SWAN RH Awareness & Data Collection Training Course Report Ban Nam Resort Mae Sai District, Chiang rai 19-25 September 2016 1 1. Overview: This is the sixth consecutive year that SWAN has conducted RH Awareness & Data Collection Training courses aimed at expanding reproductive health-family planning- maternal and child health service delivery in rural/remote areas of the Shan State of northern Burma. In preparation for this training exercise Ms. Hearn, the Programs Director of the SWAN Health Program, asked SWAN team members working in Kali/Kunhing, Kesi, and Mong Hsu townships to help identify friends and colleagues living in nearby communities to see if the latter would like to receive refresher training as well as become part of the expanded SWAN reproductive health service delivery network in these 3 townships. Ms. Hearn also contacted several Shan/Tai NGOs and CBOs operating in different sections of the Shan State to see if they could similarly help identify health workers that would like to attend this special training course as well as join SWAN's efforts to increase access to basic reproductive-family planning-maternal and child health services to underserved communities. The SWAN sponsored RH Awareness & Data Collection Training Workshop took place over a 7 day period [i.e. from 19-25 September 2016] at the Ban Nam Resort located in Mae Sai district of Chiang rai province; approximately 15 kms from the Thai-Myanmar/Shan State border. This training site was selected in order to make it easy for the many participants, from the Shan State, to reach the training venue site. It also made it convenient for the different trainers, all of whom live in Chiang mai, to attend the workshop. Table I indicates the names, as well as other demographic/professional data, regarding the 31 participants invited to attend the RH Awareness & Data Collection Training Course. 2. The RH-FP & Data Collection Training Course: As mentioned in other reports, the 5-day RH-FP & Data Collection Training session focuses on various aspects of reproductive health. The first 2 1/2 days of this training component includes topics such as human reproduction, normal vaginal delivery, complicated delivery [e.g. requiring a Cesarean Section procedure], the benefits of FP services, the manner in which each modern FP method [as well as Natural FP Method] works to prevent an "unwanted pregnancy" [and/or to prevent STIs], and other relevant topics related to the provision of FP services at the village/household level. The final 2 days of this segment of the training session is devoted to (a) teaching the trainees the importance of routinely collecting relevant data from each household/village that can help identify important health issues and problems, (b) how to use this data to possibly identify topics for further in-service/refresher training, (c) how to enumerate data onto village household demographic-FP-vital events "recording" and "reporting" forms so that SWAN health workers can calculate "key health indicators" or "key vital events rates" [e.g. CBR, CDR, PGR, IMR, CMR, MMR, and CPR] to assess the health status of villagers [especially mothers and young children], and (d) how to use the village household survey data, collected each year, to evaluate the impact of specific SWAN health services [e.g. family planning] on improving the health status of women and young children as well as in reducing infant, early childhood, and maternal mortality rates/ratios. 3. Topics Covered in the RH-FP & Data Collection Training Course: 3.1. RH-FP Training Component: As indicated above the RH-FP training component covered a wide range of subjects that included the following topics: (a) human anatomy, focusing on the male and female reproductive organs, (b) the process in which eggs are produced and released from the ovaries [i.e. ovulation] as well as the process in which sperm are produced 2 in the testis and proceed to enter the female reproductive system during sexual intercourse, (c) how fertilization/conception takes place, leading to a pregnancy and the beginning of a new life, (c) the normal 9-month gestation development process, (d) the different stages of a normal vaginal birth/delivery, (e) the conditions under which an abdominal or "Cesarean Section" delivery should take place, (e) what is meant by the term "family planning" as well as the different types of individuals who should know about and/or have access to FP services to prevent unwanted pregnancies or to prevent STIs, (f) a review of major STIs and how each type of infection can potentially adversely affect the health of the patient, his/her partner, and/or the unborn/newly born child, (g) a detailed review of all FP methods, highlighting the fact that all are "safe" and "effective", but not necessarily meant to be taken by all interested clients, (g) a detailed review of all FP methods, focusing on the way in which they prevent unwanted pregnancies and/or STIs; including sub-topics such as, client eligibility, the time when to initially start using/taking each FP method, the manner in which to correctly continue using each FP method, what measures to take if one inadvertently does not use the method properly [e.g. forgets to take daily Oral Contraceptives], common side effects, contra-indications and/or potential problems associated with each FP method, and any other relevant information concerning the different FP methods. Uncle Stan providing comments, to trainees, on how to better use health education materials to explain to villagers the manner in which hormonal contraceptives prevent ovulation 3 Trainees explaining, by using FP health education materials, how a "male sterilization" prevents sperm from meeting an egg during sexual intercourse 3.2. Data Collection Training Component: The Data Collection Training session teaches trainees (a) the manner in which to conduct village household surveys as well as how to actually collect and enumerate data onto specific Demographic-FP Survey "recording" forms, (b) the manner in which to summarize and then extrapolate important information from the "recording forms" and subsequently enumerate it onto "summary" or "reporting" forms, (c) the manner in which to to conduct village household Vital Events surveys as well as how to enumerate this data [i.e. births, deaths, age at the time of death, cause of death, and fetal events] onto Vital Events Survey "recording" forms, (d) the manner in which to summarize and then extrapolate important data from the "recording" forms and enumerate it onto "summary" or "reporting" forms, (e) the manner in which to calculate "key health indicators" or "key vital events rates/ratios" [i.e. Crude Birth Rate (CBR), Crude Death Rate (CDR), Population Growth Rate (PGR), Infant Mortality Rate (IMR), Early Childhood Mortality Rate (CMR), Maternal Mortality Ratio (MMR), and Contraceptive Prevalence Rate (CPR), and (f) how to assess the health status of a community or "catchment area" [especially that of special "target groups" such as infants, young children, and women/mothers] by calculating "key health indicators" and comparing these "numerical values" with those of developed countries that have good health care delivery systems or with those of under-developed countries that have poor health care delivery systems. Lung Stan served as the main trainer assisted by Ms. Hearn and Ms. Morn Horm who acted as facilitators and translators for all sessions during the initial 5 day RH Awareness & Data Collection training course. 4 Trainees, from Mong Kung township, practicing calculating "key health indicators", or "vital events rates" during the data collection training component The final 2 days of the course included a special Maternal and Child Health Care segment conducted by the training team from the Chiang Mai Rajabhat University Department of Public Health. This team has participated in several SWAN sponsored RH training courses since February 2011. The team consisted of Ms. Jitima and Ms. Warunyupha who were similarly assisted by Ms. Ying Charm Hom from the SWAN health team. This portion of the course focused on (a) human reproduction-fertilization-fetal development, (b) ante-natal care, (d) delivery, (e) post-partum care, (f) proper nutrition for pregnant and post-partum women as well as for newborns and young children up to five years of age, and (g) ways to deal with specific complications associated with pregnancy, delivery, and the early post- partum period. 5 Acharn Jitima demonstrating how mothers should hold newborn infants when breast- feeding Acharn Warunyupha demonstrating the proper way for mothers to "wash hands" to insure that disease-causing pathogens are not transmitted to infants and young children 6 Examples of the types, and amounts, of different foods that young infants should eat between the ages of 6-12 months It should be noted that at the end of the 5 day RH-FP & Data Collection training course, the trainees were divided into 4 sub-groups. These sub-groups were asked to discuss the following topics, while pretending that they were "health workers" visiting a community or a specific household in their "village" or "catchment area". Each group was instructed to use (a) the health educational materials which they received as part of the RH-FP training course, and/or (b) additional health educational materials or contraceptive supplies used by Lung Stan [i.e. different types of IUDs, different types of Norplant/Implants, different types of Oral Contraceptives, etc.] during their presentations. The 4 groups were asked to discuss the following topics: 1. Group I 1.1. Human Reproduction: How/where/when are sperm and eggs produced in the male and female reproductive organs? How/where do sperm meet eggs as part of conception? 1.2. Family Planning: What is meant by the term Family Planning? Which types of individuals should know about or have access to FP services? What do we mean by the terms "temporary" and/or "permanent" FP methods [and give examples of both categories of FP method].