMA SC UNFPA CARE MSI WV SC MMA MdM MRCS MSI Malteser UNFPA MSI MMA MSI UNFPA MMA UNFPA MRCS WV SC WV MSI UNFPA UNFPA WV No. 6 4 6 3 10 2 2 11 8 4 7 18 39 9 Tsp. Diagnosis and treatment of RTIs (including STIs) * Org. MdM UNFPA AFXB UNFPA Malteser UNFPA UNFPA MMA MMA AMDA AMDA AFXB MMA UNFPA MMA MMA MSI UNFPA MMA MMA AMI MSI MSI UNFPA UNFPA MSI MdM UNFPA SC UNFPA MMA UNFPA MSI UNFPA No. 6 2 6 1 5 2 1 10 8 7 17 30 6 Tsp. Voluntary counseling and testing for HIV * Org. MdM AFXB Malteser WV MMA MMA WV MMA MMA AFXB MMA MMA MMA WV AMI WV MdM MMA MSI WV No. 3 5 2 2 9 5 3 7 9 28 2 Tsp.
Syphilis screening and treatment * Org. MdM AMI MdM No. 3 11 Tsp. PMTCT Org. MMA UNFPA MMA UNFPA MMA MMA MMA MMA AMI MMA UNFPA UNFPA UNFPA UNFPA SC MMCWA MMA UNFPA UNFPA UNFPA UNFPA No. 5 2 1 2 9 6 8 7 + 11 6 Tsp.
* MMCWA covers all townships in all states/divisions
Antenatal Care
KCN KYA KYN CHN MON RKN SHN(N) SHN(S) SHN(E) BGO SGN TTY MGW MDY YGN AYW
Home-based records (preparation of birth plans) * Organization UNFPA UNFPA UNFPA Maltese AMDA UNFPA UNFPA UNFPA UNFPA SC AMDA AMDA UNFPA Merlin UNFPA JICA UNFPA SC UNFPA UNFPA JOICFP UNFPA UNFPA No. Tsp. 2 2 5 5 6 3 1 21 11 5 13 13 14 15 Immunization against tetanus * Organization MSI Malteser AMI WV MSI WV AMDA AMDA MSI MSI JICA MSI WV WV JOICFP WV No. Tsp. 1 1 3 2 1 3 1 9 5 2 Detection and treatment of hypertensive disorders in pregnancy *
Organization UNFPA UNFPA MSI UNFPA AMDA UNFPA UNFPA MSI UNFPA UNFPA AMDA AMDA MSI MSI UNFPA AMI UNFPA UNFPA MSI UNFPA UNFPA JICA UNFPA JOICFP UNFPA No. Tsp. 2 2 5 5 9 3 1 21 11 4 13 17 16 15 Detection and treatment of malaria * Organization Malteser JICA AMDA AMDA Merlin JOICFP No. Tsp. 1 2 1 2 1 Advice on early detection of complications and danger signs * Organization UNFPA UNFPA MSI AMI AMDA UNFPA UNFPA MSI UNFPA SC AMDA AMDA AMI Merlin UNFPA Malteser AMI UNFPA UNFPA SC MSI MSI MSI UNFPA JICA UNFPA UNFPA UNFPA UNFPA JOICFP YWCA UNFPA No. Tsp. 2 2 5 5 9 3 1 21 11 5 13 19 16 16
Provision of iron/folate supplement * Organization UNFPA UNFPA MSI AMI AMDA UNFPA UNFPA MSI UNFPA SC SC MSI MSI Merlin UNFPA Malteser AMI UNFPA UNFPA UNFPA UNFPA UNFPA MSI JICA UNFPA JOICFP UNFPA No. Tsp. 2 2 5 1 9 3 1 21 11 5 13 18 16 16 Detection and treatment of anaemis * Organization MSI Malteser AMDA MSI AMDA AMDA MSI Merlin JICA MSI MSI JOICFP No. Tsp. 1 1 3 1 1 8 2 2 Syphilis screening and treatment *
Organization UNFPA UNFPA UNFPA UNFPA JICA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA AMI UNFPA JOICFP UNFPA UNFPA No. Tsp. 2 2 5 5 5 3 1 21 11 4 13 12 14 14 Treatment of intestinal parasites
Organization Malteser AMDA AMDA YWCA Merlin No. Tsp. 1 1 2 3 1 Voluntary testing and counseling for HIV
Organization SC SC MMCWA AMI No. Tsp. 1 1 All 1
* MMCWA covers all townships in all states/divisions
Delivery Care
KCN KYA KYN CHN MON RKN SHN(N) SHN(S) SHN(E) BGO SGN TTY MGW MDY YGN AYW
Clean delivery practices * Organiza- UNFPA UNFPA UNFPA AMI AMI UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA Merlin tion Malteser JICA UNFPA UNFPA JOICFP UNFPA No. Tsp. 2 2 5 5 8 3 1 21 11 4 13 12 14 15 Administration of oxytocic drugs in the third stage of labour * Organiza- UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA tion No. Tsp. 2 2 5 5 5 3 1 21 11 4 13 12 14 14 Routine placenta examination * Organiza- UNFPA UNFPA UNFPA AMI AMI UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA tion Malteser UNFPA UNFPA No. Tsp. 2 2 5 5 8 3 1 21 11 4 13 12 14 14 Administration of oral and/or parenteral antibiotics * Organiza- tion No. Tsp. Use of the partograph *
Organiza- UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA Merlin tion UNFPA No. Tsp. 2 2 5 5 5 3 1 21 11 4 13 12 14 15 Surgery Organiza- tion No.Tsp.
* MMCWA covers 91 maternity homes in all states/divisions
Neonatal Care
KCN KYA KYN CHN MON RKN SHN(N) SHN(S) SHN(E) BGO SGN TTY MGW MDY YGN AYW Prevention and management of hypothermia* Organization AMI AMI SC SC Merlin Malteser JICA JOICFP No. Tsp. 2 5 1 1 1 Prevention and management of infections * Organization AMI AMI Merlin Malteser JICA JOICFP No. Tsp. 2 5 1 Immediate initiation of breast feeding (within first hour) * Organization AMI AMI SC SC Merlin Malteser JICA JOICFP No. Tsp. 2 5 1 1 1 Promotion of exclusive breast feeding (first 6 months) * Organization Malteser JICA SC SC AMI Merlin JOICFP No. Tsp. 1 2 1 1 1 1 Resuscitation of newborn * Organization JICA Merlin JOICFP No. Tsp. 2 1 Umbilical cord care * Organization Malteser JICA SC SC Merlin JOICFP No. Tsp. 2 2 1 2 1 Early detection and management of neonatal jaundice Organization AMI AMI Merlin Malteser JICA JOICFP No. Tsp. 2 5 1 * MMCWA covers 91 maternity homes in all states/divisions Postnatal Care
KCN KYA KYN CHN MON RKN SHN(N) SHN(S) SHN(E) BGO SGN TTY MGW MDY YGN AYW
Development of birth-spacing plan service provision * Organiza- AMI AMI WV WV AMDA AMDA WV Merlin tion Malteser JOICFP WV WV No. Tsp. 2 5 2 3 1 5 3 3 Early detection and management of puerperal complications * Organiza- AMI AMI tion Malteser JOICFP No. Tsp. 2 5 Detection and treatment of malaria *
Organiza- Malteser AMDA AMDA Merlin tion No. Tsp. 1 1 2 1 Advice and support for breastfeeding, nutrition and healthy lifestyle * Organiza- AMI AMI AMI tion JOICFP No. Tsp. 1 5 1 Provision of iron/folate supplements * Organiza- UNFPA UNFPA UNFPA AMI AMI UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA Merlin tion Malteser UNFPA UNFPA UNFPA No. Tsp. 2 2 5 5 8 3 1 21 11 4 13 12 14 15 Detection and treatment of anaemia Organiza- UNFPA UNFPA UNFPA Malteser JICA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA Merlin tion UNFPA JOICFP UNFPA UNFPA No. Tsp. 2 2 5 5 5 3 1 21 11 4 13 12 14 15
Provision of postnatal care within the first week (preferably within 2-3 days) * Organiza- AMI AMI Merlin tion Malteser JICA JOICFP
No. Tsp. 2 5 1 Through review at 6 weeks postpartum *
Organiza- UNFPA UNFPA UNFPA AMI AMI UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA Merlin tion UNFPA JICA UNFPA JOICFP UNFPA No. Tsp. 2 2 5 5 8 3 1 21 11 4 13 12 14 15 Immunization against tetanus (if nor done during ANC)
Organiza- AMI AMI Merlin tion JICA JOICFP No. Tsp. 1 5 1 Syphilis screening (if not done in ANC) *
Organiza- tion No. Tsp. Voluntary counseling and testing for HIV (if not done during ANC) MMCWA All
* MMCWA covers 91 maternity homes in all states/divisions
Post-abortion Care
KCN KYA KYN CHN MON RKN SHN(N) SHN(S) SHN(E) BGO SGN TTY MGW MDY YGN AYW
Post-abortion birth spacing service provision * Organiza- UNFPA UNFPA UNFPA Malteser UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA tion UNFPA No. Tsp. 2 2 5 5 5 3 1 21 11 4 13 12 14 14 Counselling on birth spacing and other RH issues for post-abortion clients * Organiza- UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA MRCS UNFPA UNFPA UNFPA UNFPA MRCS MRCS tion UNFPA UNFPA UNFPA No. Tsp. 2 2 5 5 5 3 1 21 11 4 13 12 15 14 Manual vacuum aspiration for management of incomplete abortion Organiza- tion No. Tsp. Prevention and management of sepsis, tetanus, injury, shock and haemorrhage Organiza- Malteser tion No. Tsp. 1
* MMCWA covers 91 maternity homes in all states/divisions
Gynaecological Cancers
KCN KYA KYN CHN MON RKN SHN(N) SHN(S) SHN(E) BGO SGN TTY MGW MDY YGN AYW
Cervical cancer screening and treatment * Organization No. Tsp. Breast cancer screening and treatment * Organization No. Tsp.
* MMCWA covers all states/divisions.
Postmenopausal Reproductive Health
KCN KYA KYN CHN MON RKN SHN(N) SHN(S) SHN(E) BGO SGN TTY MGW MDY YGN AYW
Counselling, including life style and nutrition * Organization No. Tsp.
* MMCWA covers all states/divisions.
Men’s Role in/and Reproductive Health
KCN KYA KYN CHN MON RKN SHN(N) SHN(S) SHN(E) BGO SGN TTY MGW MDY YGN AYW
Promotion of awareness of STIs/HIV/AIDS * Organiza- AFXB AMDA WV JOICFP MMA SC MMA CARE AFXB Merlin tion MMA CARE MMA WV SC MMA AMI MMA Malteser UNFPA WV JOICFP WV MMA MMA UNFPA WV No. Tsp. 5 4 2 9 5 4 7 11 28 7 Promotion of men’s role in support of reproductive health Organiza- AFXB CARE MMA MMA SC MMA CARE AFXB Merlin tion MMA MMA SC MMA AMI MMA MMA No. Tsp. 5 2 9 5 1 7 9 25 5 Promotion of community awareness about violence against women Organiza- MMA MMA WV MMA MMA SC MMA MMA MMA MMA tion WV SC WV WV WV No. Tsp. 3 1 2 9 5 4 7 9 11 6
* MMCWA covers all states/divisions.
Annex B-2
TOWNSHIPS COVERAGE BY STAKEHOLDERS IN STATE/DIVISON
1. Kachin state
2. Kayah state
3. Kayin state
4. Chin state
5. Mon state
6. Rakhine state
7. Northern Shan state
8. Eastern Shan state
9. Southern Shan state
10. Ayeyarwady division
11. Bago division
12. Mandalay division
13. Magway division
14. Sagaing division
15. Tanintharyi division
16. Yangon division
Kachin State Reproductive Health Activities Townships Stakeholder ARH BSC RTI ANC DC NC PNC PAC GCA MPS MRH 1.Myitkyina UNFPA x x x x x MdM x x 2.Bamaw UNFPA x x x x x x 4.Moegaung MdM x x 4.Hopin MdM x x 5.Waingmaw UNFPA x 6.Taning UNFPA x MMCWA implements all activities, except sub-fertility, in all townships; NC, PNC, PAC in 91 maternity homes; PMCT in Mandalay division.
Kayah State Reproductive Health Activities Townships Stakeholder ARH BSC RTI ANC DC NC PNC PAC GCA MPS MRH
MMCWA implements all activities, except sub-fertility, in all townships; NC, PNC, PAC in 91 maternity homes; PMCT in Mandalay division.
Kayin State Reproductive Health Activities Townships Stakeholder ARH BSC RTI ANC DC NC PNC PAC GCA MPS MRH 1.Kawkareik PSI x SC x x 2.Hlaingbwe PSI x SC x x 3.Phaan SC x x UNFPA x 4.Myawaddy UNFPA x MMCWA implements all activities, except sub-fertility, in all townships; NC, PNC, PAC in 91 maternity homes.
Chin State Reproductive Health Activities Townships Stakeholder ARH BSC RTI ANC DC NC PNC PAC GCA MPS MRH 1.Falam UNFPA x x x x x 2.Hakha UNFPA x x x x x MMCWA implements all activities, except sub-fertility, in all townships; NC, PNC, PAC in 91 maternity homes.
Mon State Reproductive Health Activities Townships Stakeholder ARH BSC RTI ANC DC NC PNC PAC GCA MPS MRH
1.Mawlamyine AFXB x x x PSI x SC x x MMA x x x MSI x x x x UNFPA x x x x x x 2.Kyaikhto AFXB x x x JOICFP x PSI x MMA x x x UNFPA x x x x x x x 3.Kyaikmaraw AFXB x x x SC x x UNFPA x x x x x x 4.Paung AFXB x x x PSI x SC x x 5.Bilin PSI x 6.Kyaikkhami PSI x 7.Mudon PSI x SC x x UNFPA x 8.Thanbyuzayat PSI x UNFPA x x x x x x 9.Thaton PSI x SC x x MMA x x x MSI x x UNFPA x x x x x 10.Chaungzone SC x x MMCWA implements all activities, except sub-fertility, in all townships; NC, PNC, PAC in 91 maternity homes.
Rakhine State Reproductive Health Activities Townships Stakeholder ARH BSC RTI ANC DC NC PNC PAC GCA MPS MRH
1.Buthidaung AMI x x x x x x UNFPA x x x x x 2.Maungdaw Malteser x x x x x x x x UNFPA x x x x x 3.Ponnagyun JOICFP x UNFPA x x x x x x 4.Sittway UNFPA x x x x x x x 5.Kyauktaw UNFPA x x x x x 6.Thandwe UNFPA x MMCWA implements all activities, except sub-fertility, in all townships; NC, PNC, PAC in 91 maternity homes.
Shan State (North) Reproductive Health Activities Townships Stakeholder ARH BSC RTI ANC DC NC PNC PAC GCA MPS MRH 1.Laokai AMDA x x x x x 2.Mong Pawk AMI x x x x x x Malteser x 3.Wein Kao AMI x x x x x x 4.Mong Maw AMI x x x x x x Malteser x 5.Pang Kham Malteser x x x 6.Lashio JOICFP x PSI x MMA x x x UNFPA x x x x x x x 7.Kyaukme JICA x x x x JOICFP x x x x x PSI x UNFPA x x x x x 8.Naungcho JICA x x x x JOICFP x x x x PSI x UNFPA x x x x x 9.Hsibaw PSI x UNFPA x x x x x 10.Muse PSI x SC x x CARE x x x UNFPA x x x x x 11.Namkham PSI x SC x x UNFPA x 12.Theinni SC x x 13.Namphatka SC x x MMCWA implements all activities, except sub-fertility, in all townships; NC, PNC, PAC in 91 maternity homes.
Shan State (East) Reproductive Health Activities Townships Stakeholder ARH BSC RTI ANC DC NC PNC PAC GCA MPS MRH
1.Kyaington WV x x x x x UNFPA x 2.Tachileik WV x x x x x UNFPA x x x x x 3.Mongsat UNFPA x MMCWA implements all activities, except sub-fertility, in all townships; NC, PNC, PAC in 91 maternity homes.
Shan State (South) Reproductive Health Activities Townships Stakeholder ARH BSC RTI ANC DC NC PNC PAC GCA MPS MRH
1.Pindaya JOICFP x UNFPA x x x x x x x 2.Kalaw PSI x UNFPA x x x x x x 3.Nyaungshwe PSI x UNFPA x 4.Taunggyi PSI x UNFPA x x x x x x 5.Yaksauk PSI x MMCWA implements all activities, except sub-fertility, in all townships; NC, PNC, PAC in 91 maternity homes.
Ayeyarwady Division Reproductive Health Activities Townships Stakeholder ARH BSC RTI ANC DC NC PNC PAC GCA MPS MRH 1.Zalun JOICFP x UNFPA x x x x x x 2.Yekyi JOICFP x MMA x x x UNFPA x x x x x x x 3.Nyaungdone JOICFP x PSI x MMA x x x UNFPA x x x x x x 4.Myanaung JOICFP x UNFPA x x x x x x 5.Hinthada JOICFP x PSI x UNFPA x x x x x x x 6.Laputta Merlin x x x x x x x x PSI x 7.Maubin MRCS x x x UNFPA x x x x x x 8.Kangyidaung PSI x 9.Myaungmya PSI x UNFPA x 10.Pathein PSI x MSI x x x x WV x x x x x UNFPA x 11.Wakema PSI x 12.Pantanaw PSI x MMA x x x UNFPA x x x x x 13.Ingapu UNFPA x x x x x 14.Dedaye UNFPA x x x x x 15.Kyangin UNFPA x x x x x 16.Danubyu MMA x x x UNFPA x x x x x 17.Kyaunggone MMA x x x UNFPA x x x x x 18.Kyaiklat UNFPA x x x x x 19.Kyonpyaw UNFPA x x x x x 20.Thabaung WV x x x x x MMCWA implements all activities, except sub-fertility, in all townships; NC, PNC, PAC in 91 maternity homes.
Bago Division Reproductive Health Activities Townships Stakeholder ARH BSC RTI ANC DC NC PNC PAC GCA MPS MRH
1. Bago PSI x JOICFP x x MMA x x x MSI x UNFPA x x x x x x 2.Daik U JOICFP x MRCS x x x MMA x x x UNFPA x x x x x x 3.Oaktwin JOICFP x MMA x x x PSI x UNFPA x x x x x x x 4.Gyobingauk JOICFP x PSI x UNFPA x x x x x x 5.Pyay JOICFP x PSI x MMA x x x MSI x x x x UNFPA x x x x x x 6.Phyu MRCS x x x PSI x UNFPA x x x x x x 7.Nyaunglaybin PSI x MMA x x x UNFPA x x x x x 8.Pyuntazar PSI x 9.Thanatpin PSI x UNFPA x x x x x 10.Htantabin PSI x UNFPA x x x x x 11.Taungoo PSI x MMA x x x UNFPA x x x x x x 12.Intakaw PSI x 13.Waw PSI x MMA x x x UNFPA x x x x x 14.Kyauktaga PSI x 15.Letpadan PSI x UNFPA x x x x x 16.Oatpho PSI x UNFPA x x x x x 17.Padaung PSI x 18.Paungdale PSI x 19.Paungde PSI x UNFPA x x x x x 20.Shwetaung PSI x MMA x x x UNFPA x x x x x 21.Thegone PSI x 22.Paukkhaung UNFPA x x x x x 23.Minhla UNFPA x x x x x 24.Yedashe MMA x x x UNFPA x x x x x x 25.Monyo UNFPA x x x x x 26.Nattalin UNFPA x x x x x 27.Zeegone UNFPA x x x x x MMCWA implements all activities, except sub-fertility, in all townships; NC, PNC, PAC in 91 maternity homes.
Mandalay Division Reproductive Health Activities Townships Stakeholder ARH BSC RTI ANC DC NC PNC PAC GCA MPS MRH 1.Aung Myay PSI x x Thar Zan MSI x x x CARE x x x UNFPA x 2.ChanAyeTharZan PSI x x MSI x x x UNFPA x 3.Chan Mya PSI x x Thar Zi MSI WV x x x x x UNFPA x x 4.Maha Aung PSI x x Myay MSI x x x CARE x x x UNFPA x 5.Pyi Gyi Tagun PSI x x MSI x x x x WV x x x x x UNFPA x 6.Meikhtila AMDA x x x x x x PSI x x 7.Nyaung U AMDA x x x x x x MMA x x x UNFPA x x x x x x 8.Singaing JOICFP x MMA x x x UNFPA x x x x x x x 9.Myittha JOICFP x PSI x x UNFPA x x x x x x 10.Nahtogyi JOICFP x UNFPA x x x x x x 11.Wundwin JOICFP x PSI x x MMA x x x UNFPA x x x x x x 12.Amarapura PSI x x MMA x x x WV x x x x x UNFPA x x x x x x 13.Kyaukpa- PSI x x daung UNFPA x 14.Kyaukse PSI x x 15.Madayar PSI x x MMA x x x UNFPA x x x x x x 16.Patheingyi PSI x x MMA x x x UNFPA x x x x x x 17.Sintgu PSI x x UNFPA x x x x x 18.Thabeikkyin PSI x x 19.Thazi PSI x x UNFPA x 20.Tada U PSI x x 21.Tatkone UNFPA x x x x x 22.Mahlaing UNFPA x x x x x 23. Pyin Oo Lwin MMA x x x UNFPA x x x x x x 24.Myingyan MSI x x x x UNFPA x 25.Taungtha UNFPA x 26.Nay Pyi Taw UNFPA x MMCWA implements all activities, except sub-fertility, in all townships; NC, PNC, PAC in 91 maternity homes; PMCT in Mandalay division.
Magway Division Reproductive Health Activities Townships Stakeholder ARH BSC RTI ANC DC NC PNC PAC GCA MPS MRH 1.Pakokku AMDA x x x x x x SC x x x x x x MMA x x x UNFPA x x x x x 2.Aunglan JOICFP x PSI x MMA x x x UNFPA x x x x x x x 3.Yenanchaung JOICFP x PSI x MMA x x x UNFPA x x x x x x 4.Chauk JOICFP x MMA x x x UNFPA x x x x x x 5.Sinpaungwe PSI x 6.Magway PSI x UNFPA x x x x x x 7.Minbu SC x PSI x 8.Natmauk PSI x UNFPA x x x x x 9.Pwintphyu PSI x UNFPA x x x x x 10.Salin PSI x 11.Taungtwingyi PSI x JOICFP x MMA x x x UNFPA x x x x x x x 12.Minhla UNFPA x x x x x 13.Yesagyo MMA x x x UNFPA x x x x x 14.Myaing MMA x x x UNFPA x x x x x 15.Thayet UNFPA x x x x x 16.Myothit UNFPA x x x x x MMCWA implements all activities, except sub-fertility, in all townships; NC, PNC, PAC in 91 maternity homes.
Sagaing Division Reproductive Health Activities Townships Stakeholder ARH BSC RTI ANC DC NC PNC PAC GCA MPS MRH 1.Myaung JOICFP x UNFPA x x x x x x 2.Monywa JOICFP x PSI x MMA x x x UNFPA x x x x x x 3.Kalay PSI x UNFPA x x x x x x 4.Ayardaw PSI x UNFPA x x x x x 5.Chaung U PSI x 6.Kantbalu PSI x 7.Khin U PSI x MMA x x x UNFPA x x x x x 8.Sagaing PSI x 9.Shwebo PSI x MMA x x x UNFPA x x x x x x 10.Wetlet PSI x MMA x x x UNFPA x x x x x 11.Ye U PSI x 12.Myinmu MMA x x x UNFPA x x x x x 13.Salingyi UNFPA x x x x x 14.Ngazun UNFPA x x x x x 15.Tanze UNFPA x x x x x 16.Katha UNFPA x 17.Kalewa UNFPA x 18.Htigyaint UNFPA x MMCWA implements all activities, except sub-fertility, in all townships; NC, PNC, PAC in 91 maternity homes.
Tanintharyi Division Reproductive Health Activities Townships Stakeholder ARH BSC RTI ANC DC NC PNC PAC GCA MPS MRH 1.Dawei JOICFP x WV x x x x x UNFPA x x x x x x 2.Launglone SC x x x x x x 3.Kawthoung WV x x x x x UNFPA x x x x x 4.Myeik WV x x x x x UNFPA x x x x x x 5.Thayetchaung UNFPA x x x x x MMCWA implements all activities, except sub-fertility, in all townships; NC, PNC, PAC in 91 maternity homes.
Yangon Division Reproductive Health Activities Townships Stakeholder ARH BSC RTI ANC DC NC PNC PAC GCA MPS MRH
1.Dala AMI x x x x x JOICFP x PSI x x UNFPA x x x x x x x 2.Seikkyi AMI x x x 3.S-Dagon AFXB x x x PSI x x MdM x x JOICFP x WV x x x x x UNFPA x x x x x x x x 4.N-Dagon AFXB x x x PSI x x MdM x x x UNFPA x 5..N-Okkalapa AFXB x x x MRCS x x x MdM x x PSI x x YWCA x x UNFPA x 6.S-Okkalapa AFXB x x x PSI x x MdM x x UNFPA x x 7.Thaketa AFXB x x x MSI x x x x PSI x x UNFPA x x 8.Thingangyun AFXB x x x MSI x x x x PSI x x UNFPA x x 9.Mingaladon AFXB x x x PSI x x UNFPA x 10.Hlaingthayar AFXB x x x PSI x x YWCA x x WV x x x x x UNFPA x x x x x x 11.Shwepyithar AFXB x x x MRCS x x x PSI x x Partners x UNFPA x x x x x x 12.Kamayut AFXB x x x PSI x x UNFPA x 13.Tamwe AFXB x x x MdM x x PSI x x UNFPA x 14.Mayangone AFXB x x x PSI x x MdM x x UNFPA x 15.Hlaing AFXB x x x PSI x x UNFPA x 16.Ahlone PSI x x UNFPA x 17.Bahan PSI x x UNFPA x
18.Dagon PSI x x Seikkan UNFPA x 19.Dawbon PSI x x 20.E-Dagon PSI x x UNFPA x 21.Insein PSI x x MdM x x YWCA x x UNFPA x 22.Kyimyindine PSI x x UNFPA x 23.Mingalar PSI x x taungnyunt UNFPA x 24.Shwepaukkan PSI x x 25.Yankin PSI x x UNFPA x 26.Latha MdM x x UNFPA x 27. Sanchaung PSI x x UNFPA x 28. Pabedan UNFPA x 29.Botahtaung UNFPA x 30.Pazundaung UNFPA x 31.Lanmadaw UNFPA x 32.Dagon UNFPA x 33. Laydaungkan UNFPA x 34.Kungyangone JOICFP x MMA x x x UNFPA x x x x x x 35.Thongwa JOICFP x PSI x x MMA x x x UNFPA x x x x x x 36.Kyauktan AFXB x x x PSI x x MMA x x x UNFPA x x x x x 37.Thanlyn AFXB x x x 38.Hmawbi AFXB x x x PSI x x MMA x x x YWCA x WV x x x x x UNFPA x x x x x 39.Taikkyi PSI x x MMA x x x YWCA x UNFPA x x x x x 40.Htantabin UNFPA x x x x x 41.Kawhmu MMA x x x UNFPA x x x x x 42.Twante AMI x x x PSI x x MMA x x x UNFPA x x x x x 43.Hlegu PSI x x MMA x x x UNFPA x x x x x 44.Khayan PSI x x MMA x x x UNFPA x x x x x MMCWA implements all activities, except sub-fertility, in all townships; NC, PNC, PAC in 91 maternity homes.
Annex B-3
MINIMUM ESSENTIAL PACKAGE OF REPRODUCTIVE HEALTH INTERVENTIONS IMPLEMENTING BY STAKEHOLDERS
• Adolescent Reproductive Health
• Birth Spacing and Contraceptive Services
• RTI/STI/HIV/AIDS
• Antenatal Care
• Delivery Care
• Neonatal Care
• Postnatal Care
• Post-abortion Care
• Gynaecological Cancers
• Postmenopausal reproductive Health
• Men’s Role in/and Reproductive Health Adolescent Reproductive Health
Code Activities Organization State/Division Township(s) Target Group Number Implementing No. beneficiaries Partners covered A1 Provision of AFXB Yangon N/S Okkalapa, N/S Trainees from vocational 6000 sexual and Dagon, Thaketa, center, PLHAs, Youth RH Thingangyun, from workplace; Workers information Mingaladon, from transportation sector, for young Hlaingtharyar, Uniform service personnel people Shwepyitha, Kamayut, Tamwe, Mayangone, Hlaing, Kyauktan, Thanlyn, Hmawbi Mon Mawlamyine, Kyaikhto, Kyaikmaraw, Paung AMDA Shan (N) Laokai female villagers 745 JICA, NATALA village health volunteer 52 JICA, NATALA Mandalay Meiktila mothers 240 JICA, DOH Nyaung U mothers 120 JICA, DOH Magwe Pakokku mothers 398 JICA, DOH AMI Yangon Dala Adolescents 2000 EC CARE Mandalay Aung Myay Thar Zan 15-24 yrs male & female 1252 male DOH, UNFPA Maha Aung Myay 1188 female Shan (N) Muse JOICFP 10(S/D) Except 27 UNFPA intensive Youth 920 CHEB Kachin, Kayin, Chin, townships * Kayar Merlin Ayeyarwady Laputta Men & women of 350,000 DOH reproductive age MMCWA All states/ divisions 325 townships Young people 856 trainers UNFPA, MOH 1,212,900
MRCS Yangon N-Okkalapa Adolescent, Youth (15-24 Shwepyithar & MMA, DOH Ayeyarwady Maubin Out-of school) Bago Daik-U Phyu Mon Mawlamyine, Thaton Young people 10-24 years 12383+19877 UNFPA MSI Ayeyarwady Pathein 6504 Bago Pyay 2304 Mandalay Pyigyitagun, Myingyan 747+3975 Yangon Thaketa, Thingangyun 29386+47371 PSI Yangon 32 townships General Practitioners Mandalay 17 townships SC Taninntharyi Launglone Adolescents (15-24) 9034 CBO Magway Pakokku Youth (15-24) 26,273 CBO Kayin Phaan, Hlaingbwe, Out-of school youth 108,250 MNA, Literacy & Kawkareik Cultural Ass. Mon Mawlamyine Out-of school youth Thaton, Kyaikmaraw, Paung, Mudon, Chaungzone Shan (N) Theinni, Namkham, Out-of school youth Namphatka, Muse UNFPA Yangon 28 downtown townships 15-24 years old 16,840 MMA, MRCS Bago Daik U, Phyu Ayeyarwady Maubin Mandalay 5 MDC townships ** WV Yangon Hlaingtharyar, S.Dagon, Youth, Women 16323 MOH Hmawbi Mandalay Chanmyathazi, Pyigyitagun, Amarapura Ayeyarwady Thabaung, Pathein Tanintharyi Dawei, Myeik, Kawthaung Shan (E) Kyaington, Tachileik ** Chan Aye Thazan; Chan Mya Thazi; Aung Mya Thazan; Maha Aung Myay; Pyi Gyi Tagun
A2 Youth CARE Mandalay friendly Shan (N) clinics/ 10(S/D) Except 27 UNFPA intensive Youth 1380 CHEB centers JOICFP Kachin, Kayin, Chin, townships Kayar Malteser Wa Special Region -2 Pang Kham Youth, Risk group 2000 Mon Mawlamyine, Thaton Young people 10-24 years 11083+11960 UNFPA Ayeyarwady Pathein 1854 MSI Bago Pyay 1178 Mandalay Pyigyitagun, Myingyan 3124+2038 Yangon Thaketa, Thingangyun 22470+30893 SC Mon Thaton Out-of school youth 13,200 MSI UNFPA Yangon Kungyangone, Dala, 15 – 24 years old 270,240 MSI, DOH Thonegwa, Thaketa, Thingangyun Bago Daik U, Oaktwin, Gyobingsuk, Pyi, Bago Ayeyarwady Yekyi, Nyaungdone, Myanaung, Hinthada, Zalun Mandalay Singaing, Myittha, Nahtogyi, Wundwin, Myingyan, Pyigyitagun Magwe Aunglan, Tauntwingyi, Yenanchaung, Chauk Sagaing Myaung, Monywa Shan (N) Lashio Shan (S) Pindaya Rakhine Ponnagyun Tanintharyi Dawei Mon Kyaikhto, Thaton, Mawlamyine
Birth Spacing and Contraceptive Services
Code Activities Organization State/Division Township(s) Target Group Number Implementing No. beneficiaries Partners covered B1 Emergency MSI Mon Mawlamyine, Thaton Women of reproductive age 1,290 contraception Ayeyarwady Pathein from low income Bago Pyay neighbourhood Mandalay 5 MCDC townships, Myingyan Yangon Thaketa, Thingangyun PSI * 10 states / 116 townships Women of reproductive age Private divisions practitioners B2 Oral AMDA Shan (N) Laokai Reproductive female 745 JICA, NATALA, PSI contraception Mandalay Meikhtila Reproductive female 131 JICA, DOH Nyaung U Reproductive female 100 JICA, DOH Magwe Pakokku Reproductive female 137 JICA, DOH AMI Shan (N) Mong Pawk, Wein Kao, Mong Women in reproductive age 311 ECHO, UNFPA, Wa Region Maw DOH Rakhine Buthidaung Women in reproductive age 241 ECHO Malteser Rakhine Maungdaw All women 2,500 UNHCR MdM Kachin Myitkyina, Moegaung, Hopin SWs 10 Yangon Mayangone, Insein, N- Okkalapa, S-Okkalapa, Latha, Tamwe, N.Dagon, S.Dagon Merlin Ayeyarwady Laputta Men & Women of 350,000 DOH reproductive age MMCWA All states/ 325 townships Married women 2980 x 2 yrs IPPF, MOH divisions MSI Mon Mawlamyine, Thaton Women of reproductive age 891,582 Ayeyarwady Pathein from low income Bago Pyay neighbourhood Mandalay 5 MDCD townships, Myingyan Yangon Thaketa, Thingangyun
PSI *** 10 states / 116 townships Women of reproductive age Private divisions practitioners SC Tanintharyi Launglone 15-49 5,366 CBO Magwe Pakokku Eligible couples 1,725 CBO UNFPA **** 14 States/ 112 townships Women of reproductive age 30 % of total DOH Divisions population YWCA N.Okkalapa, Insein, Women of reproductive age 200 Yangon Hlaingtharya, Hmawbi, Taikkyi B3 Monthly AMDA Shan (N) Laokai Reproductive female 745 JICA, and/or three NATALA, monthly PSI injectables Mandalay Meikhtila Reproductive female 92 JICA, DOH Nyaung U Reproductive female 280 JICA, DOH Magwe Pakokku Reproductive female 187 JICA, DOH AMI Shan (N) Mong Pawk, Wein Kao, Mong Women in reproductive age 3,939 ECHO, Wa Region Maw UNFPA, DOH Rakhine Buthidaung Women in reproductive age 1,211 ECHO MdM Kachin Myitkyina, Moegaung, Hopin Yangon Mayangone, Insein, N- SWs 100 Okkalapa, S-Okkalapa, Latha, Tamwe, N.Dagon, S.Dagon MMCWA All states/ 325 townships Married women 1863 x 2 yrs IPPF, MOH divisions MSI Mon Mawlamyine, Thaton Ayeyarwady Pathein Women of reproductive age 281,045 Bago Pyay from low income neighbourhood Mandalay 5 MCDC townships, Myingyan Yangon Thaketa, Thingangyun PSI *** 10 states / 116 townships Women of reproductive age Private divisions practitioners UNFPA **** 14 States/ 112 townships Women of reproductive age 30 % of total DOH Divisions population
B4 IUDs MSI Mon Mawlamyine, Thaton Ayeyarwady Pathein Bago Pyay Women of reproductive age 12,674 Mandalay Aungmyaythazan, from low income neighbourhood Chanayethazan, Chanmyathasi, Mahaaungmyay, Pyigyitagun, Myingyan Yangon Thaketa, Thingangyun PSI*** Yangon 32 townships Women of reproductive age Private Mandalay 17 practitioners SC Tanintharyi Launglone Eligible couples 1,725 CBO UNFPA**** 14 States/ 112 townships Women of reproductive age 30 % of total DOH Divisions population YWCA N.Okkalapa, Insein, Yangon Hlaingtharya, Hmawbi, Taikkyi Women of reproductive age 200 B5 Female MSI Mon Mawlamyine, Thaton sterilization Ayeyarwady Pathein Women of reproductive age 508 Bago Pyay from low income neighbourhood Mandalay 5 MCDC townships, Myingyan Thaketa, Thingangyun Yangon YWCA N.Okkalapa, Insein, Yangon Hlaingtharya, Hmawbi, Taikkyi Women of reproductive age 50
RTI/STI/HIV/AIDS
Code Activities Organization State/ Township(s) Target Group Number Implementing No. Division beneficiaries Partners covered C1 Condom AFXB Yangon 16 townships * promotion Mon Mawlamyine, Kyaikhto, Kyaikmaraw, Youth, PLHAs 4,000 Paung AMDA Shan (N) Laokai Villagers 7,452 JICA, NATALA, PSI Mandalay Meikhtila, Nyaung U Villagers 3,000 + JICA, DOH, 2,000 PSI Magwe Pakokku Villagers 1,200 JICA, DOH, PSI AMI Yangon Dala, Twante, Seikkyi General population, MSM, 200,000 EC, FHAM HRM, SW Wa Region Mong Pawk, Wein Kao, Mong Maw Patients coming to RHC or 51 UNFPA, Shan (N) mobile clinic ECHO Rakhine Buthidaung Patients coming to RHC or 128 ECHO mobile clinic CARE Mandalay Aung Myay Thar Zan, 15-24 yrs both male and DOH, UNFPA Maha Aung Myay female Shan (N) Muse Malteser Rakhine Maungdaw All women 107,000 UNHCR Wa Region Pang Kham Peer educators, health care 190,000 PSI Shan (N) facilities, prisons, military, police, karaoke bars, drop- in center, workshops MdM Kachin Myitkyina, Moegaung, Hopin Yangon Mayangone, Insein, Latha, SWs, DUs 5,000 N.okkalapa, S.Okkalapa, Tamwe, N.Dagon, S.Dagon Merlin Ayeyarwady Laputta Men & women of 350,000 DOH reproductive age MMA 8 S/D 45 townships All DOH, UNFPA MMCWA All S/D 325 townships 122,400 IPPF, MOH MRCS Yangon N.Okkalapa, Shwepyitha Adolescent, Youth (15-24 MMA, DOH Bago Daik U, Phyu years and out-of school) Ayeyarwady Maubin MSI Mon Mawlamyine Sex workers 220 Ayeyarwady Pathein 307 Bago Pyay 216 Mandalay 5 MCDC townships, Myingyan 953 + 282 Yangon Thaketa, Thingangyun 211 + 249 SC Tanintharyi Launglone Reproductive age men 13,000 CBO Magway Pakokku Reproductive age men & 1,365 Literature and Kayin Pha-an, Hlaingbwe, Kawkareik women Cultural Mon Mawlamyine, Thaton, Kyaikmaraw, Out-of school youths, Men 600,000 Associations, Paung, Mudon, Chaungzone & women of reproductive Youth leaders, Shan (N) Theinni, Namkham, Namphatkar, age Consortium Muse members UNFPA 11 S/D 30 townships * SW & Clients DOH WV Yangon Hlaingthayar, S.Dagon, Hmawbi Mandalay Chanmyathazi, Pyigyitagun, Youth, Women 16,323 MOH Amarapura Ayeyarwady Thabaung, Pathein Tanintharyi Dawei, Myeik, Kawthaung Shan (E) Kyaington, Tachileik C2 Diagnosis AFXB Yangon 16 townships and Mon Mawlamyine, Kyaikhto, Kyaikmaraw, Youth, PLHAs treatment of Paung RTIs and AMDA Mandalay Meikhtila Villagers 18 STIs Nyaung U 15 Magwe Pakokku Villagers 25 AMI Yangon Dala, Twante, Seikkyi General population 1,500 FHAM Malteser Wa Region Mong Maw, Mong Pawk, Pang Kham Youth, risk groups, 2,200 Shan (N) incarcerated population MdM Kachin Myitkyina, Moegaung, Hopin Yangon Mayangone, Insein, N.okkalapa, SWs, DUs 1,200 Latha, S.Okkalapa, Tamwe, N.Dagon, S.Dagon MMA 8 S/D 45 townships All DOH, UNFPA MMCWA All S/D 325 townships MSI Mon Mawlamyine 679 Ayeyarwady Pathein Women, Men and Youth 1454 Bago Pyay and Risk behaviour group 2496 Mandalay 5 MCDC townships, Myingyan 6724 + 2150 Yangon Thaketa, Thingangyun 2567 + 1993 SC Mon Thaton Out-of school youth, 1,365 MSI General youth UNFPA 11 S/D 30 townships * SW & Clients DOH C3 VCCT for AFXB Yangon 16 townships Youth, PLHAs 127 HIV Mon Mawlamyine, Kyaikhto, Kyaikmaraw, Paung AMI Yangon Dala, Twante, Seikkyi General population 980 FHAM Malteser Wa Region Pang Kham General population 2,720 Shan (N) MdM Kachin Myitkyina, Moegaung, Hopin Mayangone, Insein, N.okkalapa, SWs, DUs 1,500 Yangon Latha, S.Okkalapa, Tamwe, N.Dagon, S.Dagon MMA 8 S/D 45 townships All DOH, UNFPA MMCWA All S/D 325 townships MSI Yangon Thaketa Women, Men and Youth 425 and Risk behaviour group WV Yangon Hlaingthayar, S.Dagon, Hmawbi Mandalay Chanmyathazi, Pyigyitagun, Youth, Women 776 Amarapura Ayeyarwady Thabaung, Pathein Tanintharyi Dawei, Myeik, Kawthaung Shan (E) Kyaington, Tachileik C4 Syphilis AMI Yangon Dala, Twante, Seikkyi General population 581 FHAM screening MdM Kachin Myitkyina, Moegaung, Hopin Yangon Mayangone, Insein, N.okkalapa, SWs, DUs 1,000 Latha, S.Okkalapa, Tamwe, N.Dagon, S.Dagon MMCWA All S/D 325 townships C5 PMTCT AMI Yangon Dala, Twante, Seikkyi General population 3 FHAM MMA 8 S/D 45 townships All DOH, UNFPA MMCWA All S/D 325 townships SC Magway Pakkoku Pregnant mothers & 28,345 husbands, Youth UNFPA 10 S/D 22 townships ** Pregnant mothers, Spouses, Newborns
Antenatal Care
Code Activities Organization State/Division Township(s) Target Group Number Implementing No. beneficiaries Partners covered D1 Home base AMDA Shan (N) Laokai Pregnant women 72 JICA, NATALA records Mandalay Meikhtila, Nyaung U (Preparation of Magwe Pakokku 637 WFP, DOH birth plans) JICA Shan (N) Kyaukme, Naungcho AMW DOH JOICFP Shan (N) Kyaukme, Naungcho Pregnant mothers DOH Malteser Rakhine Maungdaw Women, Children <5 1,000 Merlin Ayeyarwady Laputta/ Pyinsalu Men & women of 350,000 DOH reproductive age MMCWA All S/D 325 townships Pregnant women 122,748 SC Tainintharyi Launglone Pregnant mothers 349 Magway Pakokku Pregnant mothers 1,036 UNFPA 14 S/D 112 townships * Pregnant mothers DOH D2 Immunization AMDA Mandalay Meikhtila, Nyaung U Pregnant women 119 + 1000 JICA, DOH against Tetanus Magwe Pakokku Pregnant women 80 JICA, DOH AMI Shan (N) / Wa Mong Pawk Pregnant women 64 UNFPA, DOH JICA Shan (N) Kyaukme, Naungcho AMW DOH JOICFP Shan (N) Kyaukme, Naungcho Pregnant mothers DOH Malteser Rakhine Maungdaw Women, Children <5 1,400 MMCWA All S/D 325 townships Pregnant women 122,748 MSI Mon Mawlamyine Ayeyarwady Pathein Bago Pyay Mandaly 5 MCDC towns, Myingyan Yangon Thaketa, Thingangyun WV Yangon Hlaingtharyar, S.Dagon, Hmawbi Mothers 23,499 MOH Mandalay Chanmyathazi, Pyigyitagun, Amarapura Ayeyarwady Thabaung, Pathein Tanintharyi Dawei, Myeik, Kawthaung Shan (E) Kyaington, Tachileik D3 Detection and AMDA Shan (N) Laokai Pregnant women 1 JICA, NATALA treatment of Mandalay Meikhtila, Nyaung U Pregnant women 11 + 9 JICA, DOH hypertensive Magwe Pakokku Pregnant women 30 JICA, DOH disorders in AMI Shan (N) / Wa Mong Pawk, Wein Kao, Mong Maw Pregnant women 2,881 ECHO, UNFPA, pregnancy DOH JICA Shan (N) Kyaukme, Naungcho AMW DOH JOICFP Shan (N) Kyaukme, Naungcho Pregnant mothers DOH MMCWA All S/D 325 townships MSI Mon Mawlamyine Ayeyarwady Pathein Bago Pyay Mandaly 5 MCDC towns, Myingyan Yangon Thaketa, Thingangyun UNFPA 14 S/D 112 townships * Pregnant mothers DOH D4 Detection and AMDA Mandalay Meikhtila, Nyaung U Pregnant women 2 + 3 JICA, DOH treatment of Magwe Pakokku Pregnant women 10 JICA, DOH malaria JICA Shan (N) Kyaukme, Naungcho AMW DOH JOICFP Shan (N) Kyaukme, Naungcho Pregnant mothers DOH Malteser Rakhine Maungdaw Women, Children <5 700/month Merlin Ayeyarwady Laputta/ Pyinsalu Men & women of 350,000 DOH reproductive age MMCWA All S/D
D5 Advice on early AMDA Shan (N) Laokai 2 JICA, NATALA detection of Mandalay Meikhtila, Nyaung U 3 + 25 JICA, DOH complications and Magwe Pakokku 3 JICA, DOH danger signs AMI Yangon Dala General Population 3,500 EC Rakhine Buthidaung Pregnant women 4,171 ECHO Shan (N) / Wa Mong Pawk, Wein Kao, Mong Pregnant women 2,881 ECHO, Maw UNFPA, DOH JICA Shan (N) Kyaukme, Naungcho AMW DOH JOICFP Shan (N) Kyaukme, Naungcho Pregnant mothers DOH Malteser Rakhine Maungdaw Women, Children <5 500/month Malteser Merlin Ayeyarwady Laputta/ Pyinsalu Men & women of 350,000 DOH reproductive age MMCWA All S/D 325 townships 2,578,512 MSI Mon Mawlamyine Ayeyarwady Pathein Bago Pyay Mandaly 5 MCDC towns, Myingyan Yangon Thaketa, Thingangyun SC Tainintharyi Launglone Reproductive age 3,600 women, VHV Magway Pakokku Pregnant mothers 1,036 UNFPA 14 S/D 112 townships * Pregnant mothers DOH WV Yangon Hlaingtharyar, S.Dagon, Hmawbi Mothers 23,499 MOH Mandalay Chanmyathazi, Pyigyitagun, Amarapura Ayeyarwady Thabaung, Pathein, Hpan Tanintharyi Dawei, Myeik, Kawthaung Shan (E) Kyaington, Tachileik YWCA Yangon N.Okkalapa, Insein, Thingangyun Women of reproductive age
D6 Provision of AMDA Shan (N) Laokai Pregnant women 72 JICA, NATALA iron / folate AMI Rakhine Buthidaung Pregnant women 4,171 ECHO supplement Shan (N) / Wa Mong Pawk, Wein Kao, Mong Maw Pregnant women 2,881 ECHO, UNFPA, DOH JICA Shan (N) Kyaukme, Naungcho AMW DOH JOICFP Shan (N) Kyaukme, Naungcho Pregnant mothers DOH Malteser Rakhine Maungdaw Women, Children <5 1,500/month Merlin Ayeyarwady Laputta/ Pyinsalu Men & women of 350,000 DOH reproductive age MMCWA All S/D 325 townships Pregnant women 122,748 MSI Mon Mawlamyine Ayeyarwady Pathein Bago Pyay Mandaly 5 MCDC towns, Myingyan Yangon Thaketa, Thingangyun SC Tainintharyi Launglone Pregnant mothers 349 Magway Pakokku Pregnant mothers 880 UNFPA 14 S/D 112 townships * Pregnant mothers DOH WV Yangon Hlaingtharyar, S.Dagon, Hmawbi Mothers 23,499 MOH Mandalay Chanmyathazi, Pyigyitagun, Amarapura Ayeyarwady Thabaung, Pathein, Hpan Tanintharyi Dawei, Myeik, Kawthaung Shan (E) Kyaington, Tachileik D7 Detection and AMDA Shan (N) Laokai Pregnant women 2 JICA, NATALA treatment of Mandalay Meikhtila, Nyaung U Pregnant women 24 + 1000 JICA, DOH anaemia Magwe Pakokku Pregnant women 50 JICA, DOH JICA Shan (N) Kyaukme, Naungcho AMW DOH JOICFP Shan (N) Kyaukme, Naungcho Pregnant mothers DOH Malteser Rakhine Maungdaw Women, Children <5 1,500/month Merlin Ayeyarwady Laputta/ Pyinsalu Men & women of 350,000 DOH reproductive age MMCWA All S/D 325 townships 30,000 MSI Mon Mawlamyine Ayeyarwady Pathein Bago Pyay
Mandaly 5 MCDC towns, Myingyan Yangon Thaketa, Thingangyun D8 Syphilis AMI Yangon Dala General Population FHAM screening and JICA Shan (N) Kyaukme, Naungcho AMW DOH treatment JOICFP Shan (N) Kyaukme, Naungcho Pregnant mothers DOH MMCWA All S/D 325 townships UNFPA 14 S/D 112 townships * Pregnant mothers DOH D9 Treatment of AMDA Mandalay Meikhtila, Nyaung U Pregnant women 3 + 350 JICA, DOH intestinal Magwe Pakokku Pregnant women 150 JICA, DOH parasites Malteser Rakhine Maungdaw Women, Children <5 Merlin Ayeyarwady Laputta/ Pyinsalu Men & women of 350,000 DOH reproductive age YWCA Yangon N.Okkalapa, Insein, Thingangyun All (especially 100 children) D10 Voluntary AMI Yangon Dala General Population FHAM counselling MMCWA Mandalay and testing for SC Pregnant mothers 653 HIV Partners 75
Delivery Care
Code Activities Organization State/Division Township(s) Target Group Number Implementing No. beneficiaries Partners covered E1 Clean delivery practices AMI Shan (N) / Wa Mong Pawk, Wein Kao, Pregnant women 76 ECHO, Mong Maw UNFPA, DOH Rakhine Buthidaung Pregnant women 181 ECHO JICA Shan (N) Kyaukme, Naungcho AMW DOH JOICFP Shan (N) Kyaukme, Naungcho Pregnant mothers DOH Malteser Rakhine Maungdaw Women 300 / month Merlin Ayeyarwady Laputta Men & women of 350,000 DOH reproductive age MMCWA All S/D 91 Maternity Homes Pregnant women 9,903 UNFPA 14 S/D 112 townships Pregnant mothers DOH E2 Administration of oxytocic drugs MMCWA All S/D 91 Maternity Homes in the third stage of labour UNFPA 14 S/D 112 townships Pregnant mothers DOH E3 Routine placenta examination AMI Shan (N) / Wa Mong Pawk, Wein Kao, Pregnant women 76 ECHO, Mong Maw UNFPA, DOH Rakhine Buthidaung Pregnant women 181 ECHO Malteser Rakhine Maungdaw Women 300 / month MMCWA All S/D 91 Maternity Homes 9,903 UNFPA 14 S/D 112 townships Pregnant mothers DOH E4 Administration of parenteral UNFPA 14 S/D 112 townships Pregnant mothers DOH anticonvulsants to treat pre- eclampsia and eclampsia E5 Administration of oral and/or MMCWA All S/D parenteral antibiotics E6 Use of the partograph Merlin Ayeyarwady Laputta Men & women of 350,000 DOH reproductive age MMCWA All S/D 91 Maternity Homes 9,903 UNFPA 14 S/D 112 townships Pregnant mothers DOH E7 Surgery
Neonatal Care
Code Activities Organization State/Division Township(s) Target Group Number Implementing No. beneficiaries Partners covered F1 Prevention and AMI Shan (N) / Wa Mong Pawk, Wein Kao, Neonates 76 ECHO, UNFPA management of Mong Maw hypothermia Rakhine Buthidaung Neonates 181 ECHO JICA Shan (N) Kyaukme, Naungcho AMW DOH JOICFP Shan (N) Kyaukme, Naungcho Women of reproductive age DOH Malteser Rakhine Maungdaw Women 300 / month Merlin Ayeyarwady Laputta Men & women of 350,000 DOH reproductive age MMCWA All S/D 91 Maternity Homes Newborns 9,903 SC Tanintharyi Launglone Pregnant mothers, Birth 1,002 attendants Magway Pakokku Pregnant mothers, Birth 1,036 attendants F2 Prevention and AMI Shan (N) / Wa Mong Pawk, Wein Kao, Neonates 76 ECHO, UNFPA management of Mong Maw infections Rakhine Buthidaung Neonates 181 ECHO JICA Shan (N) Kyaukme, Naungcho AMW DOH JOICFP Shan (N) Kyaukme, Naungcho Women of reproductive age DOH Malteser Rakhine Maungdaw Women 300 / month Merlin Ayeyarwady Laputta Men & women of 350,000 DOH reproductive age MMCWA All S/D 91 Maternity Homes 9,903 F3 Immediate AMI Shan (N) / Wa Mong Pawk, Wein Kao, Pregnant women 76 ECHO, UNFPA initiation of Mong Maw breastfeeding Rakhine Buthidaung Pregnant women 181 ECHO (within first hour) JICA Shan (N) Kyaukme, Naungcho AMW DOH JOICFP Shan (N) Kyaukme, Naungcho Women of reproductive age DOH Malteser Rakhine Maungdaw Women 300 / month Merlin Ayeyarwady Laputta Men & women of 350,000 DOH reproductive age MMCWA All S/D 91 Maternity Homes 9,903 SC Tanintharyi Launglone Pregnant mothers, Birth 1,002 attendants Magway Pakokku Pregnant mothers, Birth 1,255 Minbu attendants F4 Promotion of AMI Yangon Dala General population 3,500 EC exclusive breast JICA Shan (N) Kyaukme, Naungcho AMW DOH feeding (first 6 JOICFP Shan (N) Kyaukme, Naungcho Women of reproductive age DOH months) Malteser Rakhine Maungdaw Women 300 / month Merlin Ayeyarwady Laputta Men & women of 350,000 DOH reproductive age MMCWA All S/D 91 Maternity Homes 9,903 SC Tanintharyi Launglone Pregnant mothers, Birth 1,002 attendants Magway Pakokku Pregnant mothers, Birth 1,255 Minbu attendants F5 Resuscitation of the JICA Shan (N) Kyaukme, Naungcho AMW DOH newborn JOICFP Shan (N) Kyaukme, Naungcho Women of reproductive age DOH Merlin Ayeyarwady Laputta Men & women of 350,000 DOH reproductive age MMCWA All S/D 91 Maternity Homes F6 Umbilical cord care JICA Shan (N) Kyaukme, Naungcho AMW DOH JOICFP Shan (N) Kyaukme, Naungcho Women of reproductive age DOH Malteser Rakhine Maungdaw Women 300 / month Merlin Ayeyarwady Laputta Men & women of 350,000 DOH reproductive age MMCWA All S/D 91 Maternity Homes SC Tanintharyi Launglone Pregnant mothers, Birth 1,002 attendants Magway Pakokku Pregnant mothers, Birth 1,255 Minbu attendants F7 Early detection and AMI Shan (N) / Wa Mong Pawk, Wein Kao, Neonates 76 ECHO, management of Mong Maw UNFPA, DOH neonatal jaundice Rakhine Buthidaung Neonates 181 ECHO JICA Shan (N) Kyaukme, Naungcho AMW DOH JOICFP Shan (N) Kyaukme, Naungcho Women of reproductive age DOH Malteser Rakhine Maungdaw Women 300 / month Merlin Ayeyarwady Laputta Men & women of 350,000 DOH reproductive age MMCWA All S/D 91 Maternity Homes
Postnatal Care
Code Activities Organization State/Division Township(s) Target Group Number Implementing No. beneficiaries Partners covered G1 Development of birth- AMDA Mandalay Meikhtila, Nyaung U Mothers 240 + 120 JICA, DOH spacing plan services Magwe Pakokku Mothers 398 JICA, DOH provision AMI Shan (N) / Wa Mong Pawk, Wein Kao, Mong Maw Women in 4,316 ECHO, UNFPA, reproductive age DOH Rakhine Buthidaung Women in 1,580 ECHO reproductive age JOICFP Shan (N) Kyaukme, Naungcho Pregnant mothers DOH Malteser Rakhine Maungdaw Women 300 / month Merlin Ayeyarwady Laputta/ Pyinsalu Men & women of 350,000 DOH reproductive age MMCWA All S/D 91 Maternity Homes 9,903 WV Yangon Hlaingtharyar, S.Dagon, Hmawbi Mothers 9,615 MOH Mandalay Chanmyathazi, Pyigyitagun, Amarapura Ayeyarwady Thabaung, Pathein Tanintharyi Dawei, Myeik, Kawthaung Shan (E) Kyaington, Tachileik G2 Early detection and AMI Shan (N) / Wa Mong Pawk, Wein Kao, Mong Maw Women in 796 ECHO management of reproductive age puerperal Rakhine Buthidaung Child bearing women 692 ECHO complications JOICFP Shan (N) Kyaukme, Naungcho Pregnant mothers DOH Malteser Rakhine Maungdaw Women 300 / month MMCWA All S/D 91 Maternity Homes 9,903 G3 Detection and AMDA Mandalay Meikhtila, Nyaung U Pregnant women 3000 + 2000 JICA, DOH treatment of malaria Magwe Pakokku Pregnant women 1200 JICA, DOH Malteser Rakhine Maungdaw Women 300 / month
Merlin Ayeyarwady Laputta/ Pyinsalu Men & women of 350,000 DOH reproductive age MMCWA All S/D 91 Maternity Homes 9,903 G4 Advice and support AMI Yangon Dala General population 3,500 EC for breast feeding, Shan (N) / Wa Mong Pawk, Wein Kao, Mong Maw Child bearing women 796 ECHO nutrition and healthy Rakhine Buthidaung Child bearing women 1,126 ECHO life style JOICFP Shan (N) Kyaukme, Naungcho Pregnant mothers DOH MMCWA All S/D 91 Maternity Homes 9,903 G5 Provision of iron / AMI Rakhine Buthidaung Child bearing women 1,126 ECHO folate supplement Shan (N) / Wa Mong Pawk, Wein Kao, Mong Maw Child bearing women 796 ECHO, Malteser Rakhine Maungdaw Women 300 / month Merlin Ayeyarwady Laputta/ Pyinsalu Men & women of 350,000 DOH reproductive age MMCWA All S/D 91 Maternity Homes 9,903 UNFPA 14 S/D 112 townships * Postnatal mothers DOH WV Yangon Hlaingtharyar, S.Dagon, Hmawbi Mothers 5,107 MOH Mandalay Chanmyathazi, Pyigyitagun, Amarapura Ayeyarwady Thabaung, Pathein Tanintharyi Dawei, Myeik, Kawthaung Shan (E) Kyaington, Tachileik G6 Detection and JICA Shan (N) Kyaukme, Naungcho AMW DOH treatment of JOICFP Shan (N) Kyaukme, Naungcho Pregnant mothers DOH anaemia Malteser Rakhine Maungdaw Women 300 / month Merlin Ayeyarwady Laputta/ Pyinsalu Men & women of 350,000 DOH reproductive age UNFPA 14 S/D 112 townships * Postnatal mothers DOH G7 Provision of postnatal AMI Rakhine Buthidaung Child bearing women 354 ECHO care within the first Shan (N) / Wa Mong Pawk, Wein Kao, Mong Maw Child bearing women 220 ECHO, UNFPA, week DOH JICA Shan (N) Kyaukme, Naungcho AMW DOH JOICFP Shan (N) Kyaukme, Naungcho Pregnant mothers DOH Malteser Rakhine Maungdaw Women 300 / month
Merlin Ayeyarwady Laputta/ Pyinsalu Men & women of 350,000 DOH Reproductive age MMCWA All S/D 91 Maternity Homes 9,903 G8 Through review at 6 AMI Rakhine Buthidaung Child bearing women 354 ECHO weeks postpartum Shan (N) / Wa Mong Pawk, Wein Kao, Mong Maw Child bearing women 220 ECHO, UNFPA, DOH JICA Shan (N) Kyaukme, Naungcho AMW DOH JOICFP Shan (N) Kyaukme, Naungcho Pregnant mothers DOH
Merlin Ayeyarwady Laputta/ Pyinsalu Men & women of 350,000 DOH reproductive age MMCWA All S/D 91 Maternity Homes 9,903 UNFPA All S/D 112 townships * Postnatal mothers DOH G9 Immunization against AMI Shan (N) / WA Mong Pawk Under 1 children 59 ECHO, tetanus UNFPA, DOH JICA Shan (N) Kyaukme, Naungcho AMW DOH JOICFP Shan (N) Kyaukme, Naungcho Pregnant mothers DOH Merlin Ayeyarwady Laputta/ Pyinsalu Men & women of 350,000 DOH reproductive age G10 Syphilis screening MMCWA All S/D 325 townships and treatment G11 Voluntary counselling MMCWA Mandalay and testing for HIV
Post-abortion Care
Code Activities Organization State/Division Township(s) Target Group Number Implementing No. beneficiaries Partners covered H1 Post-abortion birth-spacing Malteser Rakhine Maungdaw Women service provision MMCWA All S/D 91 Maternity Homes Post abortion 3,690 cases UNFPA 14 S/D 112 townships Women of DOH reproductive age H2 Counselling on birth spacing and MMCWA All S/D 91 Maternity Homes 3,000 other RH issues for post-abortion UNFPA 14 S/D 112 townships Women of DOH clients reproductive age MRCS Yangon N.Okkalapa, Shwepyitha 6,500 MMA, DOH Bago Daik U, Phyu Ayeyarwady Maubin H3 Manual vacuum aspiration for management of incomplete abortion H4 Prevention and management of Malteser Rakhine Maungdaw Women 5 / month sepsis, tetanus, injury, shock and haemorrhage
Men’s Role in/and Reproductive Health
Code Activities Organization State/Division Township(s) Target Group Number Implementing No. beneficiaries Partners covered M1 Promotion of AFXB Yangon 16 townships Youth, PLHAs 4,000 awareness of sexually Mon Mawlamyine, Kyaikhto, transmitted Kyaikmaraw, Paung infections/HIV/AIDS AMDA Shan (N) Laokai Village Health 28 JICA, Volunteers NATALA AMI Yangon Dala, Twantw, Seikkyi HRM, MSM, CSW 11186 + 967 FHAM + 629(12,772) CARE Mandalay Aungmyaythazan, 15-24 youths both male Mahaaungmyay and female Shan (N) Muse JOICFP Yangon S.Dagon Men of reproductive 15,000 DOH, MMA Bago Bago age Malteser Shan (N) / Wa Pang Kham Police, Military, 1,234 Teachers, Students, PLWHA, Bar/Hotel owners, Truck drivers Merlin Ayeyarwady Laputta Men & women of 350,000 DOH reproductive age MMA 8 S/D 45 townships All DOH, UNFPA MMCWA All S/D 325 townships 1,212,900 SC Tanintharyi Launglone Reproductive age men 2,683 Magway Pakokku Reproductive age men 4,699 UNFPA Yangon Laydauntkan, S.Dagon Men of reproductive Bago Bago age WV Yangon Hlaingtharyar, S.Dagon. Youth, Women 16,523 MOH Hmawbi Mandalay Chanmyatharzi, Pyigyitagun, Amarapura Ayeyarwady Thabaung, Pathein Taninthayi Dawei, Myeik, Kawthaung Shan (E) Kyaington, Tachileik M2 Promotion of men’s AFXB Yangon 16 townships Youth, PLHAs 4,000 role in support of Mon Mawlamyine, Kyaikhto, reproductive health Kyaikmaraw, Paung AMI Yangon Dala General population 600 EC CARE Mandalay Aungmyaythazan, 15-24 youths both male Mahaaungmyay and female Shan (N) Muse Merlin Ayeyarwady Laputta Men & women of 350,000 DOH reproductive age MMA 8 S/D 45 townships All DOH, UNFPA SC Tanintharyi Launglone Reproductive age men 2,683 Magway Pakokku Reproductive age men 4,699 UNFPA Yangon Laydauntkan, S.Dagon Men of reproductive Bago Bago age WV Yangon Hlaingtharyar, S.Dagon. Youth, Women 598 MOH Hmawbi Mandalay Chanmyatharzi, Pyigyitagun, Amarapura Ayeyarwady Thabaung, Pathein Taninthayi Dawei, Myeik, Kawthaung Shan (E) Kyaington, Tachileik M3 Promotion of MMA 8 S/D 45 townships All DOH, UNFPA community SC Tanintharyi Launglone Reproductive age men 2,683 awareness about Magway Pakokku Reproductive age men 4,699 violence against WV Yangon Hlaingtharyar, S.Dagon. Youth, Women 30,795 MOH women Hmawbi Mandalay Chanmyatharzi, Pyigyitagun, Amarapura Ayeyarwady Thabaung, Pathein Taninthayi Dawei, Myeik, Kawthaung Shan (E) Kyaington, Tachileik
* JOICFP’s ‘Adolescent Reproductive Health’ Townships (UNFPA Intensive townships)
State/Division Townships 1. Yangon 1. Kungyangone 2. Thongwa 3. Dala 2. Bago 4. Daik U 5. Oattwin 6. Gyobingauk 7. Pyay 3. Ayeyarwady 8. Zalun 9. Yekyi 10. Nyaungdone 11. Myanaung 12. Hinthada 4. Mandalay 13. Singaing 14. Myitthar 15. Nahtogyi 16. Wundwin 5. Magway 17. Aunglan 18. Taungtwingyi 19. Yenanchaung 20. Chauk 6. Sagaing 21. Myaung 22. Monywa 7. Shan (N) 23. Lashio 8. Shan (S) 24. Pindaya 9. Rakhine 25. Ponnagyun 10. Tanintharyi 26. Dawei 11. Mon 27. Kyaikhto
*** PSI’s Project Townships
State/Division Townships 1. Yangon 1. Ahlone 2. Bahan 3. Dagon Seikkan 4. Dala 5. Dawbon 6. East Dagon 7. Hlaing 8. Hlaingtharyar 9. Hlegu, Dah-pain 10. Insein 11. Kamayut 12. Khayan 13. Kyauktan 14. Kyimyindine 15. Hmawbi 16. Mayangone 17. Mingalataungnyunt 18. Mingaladone 19. N. Dagon 20. N. Okkalapa 21. Sanchaung 22. Shwepyithar 23. S. Dagon 24. S. Okkalapa 25. Taikkyi, Oakkan 26. Tamwe 27. Tontay 28. Thaketa 29. Thingangyun 30.Thongwa 31. Shwepaukkan 32. Yankin 2. Mandalay 1. Amarapura 2. Aung Myay Thar Zan 3. Chan Aye Thar Zan 4. Chan Mya Thar Zan 5. Kyaukpadaung 6. Kyaukse 7. Madayar 8. Maha Aung Myay 9. Meikhtila 10. Myitthar 11. Patheingyi 12. Pyi Gyi Tagon 13. Sintgu 14. Thabeikkyin 15. Tada U 16. Thazi 17. Wundwin 3. Ayeyarwady 1. Kangyidaung 2. Laputta 3. Myaungnya 4. Pathein 5. Hinthada 6. Wakhema 7. Nyaungdone 8. Pantanaw 4. Sagaing 1. Kalay 2. Ayaydaw 3. Chaung U 4. Kantbalu 5. Khin U 6. Monywa 7. sagaing 8. Shwebo 9. Wetlet 10. Ye U 5. Bago 1. Bago 2. Nyaunglaybin 3. Pyuntazar 4. Thanatpin 5. Oaktwin 6. Htantabin 7. Phyu 8. Taungoo 9. Inntakaw 10. Waw 11. Kyauktada 12. Gyobinkauk 13. Letpadan 14. Oatpho 15. Padaung 16. Paungdale 17. Paungde 18. Pyay 19. Shwetaunh 20. Thegone 6. Magway 1. Sinpaungwe 2. Aunglan 3. Magway 4. Minbu 5. Natmauk 6. Pwintphyu 7. Salin 8. Taungtwingyi 9. Yenanchaung 7. Mon 1. Bilin 2. Kyaikhto 3. Kyaik-khami 4. Mawlamyine 5. Mudon 6. Paung 7. Thanbyuzayat 8. Thaton 8. Kayin 1. Kawkareik 2. Hlainbwe 9. Shan (N) 1. Hsipaw 2. Kyaukme 3. Lashio 4. Muse 5. Namkham 6. Naungkhio 10. Shan (S) 1. Kalaw 2. Nyaungshwe 3. Taunggyi 4. Yaksauk Annex C
CAPACITY BUILDING IN REPRODUCTIVE HEALTH
1. Association of Francois-Xavier-Bagnoud (AFXB)
2. Association of Medical Doctors of Asia (AMDA)
3. Aide Medicale International (AMI)
4. CARE International in Myanmar (CARE)
5. Japan International Cooperation Agency (JICA)
6. Japanese Organization for International Cooperation in Family Planning (JOICFP)
7. Malteser International (Malteser)
8. Merlin
9. Myanmar Medical Association (MMA)
10. Myanmar Maternal and Child Welfare Association (MMCWA)
11. Myanmar Red Cross Society (MRCS)
12. Marie Stopes International (MSI)
13. Population Services International (PSI)
14. Save the Children (SC)
15. United Nations Population Fund (UNFPA)
Association Francois-Xavier-Bagnoud (AFXB)
SN Name of Training Trainee (Category and Number) Location Number of Duration Main Topics Training Trainers Findings of Monitoring & Evaluation of training (State/Division - Training of /Subjects Manual Township) Training available 1 Participatory type Youth from vocational training Yangon (16 200 1 hr HIV/AIDS Yes Trained Participants have more knowledge on Peer group centers (375) People from townships) trainers (5) HIV/AIDS compare to birth spacing. They were training small work place (200) Bus and Mon quite happy to get the training and they got the group training Truck drivers (2918) Police (Mawlamyine, chance to make some clarifications on RH. staff (788) Vendors and Kyaikhto, males come to understand that they do have the families of police (703) Peer Kyaikmaraw, role in RH. They really welcome future trainings educator (54) HIV infected and Paung) on RH. affected people (800) 2 200 1 hr Anti Human Yes Trafficking 3 15 1 hr Birth Yes Spacing 4 15 1/2 hr Abortion Yes 5 15 1/2 hr STIs Yes 6 15 1/2 hr Male Yes involvement
Association of Medical Doctors of Asia (AMDA)
SN Name of Training Trainee (Category Location Number of Duration Main Topics/Subjects Training Trainers Findings of and Number) (State/Division - Training of Manual Monitoring & Township) Training available Evaluation of training 1 Awareness of STI/HIV/AIDS 19, WFP volunteer Shan State one 3 days information/prevention yes AMDA staff 80%
2 Basic health knowledge 56 AMDA volunteer Shan State two 5 days personal hygiene/first aid yes AMDA staff 80%
3 First aid training 21 AMDA volunteer Shan State one 2 days Emergency care yes AMDA staff/DOH 90%
4 Rural Health Management & First aid 28 VHV Mandalay/Magwe one 5 days Emergency care yes AMDA expatriates 90%
5 Safe Motherhood & Childbirth 15 AMDA staff Mandalay/Magwe one 2 days delivery stage/RH diseases yes AMDA expatriates 100%
6 Safe Motherhood & Childbirth 62 MW/AMW Mandalay/Magwe three 3 days delivery stage/RH diseases yes AMDA expatriates 100%
7 First aid & effective Health education 114 VHV/MW/AMW Mandalay/Magwe six 2 days Emergency care/ methodology yes AMDA expatriates 90%
Aide Medicale Internationale (AMI)
SN Name of Training Trainee Location Number Duration of Main Topics/Subjects Training Manual Trainers Findings of (Category and (State/Division - of Training available Monitoring & Number) Township) Training Evaluation of training
1 "Safe Motherhood" Health educators YGN Division, 1 1 day Advices for the daily life of a pregnant woman Training Manual AMI (National 7 (3) and Nurses Dala Township (details on the personal hygiene, the rest, the available medical officer) (4) good balance diet, the light exercises) / following WHO importance of the ante-natal care performed guide-lines by a qualified medical professionals (included TT immunization and Iron supplementation) / importance of the birth plan / importance of the early recognition of danger signs during pregnancy / importance of the post-natal care with immediate and exclusive breast-feeding / the importance of family planning after 6 weeks / the importance of the male involvement during the pregnancy and after the child's birth.
2 "Safe Motherhood" Peer educators (8 YGN Division, 6 1 day Same as above but for the level of non- Training Manual AMI (National Among 51 trained, to 9 per training) Dala Township medical trainees available medical officer 45 are still active following WHO and health guide-lines educators) 3 "Family Planning" Health educators YGN Division, 1 1 day Advantages of family planning / Presentation Training Manual AMI (National 7 (3) and Nurses Dala Township of 4 different alternative methods ( male and available medical officer) (4) female condoms, contraceptive pill, following WHO Depoprovera injection, Intra-uterine device ) guide-lines and one definitive (female and male sterilization) / Advices on the importance to seek medical advice for the choice of a contraceptive method and in case of apparition of complications. 4 "Family Planning" Peer educators (8 YGN Division, 5 1 day Same as above but for the level of non- Training Manual AMI (National Among 45 trained, per training) Dala Township medical trainees available medical officer 44 are still active following WHO and health guide-lines educators) 5 "Infant feeding" Health educators YGN Division, 1 1 day Advantages of an exclusive breast-feeding at Training Manual AMI (National 7 (3) and Nurses Dala Township least during the 4 first months of life (MoH available medical officer) (4) recommendation) and then, introduction of the following WHO weaning diet guide-lines 6 "Infant feeding" Peer educators (8 YGN Division, 5 1 day Same as above but for the level of non- Training Manual AMI (National Among 44 trained, per training) Dala Township medical trainees available medical officer 44 are still active following WHO and health guide-lines educators) 7 AMW training 32 AMW (18 in WA(Shan state) 2 6 months According to Government Training Manual Mong Pawk 18 were passed for 1st batch AMW training manual available in TMO & AMI- the first batch, 12 +14 in 2nd) DOH trainer are still under training 8 TBA training-basic* TBA (157 in Buthidaung 20/ 2 weeks According to Government AMI-LHV Among them total) (Rakhine state) training TBA training manual around 140 are still active 9 TBA training- TBA (140) Buthidaung 15/ 5 days AMI-midwife refresher (Rakhine state) training
Remark: TBA training-basic*: TBA-basic trainings were organized in 2004 and we continued only refresher training following WHO recommendation.
CARE International in Myanmar (CARE)
SN Name of Training Trainee Location Number of Duration of Main Topics/Subjects Training Trainers Findings of Monitoring & (Category and (State/Division - Training Training Manual Evaluation of training Number) Township) available
1 HIV/AIDS Outreached Northern Shan- 1 3 days HIV/AIDS Not organization 24 Outreached Workers Workers (24) Muse available 2 Reproductive Health Outreached Northern Shan- 1 3 days RH Not organization 25 Outreached Workers Workers (24) Muse available 3 Gender and DME (Design, Outreached Northern Shan- 1 3 days HIV/AIDS and RH Not organization 26 Outreached Workers Monitoring and Evaluation) Workers (24) Muse available 4 Peer Education and OW(12) and Mandalay 1 3 days HIV/AIDS and RH Not National freelance Training completed only 1 Participation Peer available consultant, month ago Educators(20) organization
5 Peer Education and OW(12) and Northern Shan- 1 3 days HIV/AIDS and RH Not National freelance Training completed only 1 Participation Peer Muse available consultant, month ago Educators(20) organization
Japan International Cooperation Agency (JICA)
SN Name of Training Trainee Location Number of Duration of Main Training Trainers Findings of Monitoring & (Category and (State/Division - Training Training Topics/Subjects Manual Evaluation of training Number) Township) available
1 AMW Refresher Training AMW (120) Shan (Kyaukme 6 3 days Available at Organization NA & Naungcho) DOH (JOICFP), +DOH
Japanese Organization for International Cooperation in Family Planning (JOICFP)
Findings of Location Number Duration Training Trainee (Category Monitoring & SN Name of Training (State/Division of of Main Topics/Subjects Manual Trainers and Number) Evaluation of - Township) Training Training available training
DOH/ JICA/ JOICFP Community-oriented Reproductive Health Project 1 Project Cycle Community 2 3 days Participatory analysis PCM Japanese PC Outcome reflected Management Representatives, Training was live-in of RH situation in the community, method Expert in the plan of Workshop for incl. BHS conducted in with focus on safe motherhood manual with assistants operations for the Naungcho and (each Tsp. 20 Mandalay available from DOH project Kyaukme participants) used by trained by the (one each township) in JICA expert Aug. 2005 2 AMW Refresher AMWs (active) Naungcho, 6 total 3 days comprehensive training DOH/MOH DMO/TMO and Midwifery Training Each 20 Kyaukeme 3 for on midwifery skills based upon Manual with medical officers/ knowledge from Feb. up to participants Townships each DOH/WHO manual additional HA/ LHV at the improved based August, 2006 Up to now 120 in Tsp. incl. communication skills, use of IEC township level upon the pre and for 2 model townships total Home-based Maternal Record and materials with technical post tests; (To be continued) (plan to cover all clean delivery kits provided by input from Contributions to and new ones) the Project Japanese Expert the improvement on Community of the DOH Health training manual Improvement in the training methods
3 Advocacy meetings, Community Naungcho, 2 half Orientation on the Presentations DMO/TMO Project objectives June 2006 Representatives, Kyaukeme one for a day Project: roles and functions on the prepared by Focal point and directions incl. midwives Townships each Tsp & Village Tract Working DOH and medical officers shared and roles of Tsp. Group; Plan on activities and DMO/TMO the project enhancing community support personnel confirmed; and community support ensured
Information, Education for Behaviour Change (MYA/02/P02) 1 Advocacy Training 35 Local 25 townships 25 1 day 1. Community-operated RH Yes Resource persons Community authorities in 10 States 2. UNFPA activities from Participation and NGOs and Divisions 3. Health and RH concepts CHEB/ 4. Problem Identification on RH UNFPA/
5. Micro Planning JOICFP 2 RH/BCC TOT for About 1,600 BHS 25 townships 25 3 days 1. Health education methodology Yes Resource Improvement of BHS in 10 States 2. Effective Communication and persons from training skill and Divisions BCC CHEB 3. Counselling 4. Influence of Behaviour 5. Health and Health education concepts 6. Adult learning 3 BHS TOT for About 1,600 BHS 25 townships 25 2 days 1. Microteaching on RH Yes Resource Improvement of Community in 10 States 2. CSG selection and functions persons from training and Support Group (CSG) and Divisions 3. Identification of RH Problems CHEB communication multiplier training 4. RH topics skills 4 BHS TOT for CSG About 500 BHS 8 townships in 8 2-3 days 1. RH topics refresher training 10 States and 2. Strength and weakness of CSG Divisions 5 CSG Multiplier About 25,000 About 1 day 1. RH topics Yes BHS Improvement of training CSG 1700 knowledge on RH 6 CSG Refresher About 8,000 CSG 8 townships in About 1 day 1. RH topics training 10 state and 600 division 7 RH/BCC Management 180 - TMO, Training was 4 2 days 1. Introduction to Co-RH Yes Resource persons Improved Training Health Staff from conducted in activities from management in 77 non intensive Bagan and 2. RH activities DHP/CHEB/ BCC intervention townships, Health ChaungThar 3. Evaluation indicators UNFPA/ Education 4. Result Based Management JOICFP Officers & 5. BCC/COMBI concept UNFPA field 6. Materials Utilization officers 7. Project Cycle Management 8. Adult Learning principle 9. Micro planning 8 Youth Training 920 youths 23 townships 23 5 days 1. RH topics Yes Improvement in in 10 States 2. Life skills knowledge on RH and Divisions & life skill
Increasing Male Involvement in RH through Effective BCC Strategies (RAS5R304)
1 Central TOT for GPs GPs - 27 Yangon 7 1 day 1. Project Cycle Management Yes Resource person Training skill of and BHS Bago 2 2. Adult Learning Principle from UNFPA, GP improved 3. Behaviour Change JOICFP Communication 4. Training competencies 5. Community Mobilization 6. Effective use of IEC 7. The Art of presentation 8. Male Involvement in RH 9. Gender and sexual health 10. Microteaching on Safe Motherhood, STI/HIV, Male Involvement in RH
2 Multiplier Trainings 252 Frontline Bago 24 1 day 1. Men's role in RH Yes GPs Better score in Health Promoter trainings 2. Men's role in prevention of post test (Male Volunteers) 4 1 day STI/HIV refresher 3. Basic Communication Skill Many FHPs are 4.AN, Delivery, PN and men's involved role in local activities 5. Men's role in prevention of abortion and post abortion care 6. Birth spacing and men's role 7. Reproduction track cancer 8. Sexual dysfunction 9. Menopause 10. Infertility 11. AIDS care 3 Youth Training life 38 youths from Bago 1 4 days ARH and life skills with a focus Yes Resource persons Better score in skills training project sites training on safe motherhood from UNFPA, post test 1 1 day JOICFP and refresher MMA
Malteser International (Malteser)
SN Name of Training Trainee Location Number of Duration of Main Topics/Subjects Training Manual Trainers Findings of (Category and (State/Division - Training Training available Monitoring & Number) Township) Evaluation of training 1 Regular refresher 55 TBAs NRS/Maungdaw 12/year 2 days ANC, PNC, delivery designed by Malteser Malteser midwifes refresher trainings, training for TBAs assistance, nutrition and Malteser staff twice per year
MERLIN MYANMAR (Merlin)
SN Name of Training Trainee (Category and Location Number Duration of Main Topics/Subjects Training Trainers Findings of Monitoring & Number) (State/Division - of Training Manual Evaluation of training Township) Training available
1 Community-Based Health Merlin local staff Yangon 1 5 days Health promotion around YES - DOH DOH NA Activities (CBHA) (14); DOH staff from maternal and reproductive Laputta (10) health 3 Women Child Health Merlin medical staff Yangon 1 11 days IMCI, IMPAC YES - DOH DOH Merlin staff now training Development (WCHD) - (7) and DOH staff CHWs; unsure of DOH TOT (22) 4 Women Child Health Merlin medical staff Pathein 1 6 days IMCI, IMPAC YES - DOH DOH Merlin staff now training Development (WCHD) (2) and DOH staff CHWs; unsure of DOH (~20) 5 Safe Motherhood/Birth Merlin local staff (9) Ayeyaerwaddy 1 3 days Safe motherhood, birth YES Merlin (Dr. Merlin staff now training Preparedness Div - Laputta planning, danger signs Asmatullah Khan) CHWs approach 6 CHW Basic training CHWs selected by Ayeyarwaddy 2 21 days IMCI and Safe YES Merlin local staff Still within 1st few VTHCs (76 across 3 Div - Laputta Motherhood focus and DOH staff months of 1st batch RHCs) completion 7 CHW Refresher CHWs/AMWs Ayeyarwaddy 2 8 days IMCI and Safe YES Merlin local staff Still within 1st few selected by VTHCs Div - Laputta Motherhood focus and DOH staff months of 1st batch (85 across 3 RHCs) completion
Myanmar Medical Association (MMA)
SN Name of Training Trainee Location Number Duration Main Topics/Subjects Training Trainers Findings of (Category and (State/Division - of of Manual Monitoring & Number) Township) Training Training available Evaluation of training
1 2 3 4 5 6 7 8 9 10 1 Workshop on role of GPs in GPs (86) Toungoo and Pyay 2 2 days each Adolescent Health, Antenatal MMA/DOH promotion of reproductive care, Contraception health (1999)
2 Workshop on role of GPs in GPs (103) Pathein and 2 2 days each Adolescent Health, Antenatal MMA/DOH promotion of reproductive Mawlamyaing care, Contraception health (2000)
3 Workshop on role of GPs in GPs (73) Mandalay and 2 2 days each Adolescent Health, Antenatal MMA/DOH promotion of reproductive Taunggyi care, Contraception health (2002)
4 Training of GPs on RH (2003) GPs (358) 25 townships 25 5 days each Client-oriented quality of care, Participant MMA/DOH Client-oriented communication Manual and counseling, Contraception, Post-abortion care, Antenatal care, Newborn care, Postnatal care, RTIs, VCCT 5 Training of GPs on RH (2005) GPs (199) 20 townships 20 5 days each Client-oriented quality of care, Participant MMA/DOH Client-oriented communication Manual and counseling, Contraception, Post-abortion care, Antenatal care, Newborn care, Postnatal care, RTIs, VCCT 6 RH training for workers from Workers from Yangon and Thaton 40 1 day each Anatomy, AN care, PN care, Post RH modules MMA Ministry of Industry (2), Ministry of abortion care, Contraception, Myanmar (2006) Industry (2) Male involvement, Youth (1600) development
Myanmar Maternal Child Welfare Association (MMCWA)
SN Name of Training Trainee Location Number Duration Main Topics/Subjects Training Trainers Findings of (Category and (State/Division - Township) of of Manual Monitoring & Number) Training Training available Evaluation of training 1 Central Training 1/2005 on 4 Ladies+ Central Office 1 5 days Keys person for RH, Female RH training ECM, ED, OGs RH,BCC, TOT Training 1Gent from genital organs and manual of each PTS menstruation, Pregnancy, MMCWA 2 Township Trainings and 36 Ladies+ 9 Kauktan, Tikekgyi, 1 in each 5 days Signs of Pregnancy, Ante RHTM 5 central trainees respective townships Gent each at Hmawbe, Thongwa, township natal care, Natal care, Post for each each township Khayan, Hlegu natal care, Birth spacing, township Sterilization, Abortion, 3 Central Training 2/2005 on Similar as 1/3 Central Office 1 5 days Female Cancer, RTI's, RHTM Same as 1/9 RH,BCC, TOT Training Menopause, infertility, 4 Township Trainings and Similar as 2/3 Kunchangon, Kawthmue, 1 in each 5 days HIV/AIDS, Male RHTM Same as 2/9 respective townships Tontay, Htantabin, township involvement, Reproductive S/Dagon,Dala organs (anatomy and 5 Central Training 3/2005 on Similar as 1/3 Central Office 1 5 days physiology), BCC RHTM Same as 1/9 RH,BCC, TOT Training 6 Township Trainings and Similar as 2/3 Myeik, Kawtthaung, 1 in each 5 days RHTM Same as 2/9 respective townships Dawe, Taunggyi, Kalaw, township Pindaya 7 Central Training 4/2005 on Similar as 1/3 Central Office 1 5 days RHTM Same as 1/9 RH,BCC, TOT Training Township Trainings and Similar as 2/3 Magwe, Thayetchaung, 1 in each 5 days RHTM Same as 2/9 respective townships Thanbuzayat, Kyawktaw, township Maubin, Kyaikmayaw 9 Central Training 1/2006 on Similar as 1/3 Central Office 1 5 days RHTM Same as 1/9 RH,BCC, TOT Training 10 Township Trainings and Similar as 2/3 Shawpyitha, Hlaingthayar, 1 in each 5 days RHTM Same as 2/9 respective townships Lapbatan, Oakpho, Phu, township Tha natpin 11 ARH training 1/2006 ECHO: All STD S/D Training in each
Myanmar Red Cross Society (MRCS)
SN Name of Training Trainee Location Number Duration of Main Topics/Subjects Training Trainers Findings of (Category and (State/Division - of Training Manual Monitoring & Number) Township) Training available Evaluation of training 1 Training of Trainers 25 Red Cross MRCS, Yangon 2 6 days 1. Reproductive Health MRCS's resource person, Volunteers 2. Life skills for Youth OG Professor, Counseling 3. Behavior change communication Team, STD Team, NAP, 4. Birth Spacing Counseling-International 5. STI/HIV/AIDS consultant from Planned 6. Abortion care Parenthood Federation of 7.Project Activities Managements America International 2 Youth Peer Educators 350 Red Cross MRCS, Yangon 8 5 days 1. Reproductive Health Training Volunteers 2. Life skills for Youth 3. Behavior change communication 4. Birth Spacing 5. STI/HIV/AIDS 6. Abortion care 7. Inter personal Communication 8. Gender and sex 9. Counseling 3 Peer Counselor Training 44 Red Cross MRCS, Yangon 2 5 days ARH-SRH counseling Volunteers 4 Project Cycle Management 6 Red Cross MRCS, Yangon 1 4 days 1.Definication and Step of Project training Volunteers 2.SWOT analysis 3.Needs assessment 4.Assess project impact 5.Monitoring &Evaluation 5 Refresher Training For 350 Red Cross MRCS, Yangon 8 3 days Depend on their needs Youth Peer Educators Volunteers 6 Project Sustainability 35 MRCS, Yangon 2 3 days Assess for Business, Planning for International consultant of Business Planning activities NGOs Sustainability & Business Planning from Planned Parenthood Federation of America International
Marie Stopes International Myanmar (MSI)
SN Name of Training Trainee (Category and Location Number of Duration of Main Topics/Subjects Training Manual Trainers Findings of Number) (State/Division - Training Training available Monitoring & Township) Evaluation of training
1 2 3 4 5 6 7 8 9 10 1 Youth Peer Peer Educators (13) Mon State 1 3 days Adolescent Reproductive Handouts for ARH Project Educators (Mawlamyine) Health ARH Training Team InductionTraining Module available Peer Educators (21) Ayeyarwady 1 3 days (Pathein)
Peer Educators (18) Bago (Pyay) 1 3 days
Peer Educators (6) Mandalay (Pyigyitagun) 1 3 days
Peer Educators (21) Mandalay (Myingyan) 1 3 days
Peer Educators (8) Yangon (Tharketa, Thingangyun) 1 3 days Not available Family Planning Victoria, Australia 2 Communication MSIM staff (38) Yangon (Tharketa, 1 2 days Interpersonal Not available Family Planning skills training Thingangyun) communications, Health Victoria, communications Australia 3 Service Provider MSIM staff (12) Yangon 1 3 days Provision of ARH services Not available Family Planning Training (Tharketa, Victoria, Thingangyun Australia
4 Life Skill Training Peer educators (8) Youth Yangon 1 2 days Life skills Not available Training Volunteer Trainers (8) (Tharketa, Consultant Thingangyun
5 STI Training Peer Educators (6) Yangon 2 1 day STI risks, signs and Handouts ARH Project (Tharketa, symptoms, complications, available Team Thingangyun prevention, treatment 6 Training on Family MSIM Center in Charge Mon (Mawlamyine) Induction and 3 days for FP services, Clinical MSI Operations MSIM clinical Planning Services and Nurse (2) yearly CIC Standards, Infection Manual, MSI services and and STI MSIM Center in Charge Mon (Thaton) refreshers 5 days for Prevention, STI Management, Clinical Training training team Management and Nurse (1) Nurse Service Providers Manual, WHO MSIM Center in Charge Ayeyarwady responsibilities, Counselling, STI Manual and Nurse (3) (Pathein) Communication skills, MSIM Center in Charge Bago (bago) and Nurse (3) MSIM Center in Charge Bago (Pyay) and Nurse (3) MSIM Center in Charge Mandalay and Nurse (3) (Pyigyitagun) MSIM Center in Charge Mandalay and Nurse (3) (Myingyan) MSIM Center in Charge Yangon (Thaketa) and Nurse (3) MSIM Center in Charge Yangon and Nurse (3) (Thingangyun)
7 Training on Community Based Mon (Mawlamyine) Induction and 3 days Communication skills, JPIEGO FP MSIM clinical Communication Contributing Agents (10) yearly Counselling services training services and and Counselling refresher manual training team Community Based Ayeyarwady Contributing Agents (41) (Pathein)
Community Based Mandalay Contributing Agents (10) (Pyigyitagun)
Community Based Mandalay Contributing Agents (18) (Myingyan)
Community Based Yangon Contributing Agents (8) (Thingangyun)
Population Services International (PSI)
SN Name of Training Trainee Location Number of Duration of Main Topics/Subjects Training Trainers Findings of (Category and (State/Division - Township) Training Training Manual Monitoring & Number) available Evaluation of training 1 Skills building training on 670 Yangon, Mandalay, 34 times 3 days/ each birth spacing, Counseling Available Franchising RH Sagaing, Bago, training contraceptive methods and team Ayeyarwaddy, contraceptives - pills, Mon, injections, IUDs, condoms Magway, S. Shan, N. Shan 2 STI training 198 Yangon, Mandalay, 15 times day/ each STI and syndromic Available Franchising Sagaing, Bago, training treatment team Ayeyarwaddy, Mon, Magway, S. Shan, N. Shan
Save the Children (SC)
SN Name of Training Trainee Location Number of Duration of Main Topics/Subjects Training Trainers Findings of Monitoring & Evaluation (Category and (State/Division - Training Training Manual of training Number) Township) available 1 Safe motherhood village health Magway/ 55 2days Anatomy of reproductive Training SC staff The trainees disseminate their training team members, Pakokku, Minbu, organs, physiology of notes knowledge to the pregnant mothers. TBA Tanintheryi/ menstruation, AN care, available, Pregnant mothers are practicing six LaungLone intranatal care, post natal Flip chart cleans, early recognition of danger care, danger signs during available signs and early referral. Pregnant pregnancy, delivery and mothers taking iron tablets more post natal period. Six than 180, and receiving 2 TT cleans immunization
2 Prevention of HIV/AIDS Village health Magway/ 77 1day Mode of transmission, Training SC staff The trainees disseminate their teams, Youth Pakokku, Minbu, preventive methods, risky notes knowledge to the reproductive age groups Tanintheryi/ behaviour, Clinical signs available, men and women including youth LaungLone and symptoms of AIDS/ Flip chart groups, increased condom demand STI. Condom available and usage, avoidance of risky demonstration behaviors and reduce stigma and discrimination on HIV/AIDS
3 Training on Village health Magway/ 45 1day Types of contraceptives, Training SC staff Increase in CPR in project area, contraceptives teams Pakokku, how to use it notes reduced abortion among teen age Tanintheryi/ available, LaungLone Maggie's Apron 4 PMCT village health Magway/ 28 1day Primary prevention, Mode Training SC staff, Increased in VCT among pregnant team, AMWs, Pakokku, Minbu, of transmission, notes, STD team mothers and their husband., TBA, BHS Tanintheryi/ importance of VCT, how training trained BHS increased in CPR LaungLone to stay fit for HIV + module and in mothers, infant feeding Flip chart collaboration options, exclusive breast available with SC feeding, measures to reduce MTCT, Home based care. 5 Newborn care village health Magway/ 75 2 days Danger signs of new born, Training SC staff early initiation of breast feeding, team, AMWs, Pakokku, Minbu, Breast feeding, Care of notes early recognition of danger signs, TBA Tanintheryi/ new born, resuscitation of available early referral LaungLone birth asphyxia at community level 6 Life skills training village health Magway/ 55 2 days Communication skills, Training SC staff increased age of marriage, proper team, youth Pakokku, Minbu, problem solving skills, module utilization of leisure time groups Tanintheryi/ value, negotiation skills, available LaungLone decision skills, self esteem,
7 Life skills workshop on Out of school Kayin, Mon, Shan 1884 1 or 2 days HIV/AIDS; ARH; STIs; Fledgling SC staff ARH youth (N) Life skills 1&2 (Proj. Asst., Out Reach Workers)
United Nations Population Fund (UNFPA)
SN Name of Training Trainee Location Number of Duration of Main Topics/Subjects Training Trainers Findings of Monitoring & (Category and (State/Division - Training Training Manual Evaluation of training Number) Township) available
1 Training on PCPNC BHSs All states/divisions 5 days available DOH (Pregnancy, Childbirth, (112 townships) MCH section Postnatal and Neonatal Care)
2 Training on RH Programme TMOs All states/divisions 5 days available DOH Management (112 townships) MCH section 3 Training on RH Counselling BHSs All states/divisions 5 days available DOH (112 townships) MCH section 4 Training on ARH Counselling BHSs All states/divisions 5 days available DOH (112 townships) MCH section 5 Training on insertion of IUD BHSs 2 days OGs
6 Training on RH MIS BHSs All states/divisions 4 days available DHP
7 Training of Statisticians on RH Statisticians (112 townships) 4 days available DHP MIS
Annex D
RESEARCH STUDIES
1. CARE International in Myanmar (CARE)
2. Japan International Cooperation Agency (JICA)
3. Japanese Organization for International Cooperation in Family Planning (JOICFP)
4. Merlin
5. Myanmar Maternal and Child Welfare Association (MMCWA)
6. Myanmar Red Cross Society (MRCS)
7. Save the Children (SC)
CARE International in Myanmar Research When Where Study Key Findings Published Topic (year) (State/Division Population (Yes/No) – Townships) A KABPP 2006 Northern Shan 231 young - Young people As we have Study on State (Muse) men and 229 knew more of just finished, Sexual and and young reproductive health it is not Reproductive Mandalay women than HIV/AIDS and published Health of Division STIs. Youth in both yet. Young (Mandalay study areas had more People (15- or less the same 24 years) in level of SRH. Mandalay - They revealed and Muse almost similar positive attitudes and practices - There was a gap between knowledge and safer sex practices and attempts to prevent unwanted pregnancies among sexually active youth - Studied young people were positive towards and eager to describe their vision of youth friendly services preferring IEC
Japan International Cooperation Agency (JICA)
Research Topic When Where Study Key Findings Published (year) (State/Division Population (Yes/No) – Townships) RH Services 2005 Shan (N) No Facility Kyaukme & Assessment Naungcho Midwifery-trained 2005 Shan (N) No Personnel’s Kyaukme & Performance for Naungcho Antenatal Care Midwifery-trained 2005 Shan (N) No Personnel’s Ability Kyaukme & Communication Naungcho with Clients Midwifery-trained 2005 Shan (N) No personnel’s Kyaukme & performance Naungcho delivery care Midwifery-trained 2005 Shan (N) No personnel’s Kyaukme & knowledge Naungcho obstetric complications Midwifery-trained 2005 Shan (N) No personnel’s Kyaukme & performance Naungcho postnatal care
Japanese Organization for International Cooperation in Family Planning (JOICFP)
Research Topic When Where Study Population Key Findings Published (year) (State/Division (Yes/No) – Townships) Baseline Data 2005 - Bago Total 1021 Inadequate Being Collection and Division/ Bago - 856 reproductive knowledge printed Behaviour Study Township aged men (Baseline and practice on Male - Yangon data collection in) of men on Involvement in RH Divsion/ South - 60 married men RH in spite (JOICFP executed Dagon and 26 married of a UNFPA funded Township women (IDI) generally Increasing Male - 12 service providers favourable involvement in RH and attitude through Effective - 12 influential (IDI) BCC Strategies - 55 community men RAS5R304) (FGD)
Health 2005 - Shan State/ - All RHCs + 5 Needs in the Being Infrastructure and Kyaukme and selected Sub RHCs current printed Quality of RH Naungcho - 8 FGDs (4 urban and situation of Services Townships 4 rural) health Qualitative study - 114 service infrastructure Baseline survey providers interviewed especially in Part I (59 in Kyaukme and RH services (DOH/ JICA/ 55 in Naungcho) identified JOICFP Community Oriented Reproductive Health Project)
Merlin
Research When Where Study Key Findings Published Topic (year) (State/Division Population (Yes/No) – Townships) KPC November Ayeyarwaddy 476 mothers See notes below Report survey 2005 Division – of children available Laputta under 2 years upon Township request Formative March Ayeyarwaddy 104 mothers Study highlights a Report research 2006 Division – of young critical lack of available Laputta children; awareness of maternal, upon Township 64 Mother- newborn and child request in-laws; health issues among 70 fathers; communities of Laputta 16 TBAs Township. Traditional values, cultural norms, and religious beliefs influence many behaviors related to health which can, at times, put lives at risk
KPC key findings:
Knowledge: Weakest areas: • A very small proportion of mothers knew three or more newborn and maternal-related (pregnancy, delivery and postpartum) danger signs; • Only a small proportion had knowledge about birth planning/preparedness; • Very few mothers knew two or more danger signs associated with diarrhoea or pneumonia; • Only one third of mothers knew that TT immunisation protects mother and child from contacting tetanus (maternal and newborn); • A negligible proportion of mothers knew about exclusive breastfeeding and when to initiate complementary feeding; • Only 6% of mothers knew the correct number of times a child had to be vaccinated to make sure s/he was fully immunized and few could name all six vaccine preventable diseases included in the EPI program; and • Only 11% of mothers could demonstrate how to prepare ORS correctly.
Stronger areas: • Almost half of the mothers knew that protein-rich foods and green leafy vegetables could prevent anaemia; • The vast majority of the mothers named one or more method of modern family planning and sources for family planning supplies; • The vast majority of the mothers had heard of AIDS; • Two thirds of the mothers knew that one can get malaria through mosquito bites; and • The vast majority of the mothers reported that they knew to treat water to make it safe.
Practices: Weakest areas: • Women are not eating as much as they should during pregnancy, only one third of them are consuming more food than usual;
• The vast majority of children are being delivered at home and only one in four are being delivered by a trained and skilled health professional; • A razor blade was used for cutting the umbilical cord in only 42% of instances and in only one in five of occasions was the instrument boiled before use; • In a little over half of cases the newborn cord was cut just after delivery while in one in four cases the cord was cut after placenta was delivered. While waiting for placenta to be delivered, the vast majority of the newborns were kept uncovered. After cutting the cord half of the children were placed next to the mothers; • In almost all cases something was applied to the stump after cutting of the umbilical cord; • Nearly two thirds of the newborns were bathed on the same day, with a very vast majority of them within first hour after birth; • A very small proportion of infants under six months (<10%) were being exclusively breastfed; • Only one-third of women who are not currently pregnant and do not want another child are using a modern family planning method and only one in four are using their preferred method; • Hand washing rates are low despite the availability of soap and water in a majority of houses; and • Mothers are using home remedies, pills and syrup to treat diarrhoea rather than ORS and increased breastfeeding. Only 15% of mothers treated with ORS.
Stronger areas: • Almost all the mothers had breastfed their child at some time and the very vast majority among them were currently breastfeeding their children; • Nearly half of the mothers initiated breastfeeding immediately within first hour of delivery; • Nearly half of the women are boiling water before use, and one in four are either filtering or settling it; • In the majority cases health care was sought outside the home for children suffering from malaria and cough/difficult breathing; and • The very vast majority of the household were had and slept under bed nets.
Coverage: Weakest areas: • Only about one third of mothers attended two or more ANC sessions during their most recent pregnancy, according to card and recall. In two thirds of cases, these services were provided at private clinics with the vast majority being provided by midwives. Among those who never went for ANC, the most common reasons for not attending were cost, distance, and being unaware of its importance; • A negligible proportion of mothers received adequate postpartum care; • One in five mothers received a dose of vitamin A supplement after their most recent delivery; • Only 15% of children had growth monitoring cards and of these only about one quarter had been weighed in the last four months according to the card; • Less than one third of children had a vaccination card and only one third of the children between 12 and 23 months of age with cards were fully immunized; • More than one third of children had never been vaccinated. The most common reasons noted for never receiving a vaccine were misconceptions and poor coordination of outreach activities (no one came to community for vaccinating children, unaware someone had come, etc); and • The health care providers of choice are untrained private practitioners (village pharmacy/shopkeepers, family members, friends/neighbours, traditional healers etc) particularly for the treatment of diarrhoea and pneumonia in children and the provision of advice on health and nutrition. They are the second most popular provider for ANC and PPC while untrained TBAs are the first choice for assistance at delivery, followed by trained TBAs/auxiliary midwives.
Stronger areas: • Nearly half of mothers had received two or more doses of Tetanus Toxoid vaccine when measured by card and recall;
• Just over half of the mothers took iron/folic supplements in their recent pregnancy; • Nearly half of the children between 6 and 23 months of age had received Vitamin A; • Just over one third of the women are using methods of modern family planning contraception; and • Public health facilities are among the first choices for accessing family planning supplies.
Myanmar Maternal and Child Welfare Association (MMCWA)
Research Topic When Where Study Key Findings Published (year) (State/Division Population (Yes/No) – Townships) Anaemia in 2006 Kayin State pregnancy Safe motherhood 2006 Chin State 1498 Safe motherhood 2006 Mon State Yangon Safe motherhood 2006 Division Mandalay PMCT 2006 530 Division Shan East AN Care 2006 608 State
Myanmar Red Cross Society (MRCS)
Research Topic When Where Study Key Findings Published (year) (State/Division – Population (Yes/No) Townships) Rapid survey 2001 Yangon Division - Youth 1.Knowledge of No for Youth to 1. North Okkalapa (15-24 years) STDs, Pregnancy Youth: Peer 2. Shwe Pyi Thar 2.Sexual Education for experience and Reproductive Ayeyarwaddy STDs Health Program Division 3.Premarital sexual in the selected 1. Maubin activity Townships 4.Attitudes towards an use of condoms 5.Contraceptive use among married females 6.Knowledge about puberty an sexuality 7.Other risk behaviors End-line survey 2004 Yangon Division: 1.Knowledge No for Youth to 1. North Okkalapa Youth about Sexually Youth: Peer 2. Shwe Pyi Thar: (15-24 years) Transmitted Education for Infections Reproductive Ayeyarwaddy among young
Health Program Division: people in the selected 1. Maubin 2.Premarital sex Townships Bago Division: activity among 1. Phyu male youth 2. Daik-U 3.Consequences of Premarital Sex 4.Sexual experience with CSW and condom used 5.Attitudes towards the use of condoms 6.Self reported STD infection
Save the Children (SC)
Research When Where Study Key Findings Published Topic (year) (State/Division Population (Yes/No) – Townships) Behavioural 2002 Northern Shan 576 No Surveillance Survey Youth 2004 Kayin State 6002 No Behaviour Mon State Survey
Annex E
Opinions, Perceptions and Attitudes on Organization Performance in Reproductive Health
Opinions, perceptions and attitudes on organization performance in reproductive health
Very Moderate Slight Uncertain Don’t Opinions, perceptions and attitudes much know % % % % %
Interest in RH
Gives priority to RH among others 56.3 25.0 18.8 0.0 0.0 Gives priority to base-line studies before 66.7 20.0 13.3 0.0 0.0 service implementation (n=15)* Gives priority to draw a training 35.7 35.7 14.3 14.3 0.0 curriculum (n=14)* Interest in health promotion (n=15)* 60.0 33.3 6.7 0.0 0.0 Interest in improved quality and access to 60.0 26.7 13.3 0.0 0.0 services (n=15)* Interest in partnership and networking 53.3 20.0 26.7 0.0 0.0 (n=15)* Interest in capacity building (n=15)* 73.3 26.7 0.0 0.0 0.0 Interest in sustainability (n=15)* 80.0 6.7 13.3 0.0 0.0
The plan and scope of the organization
The goal set for RH activities is strong. 43.8 43.8 12.5 0.0 0.0 Targets set are achievable. 37.5 56.3 6.3 0.0 0.0 The present scope of RH activities is 25.7 40.0 25.7 6.7 0.0 broad. (n=15)*
Organization efforts in implementation
Our organization can build a rapport with 46.7 33.3 6.3 12.5 0.0 public sector services in RH (n=15)*. Our organization can build a rapport with 42.9 28.6 14.3 7.1 7.1 other local NGOs in RH. (n=14)* Our organization can build a rapport with 46.7 40.0 13.3 0.0 0.0 other international NGOs in RH (n=15)*. Our organization can build a rapport with 13.3 53.3 20.0 6.7 6.7 other faith-based organizations in RH (n=15)*. Our organization has open discussions on 50.0 37.5 6.3 0.0 6.3 RH plans with donor agencies. Advocacies on RH by our organization to 40.0 33.3 20.0 6.7 0.0 community members are adequate (n=15)*. Advocacies on RH by our organization to 21.4 35.7 28.6 7.1 7.1 other stake holders are adequate (n=14)*. Budgetary allocation of our organization 26.7 26.7 20.0 26.7 0.0 for RH activities is adequate. (n=14)* Capacity building of staff in our 13.3 73.3 6.7 6.7 0.0 organization to implement RH activities is adequate (n=14)*.
Efforts of our organization in capacity 33.3 53.3 13.3 0.0 0.0 building of the target audience in RH are adequate (n=15)* Dissemination of RH information/feed- 12.5 43.8 12.5 31.3 0.0 back by our organization to partnership networks in Myanmar is adequate.
Efforts in management decision-making, monitoring and supervision
Top-down decisions in management of 20.0 40.0 20.0 6.7 13.3 RH activities in our organization is adequate (n=15)*. Bottom-up decisions in management of 40.0 33.3 13.3 0.0 13.3 RH activities in our organization is adequate (n=15)*. We have a built-in monitoring system for 46.7 33.3 6.7 13.3 0.0 RH activities (n=15)*. Supervisions in implementation of RH 46.7 26.7 26.7 0.0 0.0 activities by our organization are adequate (n=15)*.
Power of the organization
Our organization has influence on other 6.7 33.3 20.0 20.0 20.0 partners in carrying out RH activities in Myanmar. (n=15)* The position of our organization in RH is supportive or likely to be supportive of RH policy and plans in Myanmar. • In the past (n=13)* 25.0 37.5 12.5 6.3 0.0 • Current (n=14)* 28.6 57.1 7.1 7.1 0.0 • Future (n=14)* 57.1 21.4 0.0 14.3 7.1
Gaps and constraints
Gaps between capacity of our staff and 0.0 20.0 80.0 0.0 0.0 their performances in RH Gaps between targets and actual 0.0 40.0 60.0 0.0 0.0 implementation of RH Sometimes delays in implementation are due to problems in: • Funds (n=15)* 26.7 26.7 26.7 20.0 0.0 • Commodities (n=13)* 23.1 23.1 30.8 23.1 0.0 *Total does not add up to 16 due to missing values.
Annex F
Questionnaires
FORM A : Profile of the Organization
FORM B : Current activities on Reproductive Health
FORM C : Information on Capacity Building in Reproductive Health
FORM D : Information on Research in Reproductive Health
FORM E : Opinions, perceptions, and attitudes on organization performance
FORM A: PROFILE OF AN ORGANIZATION
Name of Organization:………………………………………………………….
SN Questions Code 1. When did your organization start activities in Myanmar? /____/ 2. What is the mission of your organization?
3. When did your organization start activities in reproductive health in Myanmar? /____/
4. What are your areas of expertise in comprehensive reproductive health package?
5. Who are your implementing partners in reproductive health?
Public sector (please specify departments related to RH):
Local NGO: (please specify):
International NGO (please specify):
United Nations Agencies (please specify):
Others (please specify):
6. Number of staff in RH activities (Top officials to township level): /__ __/ 7. Future plan for RH activities (scaling up / tail off / same):
FORM B: Current Activities on Reproductive Health by Organization
Name of Organization:
No.beneficiaries Implementing Activities Package State/Division Township(s) Target Group Code covered Partners No. Col. 1 Col. 2 Col. 3 Col. 4 Col. 5 Col. 6 A ARH A1 Provision of sexual and RH information for young people A2 Youth friendly clinics/centers B Birth spacing and contraceptives B1 Emergency contraception B2 Oral contraception B3 Monthly and/or three monthly injectables B4 IUDs B5 Female sterilization C STI/RTI/HIV/AIDS C1 Condom promotion C2 Diagnosis and tretament of RTIs and STIs C3 VCCT for HIV C4 Syphilis screening and treatment C5 PMTCT D Prenatal care D1 Home based records (preparation of birth plans) D2 Immunization against tetanus D3 Detection and treatment of hypertensive disorders in pregnancy D4 Detection and treatment of malaria D5 Advice on early detection of complications and danger signs D6 Provision of iron and foliate supplement D7 Detection and treatment of anaemia D8 Syphilis screening and treatment D9 Treatment of intestinal parasites D10 VCCT for HIV E Delivery care E1 Clean delivery practices E2 Administer oxytocic drugs in the third stage of labour E3 Routine examination of placenta E4 Administer parenteral anticonvulsants to treat pre-eclampsia and eclampsia E5 Use of the partograph E6 Administer oral and/or parenteral antibiotics E7 Perform surgery F Neonatal care F1 Prevention and management of hypothermia F2 Prevention and management of infections F3 Promotion of initiation of breastfeeding within 1 hour F4 Promotion of exclusive breastfeeding (first 6 months) F5 Resuscitation of the newborn F6 Care of the umbilical cord F7 Early detection and management of neonatal jaundice G Postnatal care G1 Development of birth spacing plan and birth spacing service provision G2 Early detection and management of complications of puerperium G3 Detection and treatment of malaria G4 Advice and support for breast-feeding, nutrition, and healthy life style G5 Provision of iron/folate supplement G6 Detection and treatment of anaemia G7 Provision of postnatal care within the first week G8 Thorough review at 6 weeks post partum G9 Immunization against tetanus (if not done during ANC) G10 VCCT for HIV (if not done during ANC) G11 Syphilis screening (if not done during ANC) H Post-abortion care H1 Post-abortion birth spacing service provision H2 Counselling on birth spacing and other reproductive health issues for post- abortion clients H3 Manual vacuum aspiration for management of incomplete abortion Prevention and management of sepsis, tetanus, injury, shock and H4 haemorrhage J Gynaecological cancer J1 Cervical cancer screening and treatment J2 Breast cancer screening and treatment
K Subfertility K1 Please specify L Postmenopausal reproductive health L1 Counselling, including lifestyle and nutrition M Men's reporductive health M1 Promotion of awareness of STI/HIV/AIDS M2 Promotion of men's role in support of RH M3 Promotion of community awareness about violence against women
FORM C: Information on Capacity Building in Reproductive Health
Name of Organization:
Trainee Findings of Location Number Duration Training (Category Monitoring & SN Name of Training (State/Division of of Main Topics/Subjects Manual Trainers and Evaluation of - Township) Training Training available Number) training 1 2 3 4 5 6 7 8 9 10
FORM D: INFORMATION ON RESEARCH IN REPRODUCTIVE HEALTH (conducted in last 3 years)
Research When Where Study Key Findings Published Topic (year) (State/Division Population (Yes/No) – Townships)
FORM - E
SECTION I: OPINIONS, PERCEPTIONS & ATTITUDES ON ORGANIZATION PERFORMANCE IN REPRODUCTIVE HEALTH
Please circle the most appropriate one from the given scale reflecting your opinions, perceptions, and attitudes on performances of your organization in reproductive health (RH).
Codes: 1 = very much; 2 = moderate; 3 = slight; 4 = uncertain; 5 = don’t know
SN Questions and filters Codes 1. Our organization gives priority to RH among others. 1 2 3 4 5 2. To my opinion, the goal set for RH activities of our organization is strong. 1 2 3 4 5 3. Targets set for specific RH activities by our organization are achievable. 1 2 3 4 5 4. Present scope of our organization in RH activities is broad. 1 2 3 4 5 5. Our organization can build a rapport with public sector services in RH. 1 2 3 4 5 6. Our organization can build a rapport with other local NGOs in RH. 1 2 3 4 5 7. Our organization can build a rapport with other international NGOs in RH. 1 2 3 4 5 8. Our organization can build a rapport with other faith-based organizations in 1 2 3 4 5 RH. 9. Top-down decisions in management of RH activities in our organization is 1 2 3 4 5 adequate. 10. Bottom-up decisions in management of RH activities in our organization is 1 2 3 4 5 adequate. 11. Our organization has open discussions on RH plans with donor agencies. 1 2 3 4 5 12. Advocacies on RH by our organization to community members are 1 2 3 4 5 adequate. 13. Advocacies on RH by our organization to other stake holders are adequate. 1 2 3 4 5 14. Budgetary allocation of our organization for RH activities is adequate. 1 2 3 4 5 15. Capacity building of staff in our organization to implement RH activities is 1 2 3 4 5 adequate. 16. Efforts of our organization in capacity building of the target audience in RH 1 2 3 4 5 are adequate. 17. Our organization gives priority to base-line studies before service 1 2 3 4 5 implementation. 18. We have a build-in monitoring system for RH activities. 1 2 3 4 5 19. Supervisions in implement 1 2 3 4 5 ation of RH activities by our organization are adequate. 20. Our organization gives priority to draw a training curriculum. 1 2 3 4 5 21. There are gaps between capacity of our staff and their performances in RH 1 2 3 4 5 activities. 22. There are gaps between targets and actual implementation of RH activities 1 2 3 4 5 by our organization. 23. Sometimes delays in implementation are due to problems in: • Funds 1 2 3 4 5 • Commodities 1 2 3 4 5 • Other (please specify) 1 2 3 4 5 24. Dissemination of RH information/feed-back by our organization to 1 2 3 4 5 partnership networks in Myanmar is adequate. 25. Our organization has influence on other partners in carrying out RH 1 2 3 4 5 activities in Myanmar. 26. The position of our organization in RH is supportive or likely to be supportive of RH policy and plans in Myanmar. • In the past 1 2 3 4 5 • Current 1 2 3 4 5 • Future 1 2 3 4 5 27. The interest of our organization in RH is in: • Health promotion. 1 2 3 4 5 • Improved quality and increase access to services 1 2 3 4 5 • Partnership and networking 1 2 3 4 5 • Capacity building 1 2 3 4 5 • Sustainability 1 2 3 4 5 • Other (please specify) 1 2 3 4 5
SECTION II: EXPECTATIONS AND SUGGESTIONS
Please express your personal expectations freely. Please write down the services that you think is necessary to expand in future by your organization in order of priority.
28. I would like to expand the following RH services by our organization in coming years (supposing 2007-2011)
(1) ------(2) ------(3) ------
29. Please give suggestions on following areas freely to improve RH services carried out by your organization:
(1) Resources mobilization
(2) Cultural fitness
(3) To achieve sustainable impact upon target audience
(This questionnaire is aimed to obtain the views on organizational performance and anonymity will be maintained.)