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-toYouth 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 2. Objectives 3. Methodology 4. Limitations 5. Study Period 6. Profile of organizations 7. Geographical coverage by stakeholders 8. Minimum essential package of reproductive health interventions 8.1 Reproductive health activities by stakeholders 8.2 Sub-component activities of each RH interventions 8.2.1 Adolescent reproductive health 8.2.2 Birth spacing and contraceptive services 8.2.3 RTI/STI/HIV/AIDS 8.2.4 Antenatal care 8.2.5 Delivery care 8.2.6 Neonatal care 8.2 7 Postnatal care 8.2.8 Post-abortion care 8.2 9 Gynaecological cancers 8.2.10 Postmenopausal reproductive health 8.2.11 Men’s role in/and reproductive health 8.3 Target population 8.4 Implementing partners 8.5 Future plan 9. Capacity Building 10. Research 1 1 2 4 4 4 5 7 7 7 8 8 9 9 9 10 10 10 10 10 10 11 12 13 13 17
11. Opinions, perceptions and attitudes on organization performance 18 12. Conclusions References Annexes Annex A Annex B-1 Annex B-2 Annex B-3 Annex C Annex D Annex E Annex F 21 22
: Profile of organizations : Geographical coverage of reproductive health interventions : Township coverage of reproductive health interventions : Minimum essential reproductive health interventions : Capacity building : Research studies : Opinion, perceptions and attitudes : Questionnaires
ABBREVIATION AIDS AMW ARH BCC BHS CBO CHEB CSG DHP DOH DU EC ECHO FBO FRHS GO HIV HRM INGO KABP LNGO MANA MCH MCHWSA MNA MOH MSM MWAF MWRA NAP NGO PH PMCT/PMTCT PPFA-International RH RHC RTI SDC SRH STI SW TBA THD ToT TMO VCCT VHV : Acquired Immno Deficiency Syndrome : Auxiliary Midwife : Adolescent Reproductive Health : Behavioural Change Communication : Basic Health Services : Community Based Organization : Central Health Education Bureau : Community Support Group : Department of Health Planning : Department of Health : Drug User : European Commission : European Commission for Humanitarian Organization : Faith-based Organization : Fertility and Reproductive Health Survey : Government Organization : Human Immuno-deficiency Virus : High Risk Men : International Non-Governmental Organization : Knowledge, Attitude, Behaviour, Practice : Local (National) Non-Governmental Organization : Myanmar Anti Narcotic Association : Maternal and Child Health : Medical Christian Health Workers Services Association : Myanmar Nurses Association : Ministry of Health : Men having sex with men : Myanmar Women Affairs Federation : Myanmar Women of Reproductive Age : National AIDS Programme : Non-Governmental Organization : Public Health : Prevention of Mother to Child Transmission : Planned Parenthood Federation of America-International : Reproductive Health : Rural Health Center : Reproductive Tract Infection : Swiss Development Committee : Sexual Reproductive Health : Sexually Transmitted Infection : Sex Worker : Traditional Birth Attendant : Township Health Department : Training of Trainer : Township Medical Officer : Voluntary Confidential Counselling and Testing : Village Health Volunteer
ABBREVIATION OF ORGANIZATIONS/STAKEHOLDERS AFXB AMDA AMI CARE JICA JOICFP Malteser MdM MMA MMCWA MRCS MSI PSI SC UNFPA WV YWCA : Association of Francois-Xavier-Bagnoud : Association of Medical Doctors of Asia : Aide Medicale International : Cooperation Assistance Relief Everywhere : Japan International Cooperation Agency : Japanese Organization for International Cooperation in Family Planning : Malteser International : Medicins du Monde : Myanmar Medical Association : Myanar Maternal and Child Welfare Association : Myanmar Red Cross Society : Marie Stopes International : Population Services International : Save the Children : United Nations Population Fund : World Vision : 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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RH Stakeholders Analysis
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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RH Stakeholders Analysis
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.
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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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RH Stakeholders Analysis
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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RH Stakeholders Analysis
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 1.AFXB 2.AMDA 3.AMI 4.CARE 5.JICA 6.JOICFP 7.Malteser 8.MdM 9.Merlin 10.MMA 11.MMCWA
Year began in Year began RH Myanmar 1993 1993 1995 1995 2002 2005 1996 2002 1981 1998 2000 2000 2001 2004 1994 2002 2005 1949 1999 1991 1991
No. of staff in RH 14 15 20 31 5 22 60 82 20 26 central; 50 x 106 project tsps.; 20 x nonproject tsps.
RH Training Research Interventions* 3 x 7 x 8 x 3 x x 4 x x 6 x x 10 x 3 8 x x 3 x 11 3 4 2 6 8 5 2 x x x x x x x x
12.MRCS 1920 2000 48 13.MSI 1998 1998 380 14.PSI 1994 2001 24 15.SC 1995 1999 97 16.UNFPA 1973 1996 10 UNFPA + 9 DOH 17.WV 1993 1993 32 18.YWCA 1900 1998 * Minimum essential package of RH interventions according to the life cycle approach DOH started since 1948. WHO provides support since 1950s.3
x
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RH Stakeholders Analysis
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 Kachin Kayah Kayin Chin Mon Rakhine Shan (S) Shan (N) Shan (E) Bago Sagaing Tanintharyi Magway Mandalay Yangon Ayeyarwady Stakeholders 1. MdM 2. MMCWA 3. UNFPA 1. MMCWA 1. MMCWA 2. PSI 3. SC 4. UNFPA 1. MMCWA 2. UNFPA 1. AFXB 2. JOICFP 3. MMA 4. MMCWA 5. MSI 6. PSI 7. SC 8. UNFPA 1. AMI 2. JOICFP 3. Malteser 4. MMCWA 5. UNFPA 1. JOICFP 2. MMCWA 3. PSI 4. UNFPA 1. AMDA 2. AMI 3. CARE 4. JICA 5. JOICFP 6. Malteser 7. MMA 8. MMCWA 9. PSI 10. SC 11. UNFPA 1. MMCWA 2. UNFPA 3. WV 1. JOICFP 2. MMA 3. MMCWA 4. MRCS 5. MSI 6. PSI 7. UNFPA 1. JOICFP 2. MMA 3. MMCWA 4. PSI 5. UNFPA 1. JOICFP 2. MMCWA 3. SC 4. UNFPA 5. WV 1. AMDA 2. JOICFP 3. MMA 4. MMCWA 5. PSI 6. SC 7. UNFPA 1. AMDA 2. CARE 3. JOICFP 4. MMA 5. MMCWA 6. MSI 7. PSI 8. UNFPA 9. WV 1. AFXB 2. AMI 3. JOICFP 4. MdM 5. MMA 6. MMCWA 7. MRCS 8. MSI 9. PSI 10. UNFPA 11. WV 12. YWCA 1. JOICFP 2. Merlin 3. MMA 4. MMCWA 5. MRCS 6. MSI 7. PSI 8. UNFPA 9. WV Total 3 1 4 2 8 5 4 11 3 7 5 5 7 9 12 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 KCN 1.AFXB 2.AMDA 3.AMI KYA KYN Chin Mon 4 1 1 3 1 1 3 RKN Number of townships in each State/Division Shan Shan Shan Bago SGN TTY N S E MGW MDY YGN 16 AYE Total 20 3 7
8
RH Stakeholders Analysis 4.CARE 5.JICA 6.JOICFP 7.Malteser 8.MdM 9.Merlin 10.MMA 11.MMCWA 12.MRCS 13.MSI 14.PSI 15.SC 16.UNFPA 17.WV 18.YWCA 1 2 1 3 2 1 4 2 1 4 4 3 8 3 2 8 6 5 1 9 5 Covers all townships in all states/divisions 2 1 6 4 20 10 4 5 5 3 1 21 11 2 7 7 6 17 12 3 9 2 2 32 14 3 5 1 4 1 1 8 14 2 5 3 2 27 4 11 1 45 325 5 12 116 15 114 13 5
1 3
1 1
2
2 3 2
2
1 4 3
9 1 13
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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RH Stakeholders Analysis
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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RH Stakeholders Analysis
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 (No. sub-component activities) ARH BSC RTI/STI/ ANC DC NC PNC PAC GCA PMRH (2) (5) HIV/AIDS (10) (7) (7) (11) (4) (2) (1) (5) 1.AFXB 1 3 2.AMDA 1 2 2 8 1 2 3.AMI 1 2 5 6 2 5 7 4.CARE 2 1 5.JICA 8 1 7 4 6.JOICFP 2 8 1 7 7 7.Malteser 1 1 3 7 2 6 6 2 8.MdM 2 4 9.Merlin 1 1 1 6 2 7 7 10.MMA 4 2 11.MMCWA 1 2 5 9 5 7 11 2 1 1 12.MRCS 1 1 1 13.MSI 2 5 3 1 14.PSI 1 4 15.SC 2 2 3 4 4 16.UNFPA 2 3 3 5 5 3 2 17.WV 1 2 3 1 2 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. Stakeholders
MRH (3) 2 1 2 2 1 1 2 3 1
3 2 3
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 “youthfriendly clinics/centers” in 39 townships in 11 states/divisions. 8.2.2 Birth Spacing and Contraceptive Services 11
RH Stakeholders Analysis
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
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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.
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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 Organization AFXB AMDA Youth & Adolescent Youth; Youth from workplace Mothers; Reproductive female; Pregnant women Women in reproductive age; Pregnant women; Child bearing women; Neonates; <1 children
Women & Children
Men
Target population groups High risk Uniform group service personnel Workers from transportation Uniform service personel
PLHAs / Patients PLHAs
Service providers
General population
Village health volunteers MSM; Trishaw drivers; Boat men; High risk men; CSW Patients to RHC / mobile clinics
Female villagers; Villagers General population
AMI
Adolescents
CARE JICA JOICFP Malteser
15-24 years Youth Women of reproductive age Women; Children <5; Men of reproductive age Men; AMW AMW
Youth
MdM Merlin MMA MMCWA Young people
Risk groups; Karaoke bars; Incarcerated population; Bar/Hotel owners; Truck drivers SWs; DUs
Prisons; Military; Police
PLHA
Peer educators;
General population;
Health care facilities; Teachers
Women of reproductive age Pregnant women Married women; Pregnant women;
Men of reproductive age All Married men Postabortion cases
15
RH Stakeholders Analysis Women of reproductive age; Newborns
MRCS
MSI
Adolescents; Youth (15-24 years & outof school) 10-24 years
PSI SC 15-24 years; Out-of school youth; General youth; Adolescent girls 15-24 years
Women of reproductive age from low income neighbourhood; Women Women of reproductive age 15-49 eligible couples; Reproductive age women; Pregnant mothers Women of reproductive age; Pregnant mothers; Newborn Women; Mothers Women of reproductive age
Men
SWs; Risk behaviour group
UNFPA
15-49 eligible couples; Reproductive age men; Husband of pregnant mothers Spouses; Men of reproductive age
General practitioners Birth attendants
SWs & clients
WV YWCA
Youth
Risk groups All ages
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)
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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 AFXB Public Sector DOH (NAP) Implementing Partners UN agencies LNGO UNAIDS, MRCS UNICEF, UNFPA, UNIAP UNFPA, UNDP, UNAIDS, WFP UNFPA UNFPA MNA
INGO AZG, PSI, MSI PSI
Others SDC
AMDA AMI CARE
DOH, NATALA DOH (township) DOH (NAP, RH, PHC), THD, STI team DOH (MCH, State/Township) DOH (MCH, PH, CHEB)
JICA EC, ECHO, FHAM
PSI, MSI
JICA JOICFP Malteser MdM Merlin MMA MMCWA
UNFPA, UNICEF UNFPA UNFPA, UNHCR MMA
JOICFP JICA PSI, Health Unlimited MdM Ministry of Industry - 2 MWAF, MMA, MRCS, MNA, MHA MMA JOICFP, IPPF PPFAInternational
DOH DOH (MCH, PH, CHEB) DOH, DOSF
UNICEF UNFPA, WHO UNFPA
MRCS MSI PSI SC
DOH (MCH/BS) DOH (NAP, MCH)
UNFPA UNFPA
Private practitioners DOH UNFPA CBOs, MNA, Literacy and cultural Association MMCWA, MMA, MRCS, MANA CBO MCHWSA PSI, MSI
UNFPA
DOH (MCH), DHP MOH, THD DOH
WHO, UNAIDS, WFP, UNODC, UNHCR
MSI, PSI, CARE, AMI, Malteser
WV YWCA
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.
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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)
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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 Birth Spacing, Safe RTI/STI/ Male Supporting Project Contraception, motherhood, HIV/AIDS Involvement Skills Management Family Neonatal Development Planning Care, Women & Child Dev. x x x x x x x x x x x x x x
Stakeholders AMW/ TBA
RH
1.AFXB 2.AMDA 3.AMI 4.CARE 5.JICA 6.JOICFP 7.Malteser 8.MdM 9.Merlin 10.MMA 11.MMCWA 12.MRCS 13.MSI 14.PSI 15.SC 16.UNFPA 17.WV 18.YWCA
x x x x x x
x x x x x x x x x x x
x x x x
x
x
x x
x
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 AMW/TBA Training AMW training AMW Refresher training AMWs AMWs Trainee Duration 6 months 3 days Organization AMI JICA
20
RH Stakeholders Analysis TBA training (Basic) TBA training (Refresher) TBAs TBAs 2 weeks 5 days 3 days 2 days 3 days 6 days 5 days 3 days 2 days 5 days 2-3 days 1 day 1 day 5 days 2 days 5 days 1 day 5 days 1-2 days 4 days AMI AMI JOICFP Malteser CARE MRCS MMCWA JOICFP JOICFP MMCWA JOICFP JOICFP JOICFP JOICFP MMA MMA MMA MRCS MMCWA SC JOICFP
Reproductive Health Reproductive health
Outreached workers Red Cross Volunteers RH/BCC ToT Members Basic Health Staff Community Support Group (CSG) RH/BCC township training Members RH/BCC ToT Refresher Basic Health Staff RH/BCC CSG Refresher Community Support Group (CSG) RH/BCC CSG Multiplier Community Support Group (CSG) RH, Life skills training Youth Promotion of RH General Practitioners Clinical-oriented quality care in RH General Practitioners RH training Workers from Industry (2) Peer Educator training on RH Red Cross Volunteers ARH training Members Out of school youth ARH and Safe motherhood Youth Birth Spacing, Contraceptives, Family Planning Birth spacing & contraceptive methods Birth spacing, abortion Training on contraceptives Family planning
Peer Group Village Health Teams Health Educators, Nurses, Peer educators Family planning services and STI MSIM center-in-charge management Nurse Insertion of IUD BHSs Safe Motherhood, Neonatal care, Women and Child development Safe motherhood Staff MWs, AMWs Health Educators, Nurses Staff Village Health Teams, TBAs CHWs, AMWs BHSs Staff (Merlin, DOH) Staff (Merlin, DOH) Staff Village Health Teams, AMWs, TBAs Health Educators, Nurses, Peer educators Peer Group Volunteer Outreached workers Village Health Teams, Youths Peer Group Peer educators Village Health Teams, AMWs, TBAs, BHS Peer Group General Practitioners Male volunteers
3 days 1 1/2 hr 1 day 1 day 3 days 5 days 2 days 2 days 3 days 1 day 3 days 2 days 2 days 5 days 11 day 6 days 5 days 2 days 1 day
PSI AFXB SC AMI MSI MSI UNFPA AMDA AMDA AMI Merlin SC Merlin UNFPA Merlin Merlin SC AMI
IMCI and Safe motherhood Pregnancy, Childbirth, Postnatal and Neonatal Care (PCPNC) Women & Child Health Development – ToT Women & Child Health Development Community-based Health Activities New born care Infant feeding RTI/STI/HIV/AIDS HIV/AIDS/STI HIV/AIDS STI
PMCT Male Involvement Male Involvement Increasing male involvement ToT Multiplier training
1 hr 3 days 3 days 1 day 1 day ½ hr 1 day 1 day
AFXB AMDA CARE SC PSI AFXB MSI SC
1/2 hr 1 day 1 day
AFXB, JOICFP JOICFP
21
RH Stakeholders Analysis Anti Human Trafficking Supporting Skills Development Counselling training RH Counselling ARH Counselling Communication and counselling Life Skills training First Aid First Aid & Health Education Basic Health Knowledge Peer education Peer Educators induction Communication skills Service provider training Project Management RH Programme Management RH/BCC Management Rural Health Management Project Cycle Management Project Sustainability and Business Planning RH Management Information System Gender and Design, Monitoring and Evaluation Advocacy meeting Advocacy training Peer Group Red Cross Volunteers BHSs BHSs Community Based Contributing Agents Out of school youth Peer educators, Youth volunteers Volunteers VHV/MW/AMW Volunteers Outreached workers, Educators Peer educators MSIM staff MSIM staff BHSs, TMOs TMO, Health staff VHV Community, Basic Health Staff Red Cross Volunteers Red Cross Volunteers BHSs, Statisticians Outreached workers Community, MWs Local authorities 1 hr 5 days 5 days 5 days 3 days 2 days 2 days 2 days 2 days 5 days 3 days 3 days 2 days 3 days 5 days 2 days 5 days 3 days 4 days 3 days 4 days 3 days ½ day 1 day AFXB, MRCS UNFPA UNFPA MSI SC MSI AMDA AMDA AMDA CARE MSI MSI MSI UNFPA JOICFP AMDA JOICFP MRCS MRCS UNFPA CARE JOICFP 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.
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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 Youthto-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 CARE JICA JICA JICA JICA JICA JICA JOICFP JOICFP Merlin Merlin MMCWA MMCWA MMCWA MMCWA MRCS MRCS SC SC Research Topic A KABP Study on sexual and reproductive health of young people (15-24 years) RH Services Facility Assessment Midwifery-trained Personnel’s Performance for Antenatal Care Midwifery-trained Personnel’s Ability Communication with Clients Midwifery-trained Personnel’s Performance Delivery Care Midwifery-trained Personnel’s Knowledge Obstetric Complications Midwifery-trained Personnel’s Performance Postnatal Care Baseline data collection and behavioural study on male involvement in RH Health infrastructure and quality of RH services Qualitative study Baseline survey Part I KPC Survey Formative research Anaemia in pregnancy Safe motherhood PMCT AN care Rapid survey for Youth-to-Youth Peer Education for RH program in selected townships End-line survey for Youth-to-Youth Peer Education for RH Program in selected townships Behavioural surveillance survey 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.
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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 11.2.1 Organization efforts 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: General Background Year began in Myanmar: Mission:
Association of Francois-Xavier-Bagnoud (AFXB) 1993 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 1993 . HIV/AIDS . Anti-human trafficking linked to HIV/AIDS . Birth spacing . Male role in RH . Peer approach in RH . Youth & PLHA network 14 Adolescent reproductive health; STI/RTI/HIV/AIDS; Men’s role in/and reproductive health 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) Trainees from vocational centre; PLHAS; Youth from work place; Workers from transportation sector; uniform personnel . Birth spacing . Abortion . STIs . HIV/AIDS . Male involvement . Anti-human trafficking NA NAP Would like to expand: . Provision of injectables and oral contraceptives . Condom distribution . Training on male involvement . Training on negotiation and decision making skills
Year began RH: Areas of expertise in RH:
Number of staff in RH: Activities: Locations:
Target Groups: Capacity Building:
Research: Implementing partners: Future plan:
Name of Organization: General Background Year began in Myanmar: Mission: Year began in RH: Areas of expertise in RH:
Association of Medical Doctors of Asia (AMDA) 1995 A global network of partnership for peace through projects with ‘sogo-fujo’ (or mutual assistance) spirit under local initiatives. 1995 (as part of primary health care and maternal and child health projects) 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 15 ARH; BS & Contraceptives; STI/RTI/HIV/AIDS; Prenatal Care; Neonatal Care; Post-natal Care; Men’s RH Shan - N (Laokai); Mandalay (Meiktila, Nyaung U); Magwe (Pakoku)
Number of staff in RH: Activities: Locations:
Target Groups & Number: Female villagers; Village health volunteers; mothers; Reproductive female; Villagers; Pregnant women Capacity Building: . STI/HIV/AIDS . Safe motherhood . First aid NA Department of Health; NATALA; PSI; UNFPA; UNDP; UNAIDS; WFP; JICA 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.
Research: Implementing partners: Future plan:
Name of Organization: General Background Year began in Myanmar: Mission:
Aide Medicale International (AMI) July 2002 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 March 2005 in Wa special region 2 January 2006 in Dala township . 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 20 including 3 expatriates ARH; BS & Contraceptives; STI/RTI/HIV/AIDS; Prenatal care; Delivery care; Neonatal care; Post-natal care; Men’s reproductive health Shan-N (Mong Pawk, Wein Kao, Mong Maw); Rakhine (Buthidaung); Yangon (Dala, Twante, Seikkyi) Adolescents; Women in reproductive age; General population; MSM; High risk men; SW; Patients; Pregnant women; Neonates; Child bearing women; Under 1 children . Safe motherhood . Family planning . Infant feeding . AMW training . TBA training NA UNFPA, UNHCR, UNICEF, UNAIDS, DOH, EC, FHAM, ECHO
Year began in RH: Areas of expertise in RH:
Number of staff in RH: Activities:
Locations: Target Groups :
Capacity Building:
Research: Implementing partners:
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: General Background Year began in Myanmar: Mission:
CARE International in Myanmar (CARE) June 1996 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 2002 . 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 31 including 24 outreach workers Adolescent reproductive health; STI/RTI/HIV/AIDS; Men's role in RH Mandalay (Aung Myay Tha Zan, N|Maha Aung Myay) Shan-N (Muse) 15-24 years both male and female . Reproductive health . HIV/AIDS . Gender and Design, Monitoring and Evaluation . Peer education . A KABPP Study on Sexual and Reproductive Health of Young People DOH (NAP, RH, PHC), PSI, MSI, UNFPA, MNA scaling up the existing programme
Year began in RH: Areas of expertise in RH:
Number of staff in RH: Activities: Locations: Target Groups: Capacity Building:
Research: Implementing Partners: Future plan:
Name of Organization: General Background Year began in Myanmar Goal:
Department of Health (DOH) :1948
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 inservice 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: General Background Year began in Myanmar: Mission:
Japan International Cooperation Agency (JICA) 1981 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. 1998 . Midwifery education & training . Advocacy . Essential medical equipment supply . Community mobilization 5 Prenatal care; Delivery care; Neonatal care; Postnatal care Shan state (North) – Kyaukme, Naungcho AMW AMW refresher training . 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) DOH Implementation of current technical cooperation project in reproductive health, namely “Community-Oriented Reproductive Health Project 2005-2010” entrusted to JOICFP
Year began in RH: Areas of expertise in RH:
Number of staff in RH: Activities: Locations: Target Groups: Capacity Building: Research:
Implementing partners: Future plan:
Name of Organization: General Background Year began in Myanmar: Mission:
Japanese Organization for International Cooperation in Family Planning (JOICFP) 2000 To enable individuals to make their own choices regarding reproductive health and rights while ensuring access to quality services and appropriate information 2000 . Behaviour Change Communication . Safe Motherhood . Birth spacing . Adolescent Sexual and Reproductive Health . Male Involvement for RH 12 local + 10 international (long-term and short-term) Adolescent reproductive health; Prenatal care; Delivery care; Neonatal care; Postnatal care; Men's role in/and RH
Year began in RH: Areas of expertise in RH:
Number of staff in RH: Activities:
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: Capacity Building: Youth; Women of reproductive age . 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 . 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) DOH (MCH section, CHEB); MMA; UNFPA; JICA Executed project funded by UNFPA . Information, Education for Behavioural Change (2002 Sep2006 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)
Research:
Implementing partners: Future plan:
Name of Organization: General Background Year began in Myanmar: Mission:
Malteser International 2001 . 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 2004 Antenatal Care, Intrapartum and Postpartum Care; RH education and awareness including HIV/AIDS, VCCT, STI prevention, detection and treatment; family planning 60 ARH; BS & Contraception; STI/RTI/HIV/AIDS; Prenatal care; Delivery care; Neonatal care; Postnatal care; Post-abortion care; Men's RH Shan-N (Pang Kham, Mong Pawk, Mong Maw); Rakhine (Maungdaw) Youth; Risk groups; Women; Men; Peer educators; Health care facilities; Prisons; Military; Police; Karaoke bars; Drop-in centers; PLWHA; Truck drivers; Bar/Hotel owners Refresher training for TBAs NA UNHCR, PSI 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
Year began in RH: Areas of expertise in RH:
Number of staff in RH: Activities:
Locations: Target Groups:
Capacity Building: Research: Implementing partners: Future plan:
Name of Organization: General Background Year began in Myanmar: Mission: Year began in RH: Areas of expertise in RH: Number of staff in RH: Activities: Locations:
Medicins du Monde (MdM) 1994 To provide access to health care to vulnerable populations 2002 STI and HIV and AIDS couselling, health education and medical care
Birth spacing and contraceptives; STI/RTI/HIV/AIDS Yangon (Mayangone, Insein, N.Okkalapa, S.Okkalapa, Tamwe, Latha, N.Dagon, S.Dagon); Kachin (Myitkyina, Moegaung, Hopin) SW; Drug users NA NA
Target Groups: Capacity Building: Research: Implementing Partners: Future plan:
same
Name of Organization: General Background Year began in Myanmar: Mission:
Merlin 2005 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: Number of staff in RH: Activities: Integrated Management of Maternal and Child Illness (IMMCI) 82 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 Ayeyarwady Division (Laputta) Men & women of reproductive age . 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) . Knowledge, Practice, Coverage Survey . Formative Research DOH, UNICEF same activities till June 2008 Will expand in: . Basic Emergency Obstetric Care (BEOC) . Comprehensive Emergency Obstetric Care
Locations: Target Groups: Capacity Building:
Research: Implementing partners: Future plan:
Name of Organization: General Background Year began in Myanmar: Mission: Year began in RH: Areas of expertise in RH: Number of staff in RH: Activities: Locations: Target groups: Capacity building: Research: Implementing partners: Future plan:
Myanmar Health assistant association (MHAA) 1994 To help the public health problems to the Myanmar Community and prevention and control of contagious disease activities Not yet
. Condom promotion . VCCT for HIV . Tanintharyi Division (Myeik, Kawthaung); Yangon (Thanlyn, Kyauktan); Mon (Thanbyuzayat) . Seafarers
NAP
Name of Organization: General Background Year began in Myanmar: Mission:
Myanmar Medical Association (MMA) 1949 . 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 1999 . 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 20 STI/RTI/HIV/AIDS; Prenatal care; Men's role in/and reproductive health 8 S/D 45 townships – Yangon (9); Bago (9); Sagaing (5); Ayeyarwady (4); Mandalay (7); Shan-N (1); Magwe (7); Mon (3) Pregnant mothers; All . Workshop on role of GPs in promotion of RH . Training of GPs on RH . Training of workers from Ministry of Industry (2) NA UNFPA, WHO, Ministry of Industry (2) . 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
Year began in RH: Areas of expertise in RH:
Number of staff in RH: Activities: Locations: Target Groups: Capacity Building:
Research: Implementing Partners: Future plan:
Name of Organization: General Background Year began in Myanmar: Mission:
Myanmar Maternal and Child Welfare Association (MMCWA) 1991 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. 1991 . 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 26 at central level; 50 persons each in all 106 project townships; 20 persons each in non-project township 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 All States and Divisions Young people, Married women and men, Pregnant women, New born, Post-abortion case, Women of reproductive age . Central Training on RH, BCC, TOT . Township trainings . ARH training . Anaemia in pregnancy . Safe motherhood . PMCT . AN care MWAF, MMA, MROS, MNA, MHA, JOICFP, WHO, UNFPA, UNAIDS, UNICEF Will expand on safe motherhood, new born care and male involvement
Year began in RH: Areas of expertise in RH:
Number of staff in RH: Activities:
Locations: Target Groups: Capacity Building:
Research:
Implementing Partners: Future plan:
Name of Organization: General Background Year began in Myanmar: Mission:
Myanmar Red Cross Society (MRCS) 1920 (under India Red Cross) 1937 (Burma Red Cross) 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. October 2000 . Peer education . Peer counseling . Outreach activities for high risk youth . Prevention of sexual reproductive health problems . Promoting sexual reproductive health problems 48 Adolescent reproductive health; STI/RTI/HIV/AIDS; Postabortion care Yangon Division (North Okkalapa; Shwepyitha); Bago Division (Daik-U, Phyu); Ayeyarwady Division (Maubin) Adolescent; Youth (15-24 & out-of school) . Training of Trainers . Youth Peer Educators Training & Refresher Training . Peer Counselling Training . Project Cycle Management training . Project Sustainability Business Planning . Rapid Survey for Youth to Youth: Peer Education for RH Programme . End-line Survey for Youth to Youth: Peer Education for RH Programme MMA, DOH (MCH, BS section) . 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
Year began RH: Areas of expertise in RH:
Number of staff in RH: Activities: Locations: Target Groups: Capacity Building:
Research:
Implementing partners: Future plan:
Name of Organization: General Background Year began in Myanmar: Mission: Year began in RH: Areas of expertise in RH:
Marie Stopes International Myanmar (MSI) 1998 Right Choices Save Women. Providing Choices in Reproductive Health Care. 1998 . 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 380 (319 not full time staff) ARH; Birth spacing & contraceptives; STI/RTI/HIV/AIDS; Prenatal care Mon (Mawlamyine, Thaton); Ayeyarwady (Pathein); Bago (Pyay); Mandalay (Pyigyitagun, AMTZ, CATZ, CNTZ, MHAM, Myingyan);Yangon (Thaketa, Thingangyun) Women of Reproductive age; Children . 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 NA UNFPA 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
Number of staff in RH: Activities: Locations:
Target Groups: Capacity Building:
Research: Implementing partners: Future plan:
Name of Organization: General Background Year began in Myanmar: Mission:
Partners Myanmar (Partners) 1998 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. 2004 . Condom promotion . HIV/AIDS prevention . Capacity building 14 STI/RTI/HIV/AIDS Yangon (Shwepyithar) Women of Reproductive age; Children . HIV/AIDS prevention NA MRCS, MBCA, Karuna, Cholia Muslim Trust, Thingaha, MMA, PSI, BI, CBI, AZG, MdM, UNAIDS, UNDP, UNFPA, UNOPS, UNICEF FHAM project is to be completed by the end of November 2006. After this project, no other RH activities have been foreseen yet.
Year began in RH: Areas of expertise in RH:
Number of staff in RH: Activities: Locations: Target Groups: Capacity Building: Research: Implementing partners:
Future plan:
Name of Organization: General Background Year began in Myanmar: Mission:
Population Services International (PSI)
1994 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 2001 . 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 24 Adolescent reproductive health; Birth spacing and contraceptives; 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.) Health care service providers; Women of reproductive age Skill building training on RH STI training
Year began in RH: Areas of expertise in RH:
Number of staff in RH: Activities: Locations:
Target Groups: Capacity Building: Research: Implementing partners: Future plan:
Private practitioners . 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: General Background Year began in Myanmar: Mission: Year began in RH: Areas of expertise in RH:
Save the Children (SC) 1995 Save the Children fight for children's rights. It delivers immediate and lasting improvements to children's lives worldwide. 1999 . Community mobilization and empowerment . Life skills training . Working in partnership with civil society groups . Partner Defined Quality 97 Adolescent reproductive health; Birth spacing & contraceptives; STI/RTI/HIV/AIDS; Prenatal care; Neonatal care; Men's role in/and RH Tanintharyi (Launglone); Magway (Pakokku); Kayin (Phaan, Hlaingbwe, Kawkareik); Mon (Mawlamyine, Thaton, Kyaikmaraw, Paung, Mudon, Chaungzone); Shan-N (Theinni, Namkham, Namphatka, Muse) Adolescent (15-24); Youth (15-24); Out-of school youth; Reproductive age group; Eligible couples; Pregnant mothers and their husbands; Birth attendants . Safe motherhood training . Prevention of HIV/AIDS . Training on contraceptives . PMCT . Newborn care . Life skill training . Life skill workshop on ARH . Behavioural Surveillance Survey (2002) . Youth Behaviour Survey (2004) CBO, MNA, Literacy and Cultural Association, MSI Plan to scale up community based RH and Adolescent Reproductive Health Programs
Number of staff in RH: Activities:
Locations:
Target Groups:
Capacity Building:
Research: Implementing partners: Future plan:
Name of Organization: General Background Year began in Myanmar: Mission:
United Nations Population Fund (UNFPA) 1973 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 1996 . Antenatal care . Delivery care . Postnatal care . Birth spacing . ARH . SII/HIV/AIDS 10 (UNFPA) and 9 (DOH) ARH; Birth spacing & contraceptives; STI/RTI/HIV/AIDS; Prenatal care; Delivery care; Postnatal care; Post-abortion care; Men’s RH 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) 15-24 years old; Women of Reproductive age; SW and clients; Pregnant mothers; Postnatal mothers; Men of reproductive age . 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 NA DOH, MMCWA, MMA, MRCS, MANA, MSI, PSI, CARE, AMI, Malteser, WHO, UNAIDS, WFP, UNODC, UNHCR Scaling up to cover the whole country (2007 – 2010)
Year began in RH: Areas of expertise in RH:
Number of staff in RH: Activities:
Locations:
Target Groups: Capacity Building:
Research: Implementing partners: Future plan:
Name of Organization: General Background Year began in Myanmar: Mission:
World Vision Myanmar (WV) 1993 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 1993 To increase access to AN, Delivery and PN care 32 Adolescent reproductive health; RTI/STI/HIV/AIDS; Prenatal care; Neonatal care; Postnatal care; Men’s RH Yangon (Hlaingtharyar, S.Dagon, Hmawbi); Mandalay (Chanmyatharzi, Pyigyitagun, Amarapura); Ayeyarwady (Thabaung, Pathein); Shan-E (Kyaungton, Tachileik); Tanintharyi (Dawei, Myeik, Kawthaung) Youth, Women, Risk group, Mothers NA NA DOH Strengthening of mother’s group for sharing and caring each other with RH issues
Year began in RH: Areas of expertise in RH: Number of staff in RH: Activities: Locations:
Target Groups: Capacity Building: Research: Implementing partners: Future plan:
Name of Organization General Background Year Began in Myanmar: Mission:
:World Health Organization (WHO)
1950 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 (20042008) 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: General Background Year began in Myanmar: Mission: Year began in RH: Areas of expertise in RH: Number of staff in RH: Activities: Locations: Target Groups: Capacity Building: Research: Implementing partners: Future plan:
National Young Women Christian Association (YWCA) 1900 Train a woman – build a nation. 1998 . Family planning Birth spacing & contraceptives; Prenatal care Yangon Division (N. Okkalapa, Insein, Hlaingtharyar, Hmawbi, Taikkyi) Women of Reproductive age; All age (esp. children) NA NA MCHWSA (Medical Christian Health Workers Services Association), PSI
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 MON RKN SHN(N) SHN(S) SHN(E) BGO SGN TTY MGW MDY YGN AYW
KCN KYA KYN CHN
Provision of sexual and reproductive health information for young people * AFXB JOICFP WV MRCS MSI UNFPA JOICFP JOICFP
Org. SC WV MSI SC SC
SC
AMDA CARE
JOICFP
JOICFP
JOICFP JOICFP
JOICFP
Merlin MRCS MSI WV UNFPA UNFPA
AMDA AMDA AFXB JOICFP CARE AMI JOICFP JOICFP SC MSI MRCS PSI MSI WV PSI UNFPA WV 5 19 37
No. Tsp. 3 Youth-friendly clinics/centers JOICFP JOICFP UNFPA JOICFP JOICFP CARE Malteser UNFPA
7 JOICFP UNFPA
1
6
1
2
5
2
4 JOICFP UNFPA
9 JOICFP UNFPA
Org. MSI UNFPA
CARE JOICFP
JOICFP
JOICFP
MSI MSI UNFPA UNFPA
MSI UNFPA
MSI SC UNFPA JOICFP 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 MON RKN SHN(N) SHN(S) SHN(E) BGO SGN TTY MGW MDY YGN AYW
KCN
KYA KYN
CHN
Emergency contraception Org. PSI 6 AMI Malteser UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA
PSI 4 PSI UNFPA
PSI 10 PSI SC 9
PSI
PSI
No. Tsps. Oral contraceptives * MSI PSI UNFPA
2
PSI MSI 8
PSI MSI 20
PSI MSI 18
PSI MSI 32
PSI MSI 9
Org.
MdM
PSI
UNFPA
UNFPA
AMDA AMI PSI 10 PSI UNFPA UNFPA UNFPA
MSI PSI 27 PSI UNFPA
AMDA AMDA PSI MSI SC PSI UNFPA UNFPA
MdM MSI PSI UNFPA
Merlin MSI PSI UNFPA
No. Tsps. 4 2 2 Monthly and/or three monthly injectables * MSI PSI UNFPA UNFPA AMI UNFPA
9
5
5
1
15
5 UNFPA
18
24
37
20
Org.
MdM
PSI
UNFPA
UNFPA
MSI PSI 27 MSI UNFPA
MSI PSI UNFPA UNFPA UNFPA
AMDA AMI PSI 10 UNFPA UNFPA UNFPA
AMDA AMDA PSI MSI UNFPA PSI 15 UNFPA
MdM MSI PSI 4 SC UNFPA
No. Tsps. IUDs MSI UNFPA UNFPA
4
2
2
9
5
5
1
17 UNFPA
24
37
20 MSI UNFPA UNFPA UNFPA
Org.
UNFPA
UNFPA
MSI PSI 1 15 MSI 1 11 5 13 24 MSI 6
MSI PSI YWCA 35
No. Tsps. 2 Sterilizations MSI 2
2
2
5
5
3
15 MSI 1
Org.
No. Tsps.
MSI YWCA 7
* MMCWA covers all townships in all states/divisions
RTI/STI/HIV/AIDS MON RKN SHN(N) SHN(S) SHN(E) BGO SGN TTY MGW MDY YGN AYW
KCN
KYA
KYN
CHN
Condom promotion * UNFPA UNFPA
Org. WV Malteser
MdM
SC
UNFPA
UNFPA
AFXB AMI MMA Malteser UNFPA SC MSI UNFPA
AMDA AMI CARE MMA SC UNFPA
MMA MMA SC AMDA AMDA UNFPA UNFPA MRCS MMA CARE WV MSI SC MMA UNFPA MSI WV
UNFPA
AFXB AMI MdM MMA MRCS MSI UNFPA
Merlin MMA MRCS MSI WV WV
No. 6 4 6 3 Tsp. Diagnosis and treatment of RTIs (including STIs) * Malteser UNFPA UNFPA
10
2
2
11
8
4
7
18
39
9
Org. MMA UNFPA UNFPA
MdM
UNFPA
MMA UNFPA
UNFPA
MMA MSI
MMA MSI UNFPA UNFPA
AFXB UNFPA MMA MSI SC 1 5 2 1 10
AMDA AMDA MMA MMA MSI
UNFPA
AFXB AMI MdM MMA MSI UNFPA
No. 6 2 6 Tsp. Voluntary counseling and testing for HIV * Malteser
8
7
17
30
6
Org. MMA
MdM
AFXB MMA
WV
MMA
MMA
WV
MMA
MMA WV
MMA WV
No. Tsp.
3
5
2
2
9
5
3
7
9
AFXB AMI MdM MMA MSI WV 28
2
Syphilis screening and treatment *
Org.
MdM
No. Tsp. PMTCT UNFPA
3
AMI MdM 11
Org. MMA UNFPA UNFPA UNFPA UNFPA
MMA MMA 9 6 8 5 2 1 2
UNFPA
MMA
MMA MMCWA UNFPA
MMA UNFPA UNFPA
UNFPA
MMA SC
AMI MMA 7+ 11
No. Tsp.
6
* MMCWA covers all townships in all states/divisions
Antenatal Care MON RKN SHN(N) SHN(S) SHN(E) BGO SGN TTY MGW MDY YGN AYW
KCN
KYA KYN
CHN
Home-based records (preparation of birth plans) * UNFPA UNFPA Maltese Organization UNFPA UNFPA
AMDA
UNFPA
UNFPA
UNFPA
UNFPA
SC UNFPA UNFPA
AMDA AMDA UNFPA
JICA JOICFP UNFPA
SC 13
UNFPA
Merlin UNFPA
2 MSI JOICFP Malteser
No. Tsp. 2 Immunization against tetanus * Organization AMI JICA 2 UNFPA UNFPA
5 WV 1 MSI UNFPA UNFPA
5 MSI 3 UNFPA
6 WV
3
1
21
11
5
13
14
15
AMDA AMDA MSI
WV 1 5 AMDA AMDA MSI UNFPA
No. Tsp. 1 1 3 Detection and treatment of hypertensive disorders in pregnancy * MSI AMDA UNFPA UNFPA
MSI WV 9
MSI WV 2 MSI MSI UNFPA UNFPA UNFPA
Organization UNFPA AMI JICA JOICFP UNFPA
UNFPA
2 Malteser
5 JICA JOICFP
5
9
3
1
21
11
4
13
17 AMDA AMDA
No. Tsp. 2 Detection and treatment of malaria * Organization 2 AMDA UNFPA
16
15 Merlin 1 2 1
No. Tsp. 1 Advice on early detection of complications and danger signs * MSI UNFPA Malteser UNFPA
Organization UNFPA AMI AMI JICA
UNFPA
UNFPA
MSI UNFPA
UNFPA
SC UNFPA
AMDA
SC UNFPA
AMDA AMI
MSI
UNFPA
MSI UNFPA
Merlin MSI UNFPA
JOICFP UNFPA
YWCA
No. Tsp.
2
2
5
5
9
3
1
21
11
5
13
19
16
16
Provision of iron/folate supplement * MSI UNFPA Malteser UNFPA UNFPA UNFPA UNFPA
Organization UNFPA AMI MSI UNFPA
UNFPA
UNFPA
UNFPA
SC
SC
MSI
MSI UNFPA
Merlin MSI UNFPA
AMDA AMI JICA JOICFP UNFPA
No. Tsp. 2 2 Detection and treatment of anaemis * MSI 1 UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA Malteser
5 MSI 1 UNFPA
1
9
3
1
21
11
5
13
18
16 MSI 8 2
16 Merlin MSI
Organization 1 1
No. Tsp. Syphilis screening and treatment * JICA JOICFP UNFPA
AMDA JICA JOICFP 3
AMDA AMDA MSI
2 UNFPA UNFPA
Organization UNFPA 5 Malteser
UNFPA
AMI UNFPA
UNFPA
No. Tsp. 2 Treatment of intestinal parasites 1
2
5
5
3
1
21
11
4
13
12 AMDA AMDA 1 2 SC 1 SC 1 MMCWA All
14
14 YWCA Merlin 3 1 AMI 1
Organization No. Tsp. Voluntary testing and counseling for HIV
Organization No. Tsp.
* MMCWA covers all townships in all states/divisions
Delivery Care MON RKN SHN(N) SHN(S) SHN(E) BGO SGN TTY MGW MDY YGN AYW
KCN
KYA KYN
CHN
UNFPA
UNFPA
UNFPA
UNFPA
UNFPA
UNFPA
UNFPA
UNFPA
UNFPA
UNFPA
Merlin UNFPA
Clean delivery practices * Organiza- UNFPA tion AMI AMI Malteser JICA UNFPA JOICFP UNFPA
3 UNFPA UNFPA UNFPA UNFPA UNFPA
1
21
11
4
13 UNFPA
12 UNFPA
14 UNFPA
15 UNFPA
No. Tsp. 2 2 5 5 8 Administration of oxytocic drugs in the third stage of labour * UNFPA UNFPA UNFPA UNFPA Organiza- UNFPA tion No. Tsp. 2 2 5 5 5 Routine placenta examination * 3 UNFPA UNFPA UNFPA UNFPA
1
21
11
4 UNFPA
13 UNFPA
12 UNFPA
14 UNFPA
14 UNFPA
Organization UNFPA
UNFPA
UNFPA
UNFPA
AMI AMI Malteser UNFPA 5 8 3 1 21
No. Tsp. 2 2 5 Administration of oral and/or parenteral antibiotics *
11
4
13
12
14
14
Organization No. Tsp. Use of the partograph * UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA
UNFPA
UNFPA
Merlin UNFPA
Organization No. Tsp. Surgery Organization No.Tsp. 5 5 5
2
2
3
1
21
11
4
13
12
14
15
* MMCWA covers 91 maternity homes in all states/divisions
Neonatal Care SHN(N) SC 1 1 SC SHN(S) SHN(E) BGO SGN TTY MGW MDY YGN AYW Merlin 1 Merlin 1 SC 1 SC 1 SC 1 SC 1 AMI 1 Merlin 1 Merlin 1 Merlin 1 SC 1 SC 2 Merlin 1 Merlin JOICFP
KCN KYA KYN CHN MON RKN Prevention and management of hypothermia* Organization AMI Malteser JOICFP
AMI JICA 5 AMI JICA JOICFP
No. Tsp. Prevention and management of infections * Organization AMI Malteser
2
No. Tsp. 2 Immediate initiation of breast feeding (within first hour) * Organization AMI Malteser JOICFP
5 AMI JICA 5 JICA JOICFP
No. Tsp. 2 Promotion of exclusive breast feeding (first 6 months) * Malteser Organization 1 JICA JOICFP
No. Tsp. Resuscitation of newborn * Organization 2 Malteser JOICFP
2
No. Tsp. Umbilical cord care * Organization JICA 2 AMI JICA 5
No. Tsp. 2 Early detection and management of neonatal jaundice AMI Organization Malteser
No. Tsp. 2 * MMCWA covers 91 maternity homes in all states/divisions
1
Postnatal Care MON RKN SHN(N) SHN(S) SHN(E) BGO SGN TTY MGW MDY YGN AYW
KCN
KYA KYN
CHN
WV 2 3 1 WV 5
WV
AMDA AMDA WV
Development of birth-spacing plan service provision * OrganizaAMI AMI tion Malteser JOICFP No. Tsp. 2 5 Early detection and management of puerperal complications * OrganizaAMI AMI tion Malteser JOICFP No. Tsp. 2 5 Detection and treatment of malaria * AMDA AMDA
3
Merlin WV 3
Merlin 1 2 AMI 1 1
OrganizaMalteser tion No. Tsp. 1 Advice and support for breastfeeding, nutrition and healthy lifestyle * OrganizaAMI AMI JOICFP tion No. Tsp. 1 5 Provision of iron/folate supplements * UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA
UNFPA
UNFPA
UNFPA
UNFPA
UNFPA
Merlin UNFPA
Organization UNFPA
AMI AMI Malteser UNFPA 5 Malteser JICA UNFPA
No. Tsp. 2 2 Detection and treatment of anaemia UNFPA UNFPA
5
8
3 UNFPA
1 UNFPA
21 UNFPA
11 UNFPA
4 UNFPA
13 UNFPA
12 UNFPA
14 UNFPA
15 Merlin UNFPA
UNFPA
UNFPA
Organization 5 5 5
JOICFP
No. Tsp.
2
2
3
1
21
11
4
13
12
14
15
Provision of postnatal care within the first week (preferably within 2-3 days) * AMI AMI Malteser JICA JOICFP
Organization 2 UNFPA
Merlin
No. Tsp. Through review at 6 weeks postpartum * AMI UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA
5 UNFPA UNFPA
1 Merlin UNFPA
Organization JOICFP UNFPA
UNFPA
UNFPA
AMI JICA 8 AMI JICA JOICFP
No. Tsp. 2 2 5 5 Immunization against tetanus (if nor done during ANC) AMI 1 5
3
1
21
11
4
13
12
14
15 Merlin 1
Organization
No. Tsp. Syphilis screening (if not done in ANC) *
Organization 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 MON RKN SHN(N) SHN(S) SHN(E) BGO SGN TTY MGW MDY YGN AYW
KCN
KYA KYN
CHN
UNFPA
UNFPA
UNFPA
UNFPA
UNFPA
UNFPA
UNFPA
UNFPA
Post-abortion birth spacing service provision * UNFPA UNFPA Malteser UNFPA UNFPA Organiza- UNFPA UNFPA tion No. Tsp. 2 2 5 5 5 3 Counselling on birth spacing and other RH issues for post-abortion clients * 1 UNFPA MRCS UNFPA UNFPA UNFPA UNFPA
21
11
4
13
12 UNFPA
14 MRCS UNFPA
14 MRCS UNFPA
UNFPA
UNFPA UNFPA UNFPA UNFPA Organiza- UNFPA tion No. Tsp. 2 2 5 5 5 Manual vacuum aspiration for management of incomplete abortion
3
1
21
11
4
13
12
15
14
Organization No. Tsp. Prevention and management of sepsis, tetanus, injury, shock and haemorrhage Malteser 1
Organization No. Tsp.
* MMCWA covers 91 maternity homes in all states/divisions
Gynaecological Cancers RKN SHN(N) SHN(S) SHN(E) BGO SGN TTY MGW MDY YGN AYW
KCN KYA KYN CHN MON
Cervical cancer screening and treatment * Organization No. Tsp. Breast cancer screening and treatment * Organization No. Tsp.
* MMCWA covers all states/divisions. Postmenopausal Reproductive Health RKN SHN(N) SHN(S) SHN(E) BGO SGN TTY MGW MDY YGN AYW
KCN KYA KYN CHN MON
Counselling, including life style and nutrition * Organization No. Tsp.
* MMCWA covers all states/divisions.
Men’s Role in/and Reproductive Health MON RKN SHN(N) SHN(S) SHN(E) BGO SGN TTY MGW MDY YGN AYW
KCN KYA KYN CHN
Promotion of awareness of STIs/HIV/AIDS * AFXB OrganizaMMA tion AMDA CARE Malteser MMA WV JOICFP MMA UNFPA MMA SC WV MMA SC CARE MMA WV
AFXB AMI JOICFP MMA UNFPA WV
Merlin MMA WV
No. Tsp. 5 Promotion of men’s role in support of reproductive health AFXB MMA CARE MMA MMA MMA SC
4
2
9
5
4
7 MMA SC
11 CARE MMA
28 AFXB AMI MMA
7 Merlin MMA
Organization 9 WV MMA
No. Tsp. 5 2 Promotion of community awareness about violence against women MMA MMA
5 MMA
1 SC WV
7 MMA SC
9 MMA WV
25 MMA WV
5 MMA WV
Organization 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 Townships 1.Myitkyina Stakeholder ARH BSC RTI Reproductive Health Activities ANC DC NC PNC PAC GCA MPS MRH
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 Townships Stakeholder ARH BSC RTI Reproductive Health Activities 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 Townships 1.Kawkareik Stakeholder ARH BSC RTI Reproductive Health Activities ANC DC NC PNC PAC GCA MPS MRH
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 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. Townships Stakeholder ARH Mon State Townships 1.Mawlamyine Stakeholder AFXB PSI SC MMA MSI UNFPA 2.Kyaikhto AFXB JOICFP PSI MMA x x x x x x x x x x ARH x x x x x x x x x x x x x x x BSC RTI x Reproductive Health Activities ANC DC NC PNC PAC GCA MPS MRH x
UNFPA 3.Kyaikmaraw AFXB SC UNFPA 4.Paung
x x x
x
x x x
x
x
x
x x
x
x
x
x
x
x
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 Townships 1.Buthidaung Stakeholder ARH BSC RTI Reproductive Health Activities ANC DC NC PNC PAC GCA MPS MRH
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) Townships 1.Laokai 2.Mong Pawk 3.Wein Kao 4.Mong Maw 5.Pang Kham 6.Lashio Stakeholder AMDA AMI Malteser AMI AMI Malteser Malteser JOICFP PSI MMA UNFPA JICA JOICFP PSI UNFPA JICA ARH x BSC x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x RTI x x x x x x x Reproductive Health Activities ANC DC NC PNC PAC x x x x x x x x x x x x x x GCA MPS MRH x
7.Kyaukme
x
8.Naungcho
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) Townships 1.Kyaington Stakeholder WV UNFPA 2.Tachileik WV UNFPA x x ARH x BSC RTI x x x x x x x x x x Reproductive Health Activities ANC DC NC PNC PAC x x GCA MPS MRH 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) Townships 1.Pindaya Stakeholder ARH BSC RTI Reproductive Health Activities ANC DC NC PNC PAC GCA MPS MRH
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 Townships 1.Zalun 2.Yekyi Stakeholder JOICFP UNFPA JOICFP MMA UNFPA JOICFP PSI MMA UNFPA JOICFP ARH x x x x x BSC x x x RTI Reproductive Health Activities ANC DC NC PNC PAC x x x x x x x x x x GCA MPS MRH
x x
3.Nyaungdone
x x x x
x x
x x x x
4.Myanaung
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 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 UNFPA x 11.Wakema PSI x 12.Pantanaw PSI x MMA 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 UNFPA x x x x x 17.Kyaunggone MMA 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 MMCWA implements all activities, except sub-fertility, in all townships; NC, PNC, PAC in 91 maternity homes. Bago Division Townships 1. Bago Stakeholder PSI JOICFP MMA MSI UNFPA JOICFP MRCS MMA UNFPA JOICFP MMA PSI UNFPA JOICFP PSI UNFPA JOICFP PSI MMA MSI UNFPA ARH BSC x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x RTI Reproductive Health Activities ANC DC NC PNC PAC GCA MPS
x
x
x
x x
x
MRH
x x x x x x x
2.Daik U
x x x x
x x x x x x x x
3.Oaktwin
4.Gyobingauk
x
x
x
x
5.Pyay
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 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 UNFPA x x x x x x 12.Intakaw PSI x 13.Waw PSI x MMA 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 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 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 Townships 1.Aung Myay Thar Zan Stakeholder PSI MSI CARE UNFPA PSI MSI UNFPA PSI MSI WV UNFPA PSI ARH x BSC x x x x x x x x x x x x x RTI Reproductive Health Activities ANC DC NC PNC PAC GCA MPS
x
x
x
x
x
MRH
x
2.ChanAyeTharZan
x x x
x
x
3.Chan Mya Thar Zi
x x x
x
x
x
4.Maha Aung
Myay MSI x x x CARE x x UNFPA x 5.Pyi Gyi Tagun PSI x x MSI x x x x WV 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 UNFPA x x x x x x 8.Singaing JOICFP x MMA 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 UNFPA x x x x x x 12.Amarapura PSI x x MMA x x WV x x x x UNFPA x x x x x x 13.KyaukpaPSI x x daung UNFPA x 14.Kyaukse PSI x x 15.Madayar PSI x x MMA x x UNFPA x x x x x x 16.Patheingyi PSI x x MMA 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 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. x
x
x
x
x
x x
x
x
x
Magway Division Townships 1.Pakokku Stakeholder ARH BSC RTI Reproductive Health Activities ANC DC NC PNC PAC GCA MPS MRH x x
AMDA x x x x x x SC x x x x x MMA x x UNFPA x x x x x 2.Aunglan JOICFP x PSI x MMA x x UNFPA x x x x x x x 3.Yenanchaung JOICFP x PSI x MMA x x UNFPA x x x x x x 4.Chauk JOICFP x MMA 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 UNFPA x x x x x x x 12.Minhla UNFPA x x x x x 13.Yesagyo MMA x x UNFPA x x x x x 14.Myaing MMA 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 Townships 1.Myaung 2.Monywa Stakeholder JOICFP UNFPA JOICFP PSI MMA UNFPA PSI UNFPA PSI UNFPA ARH x x x BSC x x x x x x x x x x x x x RTI Reproductive Health Activities ANC DC NC PNC PAC x x x x GCA MPS
x
x
x
x
x x
MRH
x x x x x x x x x x
3.Kalay 4.Ayardaw
x
5.Chaung U 6.Kantbalu 7.Khin U
PSI x PSI x PSI x MMA x x UNFPA x x x x x 8.Sagaing PSI x 9.Shwebo PSI x MMA x x UNFPA x x x x x x 10.Wetlet PSI x MMA x x UNFPA x x x x x 11.Ye U PSI x 12.Myinmu MMA 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.
x
x
x
x
Tanintharyi Division Townships 1.Dawei Stakeholder ARH BSC RTI Reproductive Health Activities ANC DC NC PNC PAC GCA MPS MRH x x x x
JOICFP x WV x x x x UNFPA x x x x x x 2.Launglone SC x x x x x 3.Kawthoung WV x x x x UNFPA x x x x x 4.Myeik WV 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 Townships 1.Dala Stakeholder AMI JOICFP PSI UNFPA AMI AFXB PSI MdM JOICFP WV UNFPA AFXB PSI MdM ARH x x x x x x BSC RTI x x x Reproductive Health Activities ANC DC NC PNC PAC x x GCA MPS
MRH x
2.Seikkyi 3.S-Dagon
x x x x x x x x
x x
x
x
x x x
x x
4.N-Dagon
x x x x x
x x x
x x
x
x x
x
x x x x
UNFPA 5..N-Okkalapa AFXB MRCS MdM PSI YWCA UNFPA 6.S-Okkalapa AFXB PSI MdM UNFPA 7.Thaketa AFXB MSI PSI UNFPA 8.Thingangyun AFXB MSI PSI UNFPA 9.Mingaladon AFXB PSI UNFPA 10.Hlaingthayar AFXB PSI YWCA WV UNFPA 11.Shwepyithar AFXB MRCS PSI Partners UNFPA 12.Kamayut AFXB PSI UNFPA 13.Tamwe AFXB MdM PSI UNFPA 14.Mayangone AFXB PSI MdM UNFPA 15.Hlaing AFXB PSI UNFPA 16.Ahlone PSI UNFPA 17.Bahan PSI UNFPA
x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x
x x x x x
x x
x
x x
x x
x x x x x x x x x
x x
x x
x x
x
x x x x x x x x x x x x x x x x x x x x x x x x x
x
x x
x x x x
x x
x x x x x x x x
x
x
18.Dagon Seikkan 19.Dawbon 20.E-Dagon 21.Insein
PSI UNFPA PSI PSI UNFPA PSI MdM YWCA UNFPA PSI UNFPA PSI UNFPA PSI PSI UNFPA MdM UNFPA PSI UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA UNFPA JOICFP MMA UNFPA JOICFP PSI MMA UNFPA AFXB PSI MMA UNFPA AFXB AFXB PSI MMA YWCA WV UNFPA PSI MMA YWCA UNFPA UNFPA MMA UNFPA AMI PSI MMA
x x x x x x
x
x x x x x x x x x x x
x x
22.Kyimyindine 23.Mingalar taungnyunt 24.Shwepaukkan 25.Yankin 26.Latha 27. Sanchaung 28. Pabedan 29.Botahtaung 30.Pazundaung 31.Lanmadaw 32.Dagon 33. Laydaungkan 34.Kungyangone
x x x x x x x x x x x x x x x x x
x
x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x
35.Thongwa
36.Kyauktan
37.Thanlyn 38.Hmawbi
39.Taikkyi
40.Htantabin 41.Kawhmu 42.Twante
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 State/Division Trainees from vocational center, PLHAs, Youth from workplace; Workers from transportation sector, Uniform service personnel Township(s) Target Group Implementing Partners
Code No.
Activities
Organization
A1
Provision of sexual and RH information for young people
AFXB
Yangon
Number beneficiaries covered 6000
Mon
AMDA
Shan (N)
N/S Okkalapa, N/S Dagon, Thaketa, Thingangyun, Mingaladon, Hlaingtharyar, Shwepyitha, Kamayut, Tamwe, Mayangone, Hlaing, Kyauktan, Thanlyn, Hmawbi Mawlamyine, Kyaikhto, Kyaikmaraw, Paung Laokai
Mandalay
AMI CARE
Magwe Yangon Mandalay Youth
female villagers village health volunteer mothers mothers mothers Adolescents 15-24 yrs male & female
745 52 240 120 398 2000 1252 male 1188 female 920 350,000 856 trainers 1,212,900
JICA, NATALA JICA, NATALA JICA, DOH JICA, DOH JICA, DOH EC DOH, UNFPA CHEB DOH UNFPA, MOH
JOICFP Laputta 325 townships
Meiktila Nyaung U Pakokku Dala Aung Myay Thar Zan Maha Aung Myay Muse 27 UNFPA intensive townships *
Merlin
Shan (N) 10(S/D) Except Kachin, Kayin, Chin, Kayar Ayeyarwady
MMCWA
All states/ divisions
Men & women of reproductive age Young people
MRCS MMA, DOH
Yangon
Ayeyarwady Bago Young people 10-24 years UNFPA 12383+19877 6504 2304 747+3975 29386+47371 9034 26,273 108,250
Adolescent, Youth (15-24 & Out-of school)
MSI
PSI Adolescents (15-24) Youth (15-24) Out-of school youth Out-of school youth
General Practitioners CBO CBO MNA, Literacy & Cultural Ass.
SC
Mon Ayeyarwady Bago Mandalay Yangon Yangon Mandalay Taninntharyi Magway Kayin
Mon
Shan (N)
Out-of school youth 15-24 years old 16,840 MMA, MRCS
UNFPA
WV
Yangon Bago Ayeyarwady Mandalay Yangon
Youth, Women
16323
MOH
Mandalay
Ayeyarwady Tanintharyi
Shan (E) ** Chan Aye Thazan; Chan Mya Thazi; Aung Mya Thazan; Maha Aung Myay; Pyi Gyi Tagun
N-Okkalapa Shwepyithar Maubin Daik-U Phyu Mawlamyine, Thaton Pathein Pyay Pyigyitagun, Myingyan Thaketa, Thingangyun 32 townships 17 townships Launglone Pakokku Phaan, Hlaingbwe, Kawkareik Mawlamyine Thaton, Kyaikmaraw, Paung, Mudon, Chaungzone Theinni, Namkham, Namphatka, Muse 28 downtown townships Daik U, Phyu Maubin 5 MDC townships ** Hlaingtharyar, S.Dagon, Hmawbi Chanmyathazi, Pyigyitagun, Amarapura Thabaung, Pathein Dawei, Myeik, Kawthaung Kyaington, Tachileik
A2 Youth Youth, Risk group Young people 10-24 years 1380 CHEB 27 UNFPA intensive townships UNFPA
Youth friendly clinics/ centers
CARE
JOICFP
Malteser
MSI Out-of school youth 15 – 24 years old
SC UNFPA
Mandalay Shan (N) 10(S/D) Except Kachin, Kayin, Chin, Kayar Wa Special Region -2 Mon Ayeyarwady Bago Mandalay Yangon Mon Yangon 2000 11083+11960 1854 1178 3124+2038 22470+30893 13,200 270,240 MSI MSI, DOH
Bago
Ayeyarwady
Mandalay
Magwe
Sagaing Shan (N) Shan (S) Rakhine Tanintharyi Mon
Pang Kham Mawlamyine, Thaton Pathein Pyay Pyigyitagun, Myingyan Thaketa, Thingangyun Thaton Kungyangone, Dala, Thonegwa, Thaketa, Thingangyun Daik U, Oaktwin, Gyobingsuk, Pyi, Bago Yekyi, Nyaungdone, Myanaung, Hinthada, Zalun Singaing, Myittha, Nahtogyi, Wundwin, Myingyan, Pyigyitagun Aunglan, Tauntwingyi, Yenanchaung, Chauk Myaung, Monywa Lashio Pindaya Ponnagyun Dawei Kyaikhto, Thaton, Mawlamyine
Birth Spacing and Contraceptive Services Township(s) Women of reproductive age from low income neighbourhood Target Group Implementing Partners
Code No.
Activities
Organization State/Division
B1
Emergency contraception
MSI
Mon Ayeyarwady Bago Mandalay Women of reproductive age
Number beneficiaries covered 1,290
PSI *
Mawlamyine, Thaton Pathein Pyay 5 MCDC townships, Myingyan Thaketa, Thingangyun 116 townships
Private practitioners JICA, NATALA, PSI
B2
Oral contraception
AMDA
Yangon 10 states / divisions Shan (N) Mandalay Reproductive female Reproductive female Reproductive female Reproductive female Women in reproductive age Women in reproductive age All women SWs
AMI
745 131 100 137 311 241 2,500 10
Malteser MdM
Magwe Shan (N) Wa Region Rakhine Rakhine Kachin Yangon
JICA, DOH JICA, DOH JICA, DOH ECHO, UNFPA, DOH ECHO UNHCR
Merlin 325 townships Mawlamyine, Thaton Pathein Pyay 5 MDCD townships, Myingyan Thaketa, Thingangyun
Ayeyarwady
Laokai Meikhtila Nyaung U Pakokku Mong Pawk, Wein Kao, Mong Maw Buthidaung Maungdaw Myitkyina, Moegaung, Hopin Mayangone, Insein, NOkkalapa, S-Okkalapa, Latha, Tamwe, N.Dagon, S.Dagon Laputta Men & Women of reproductive age Married women
350,000 2980 x 2 yrs Women of reproductive age from low income neighbourhood 891,582
DOH IPPF, MOH
MMCWA
MSI
All states/ divisions Mon Ayeyarwady Bago Mandalay
Yangon
PSI ***
116 townships
Women of reproductive age
SC
UNFPA **** Women of reproductive age Reproductive female
10 states / divisions Tanintharyi Magwe 14 States/ Divisions Launglone Pakokku 112 townships 15-49 Eligible couples Women of reproductive age 5,366 1,725 30 % of total population 200 745 N.Okkalapa, Insein, Hlaingtharya, Hmawbi, Taikkyi Laokai
Private practitioners CBO CBO DOH
YWCA
B3
Monthly and/or three monthly injectables
AMDA
Yangon Shan (N)
Mandalay
AMI
Magwe Shan (N) Wa Region
Meikhtila Nyaung U Pakokku Mong Pawk, Wein Kao, Mong Maw Women in reproductive age SWs Married women
Reproductive female Reproductive female Reproductive female Women in reproductive age
92 280 187 3,939 1,211 100 1863 x 2 yrs
JICA, NATALA, PSI JICA, DOH JICA, DOH JICA, DOH ECHO, UNFPA, DOH ECHO
MdM
Rakhine Kachin Yangon
MMCWA
Buthidaung Myitkyina, Moegaung, Hopin Mayangone, Insein, NOkkalapa, S-Okkalapa, Latha, Tamwe, N.Dagon, S.Dagon 325 townships
IPPF, MOH Women of reproductive age from low income neighbourhood Women of reproductive age Women of reproductive age 30 % of total population 281,045
MSI
PSI ***
All states/ divisions Mon Ayeyarwady Bago Mandalay Yangon 10 states / divisions 112 townships
Mawlamyine, Thaton Pathein Pyay 5 MCDC townships, Myingyan Thaketa, Thingangyun 116 townships
Private practitioners DOH
UNFPA ****
14 States/ Divisions
B4 Women of reproductive age from low income neighbourhood 12,674
IUDs
MSI
Mon Ayeyarwady Bago Mandalay
PSI*** Eligible couples Women of reproductive age Women of reproductive age Women of reproductive age from low income neighbourhood
Women of reproductive age 1,725 30 % of total population 200 508
SC UNFPA****
Yangon Yangon Mandalay Tanintharyi 14 States/ Divisions N.Okkalapa, Insein, Hlaingtharya, Hmawbi, Taikkyi Mawlamyine, Thaton Pathein Pyay 5 MCDC townships, Myingyan Thaketa, Thingangyun N.Okkalapa, Insein, Hlaingtharya, Hmawbi, Taikkyi
Mawlamyine, Thaton Pathein Pyay Aungmyaythazan, Chanayethazan, Chanmyathasi, Mahaaungmyay, Pyigyitagun, Myingyan Thaketa, Thingangyun 32 townships 17 Launglone 112 townships
Private practitioners CBO DOH
YWCA
B5
Female sterilization
MSI
Yangon Mon Ayeyarwady Bago Mandalay
Yangon Women of reproductive age 50
YWCA
Yangon
RTI/STI/HIV/AIDS State/ Division Youth, PLHAs Villagers Villagers Villagers 7,452 4,000 Township(s) Target Group Number beneficiaries covered Implementing Partners
Code No.
Activities
Organization
C1
Condom promotion
AFXB
Yangon Mon
AMDA Meikhtila, Nyaung U Pakokku Dala, Twante, Seikkyi Mong Pawk, Wein Kao, Mong Maw Buthidaung
Shan (N)
16 townships * Mawlamyine, Kyaikhto, Kyaikmaraw, Paung Laokai
Mandalay
Magwe
3,000 + 2,000 1,200 200,000 51 128
AMI
Yangon
JICA, NATALA, PSI JICA, DOH, PSI JICA, DOH, PSI EC, FHAM UNFPA, ECHO ECHO DOH, UNFPA
Wa Region Shan (N) Rakhine
CARE
Mandalay
General population, MSM, HRM, SW Patients coming to RHC or mobile clinic Patients coming to RHC or mobile clinic 15-24 yrs both male and female All women Peer educators, health care facilities, prisons, military, police, karaoke bars, dropin center, workshops SWs, DUs Men & women of reproductive age All
Malteser
Shan (N) Rakhine Wa Region Shan (N)
Aung Myay Thar Zan, Maha Aung Myay Muse Maungdaw Pang Kham
107,000 190,000
UNHCR PSI
MdM
Kachin Yangon
5,000 350,000 122,400 DOH DOH, UNFPA IPPF, MOH
Merlin
Ayeyarwady
Myitkyina, Moegaung, Hopin Mayangone, Insein, Latha, N.okkalapa, S.Okkalapa, Tamwe, N.Dagon, S.Dagon Laputta 45 townships 325 townships
MMA MMCWA
8 S/D All S/D
MRCS Adolescent, Youth (15-24 years and out-of school) Sex workers
MMA, DOH
MSI
SC
Yangon Bago Ayeyarwady Mon Ayeyarwady Bago Mandalay Yangon Tanintharyi Magway Kayin Mon 220 307 216 953 + 282 211 + 249 13,000 1,365 600,000 Reproductive age men Reproductive age men & women Out-of school youths, Men & women of reproductive age SW & Clients Youth, Women 16,323
Shan (N)
UNFPA WV
CBO Literature and Cultural Associations, Youth leaders, Consortium members DOH MOH
11 S/D Yangon Mandalay
C2
AFXB
Ayeyarwady Tanintharyi Shan (E) Yangon Mon
Youth, PLHAs Villagers Villagers General population Youth, risk groups, incarcerated population SWs, DUs All
Diagnosis and treatment of RTIs and STIs
AMDA
Mandalay
AMI Malteser
N.Okkalapa, Shwepyitha Daik U, Phyu Maubin Mawlamyine Pathein Pyay 5 MCDC townships, Myingyan Thaketa, Thingangyun Launglone Pakokku Pha-an, Hlaingbwe, Kawkareik Mawlamyine, Thaton, Kyaikmaraw, Paung, Mudon, Chaungzone Theinni, Namkham, Namphatkar, Muse 30 townships * Hlaingthayar, S.Dagon, Hmawbi Chanmyathazi, Pyigyitagun, Amarapura Thabaung, Pathein Dawei, Myeik, Kawthaung Kyaington, Tachileik 16 townships Mawlamyine, Kyaikhto, Kyaikmaraw, Paung Meikhtila Nyaung U Pakokku Dala, Twante, Seikkyi Mong Maw, Mong Pawk, Pang Kham 18 15 25 1,500 2,200 1,200 FHAM
MdM
Magwe Yangon Wa Region Shan (N) Kachin Yangon
MMA
8 S/D
Myitkyina, Moegaung, Hopin Mayangone, Insein, N.okkalapa, Latha, S.Okkalapa, Tamwe, N.Dagon, S.Dagon 45 townships
DOH, UNFPA
MMCWA MSI Women, Men and Youth and Risk behaviour group MSI DOH 127 980 2,720 1,500 FHAM
SC
All S/D Mon Ayeyarwady Bago Mandalay Yangon Mon 679 1454 2496 6724 + 2150 2567 + 1993 1,365 Out-of school youth, General youth SW & Clients Youth, PLHAs General population General population SWs, DUs All Women, Men and Youth and Risk behaviour group Youth, Women 425 776
325 townships Mawlamyine Pathein Pyay 5 MCDC townships, Myingyan Thaketa, Thingangyun Thaton
C3
VCCT for HIV
UNFPA AFXB
11 S/D Yangon Mon
AMI Malteser
30 townships * 16 townships Mawlamyine, Kyaikhto, Kyaikmaraw, Paung Dala, Twante, Seikkyi Pang Kham
MdM
Yangon Wa Region Shan (N) Kachin
Yangon
MMA MMCWA MSI
8 S/D All S/D Yangon
Myitkyina, Moegaung, Hopin Mayangone, Insein, N.okkalapa, Latha, S.Okkalapa, Tamwe, N.Dagon, S.Dagon 45 townships 325 townships Thaketa
DOH, UNFPA
WV
Yangon Mandalay
C4
Syphilis screening
AMI MdM
General population SWs, DUs
581 1,000
Ayeyarwady Tanintharyi Shan (E) Yangon Kachin Yangon
FHAM
MMCWA
All S/D
Hlaingthayar, S.Dagon, Hmawbi Chanmyathazi, Pyigyitagun, Amarapura Thabaung, Pathein Dawei, Myeik, Kawthaung Kyaington, Tachileik Dala, Twante, Seikkyi Myitkyina, Moegaung, Hopin Mayangone, Insein, N.okkalapa, Latha, S.Okkalapa, Tamwe, N.Dagon, S.Dagon 325 townships
C5 28,345
PMTCT
AMI MMA MMCWA SC 22 townships ** Pregnant mothers & husbands, Youth Pregnant mothers, Spouses, Newborns
Yangon 8 S/D All S/D Magway
Dala, Twante, Seikkyi 45 townships 325 townships Pakkoku
General population All
3
FHAM DOH, UNFPA
UNFPA
10 S/D
Antenatal Care Township(s) Target Group
Code No. Pregnant women 637
Activities
Organization State/Division
Number Implementing beneficiaries Partners covered JICA, NATALA 72 WFP, DOH DOH DOH 1,000 350,000 122,748 349 1,036 DOH 119 + 1000 JICA, DOH 80 JICA, DOH 64 UNFPA, DOH DOH DOH 1,400 122,748 DOH
D1 Home base AMDA records (Preparation of birth plans) JICA JOICFP Malteser Merlin
Shan (N) Mandalay Magwe Shan (N) Shan (N) Rakhine Ayeyarwady
Laokai Meikhtila, Nyaung U Pakokku Kyaukme, Naungcho Kyaukme, Naungcho Maungdaw Laputta/ Pyinsalu
MMCWA SC
UNFPA D2 Immunization AMDA against Tetanus
AMI JICA JOICFP Malteser MMCWA MSI
All S/D Tainintharyi Magway 14 S/D Mandalay Magwe Shan (N) / Wa Shan (N) Shan (N) Rakhine All S/D Mon Ayeyarwady Bago Mandaly Yangon
325 townships Launglone Pakokku 112 townships * Meikhtila, Nyaung U Pakokku Mong Pawk Kyaukme, Naungcho Kyaukme, Naungcho Maungdaw 325 townships Mawlamyine Pathein Pyay 5 MCDC towns, Myingyan Thaketa, Thingangyun
AMW Pregnant mothers Women, Children <5 Men & women of reproductive age Pregnant women Pregnant mothers Pregnant mothers Pregnant mothers Pregnant women Pregnant women Pregnant women AMW Pregnant mothers Women, Children <5 Pregnant women
WV Mothers 23,499 MOH
AMDA
JICA, NATALA
D3 Detection and treatment of hypertensive disorders in pregnancy AMW Pregnant mothers
AMI
Yangon Mandalay Ayeyarwady Tanintharyi Shan (E) Shan (N) Mandalay Magwe Shan (N) / Wa Hlaingtharyar, S.Dagon, Hmawbi Chanmyathazi, Pyigyitagun, Amarapura Thabaung, Pathein Dawei, Myeik, Kawthaung Kyaington, Tachileik Laokai Meikhtila, Nyaung U Pakokku Mong Pawk, Wein Kao, Mong Maw Pregnant women Pregnant women Pregnant women Pregnant women 1 11 + 9 30 2,881 JICA, DOH JICA, DOH ECHO, UNFPA, DOH DOH DOH
JICA JOICFP MMCWA MSI
D4 Detection and treatment of malaria
UNFPA AMDA
2+3 10
JICA JOICFP Malteser Merlin
Shan (N) Shan (N) All S/D Mon Ayeyarwady Bago Mandaly Yangon 14 S/D Mandalay Magwe Shan (N) Shan (N) Rakhine Ayeyarwady Pregnant mothers Pregnant women Pregnant women AMW Pregnant mothers Women, Children <5 Men & women of reproductive age
Kyaukme, Naungcho Kyaukme, Naungcho 325 townships Mawlamyine Pathein Pyay 5 MCDC towns, Myingyan Thaketa, Thingangyun 112 townships * Meikhtila, Nyaung U Pakokku Kyaukme, Naungcho Kyaukme, Naungcho Maungdaw Laputta/ Pyinsalu
DOH JICA, DOH JICA, DOH DOH DOH 700/month 350,000 DOH
MMCWA
All S/D
D5 Advice on early detection of complications and danger signs Shan (N) Mandalay Magwe Yangon Rakhine Shan (N) / Wa General Population Pregnant women Pregnant women Shan (N) Shan (N) Rakhine Ayeyarwady 2 3 + 25 3 3,500 4,171 2,881
AMDA
JICA, NATALA
AMI
JICA JOICFP Malteser Merlin
Laokai Meikhtila, Nyaung U Pakokku Dala Buthidaung Mong Pawk, Wein Kao, Mong Maw Kyaukme, Naungcho Kyaukme, Naungcho Maungdaw Laputta/ Pyinsalu AMW Pregnant mothers Women, Children <5 Men & women of reproductive age 500/month 350,000 2,578,512 JICA, DOH JICA, DOH EC ECHO ECHO, UNFPA, DOH DOH DOH Malteser DOH
MMCWA MSI
SC
All S/D Mon Ayeyarwady Bago Mandaly Yangon Tainintharyi
325 townships Mawlamyine Pathein Pyay 5 MCDC towns, Myingyan Thaketa, Thingangyun Launglone
3,600 1,036 23,499 DOH MOH
UNFPA WV
Magway 14 S/D Yangon Mandalay
YWCA
Ayeyarwady Tanintharyi Shan (E) Yangon
Reproductive age women, VHV Pakokku Pregnant mothers 112 townships * Pregnant mothers Hlaingtharyar, S.Dagon, Hmawbi Mothers Chanmyathazi, Pyigyitagun, Amarapura Thabaung, Pathein, Hpan Dawei, Myeik, Kawthaung Kyaington, Tachileik N.Okkalapa, Insein, Thingangyun Women of reproductive age
D6 Provision of iron / folate supplement Pregnant women Pregnant women Pregnant women JICA, NATALA
AMDA AMI ECHO ECHO, UNFPA, DOH DOH DOH
Shan (N) Laokai Rakhine Buthidaung Shan (N) / Wa Mong Pawk, Wein Kao, Mong Maw Kyaukme, Naungcho Kyaukme, Naungcho Maungdaw Laputta/ Pyinsalu 122,748
72 4,171 2,881
JICA JOICFP Malteser Merlin
Shan (N) Shan (N) Rakhine Ayeyarwady
MMCWA MSI
AMW Pregnant mothers Women, Children <5 Men & women of reproductive age Pregnant women
1,500/month 350,000 DOH
SC
UNFPA WV
Pregnant mothers Pregnant mothers Pregnant mothers Mothers
349 880 23,499 DOH MOH
D7 Detection and treatment of anaemia
AMDA
2 24 + 1000 50
JICA, NATALA
JICA JOICFP Malteser Merlin 325 townships Mawlamyine
All S/D Mon Ayeyarwady Bago Mandaly Yangon Tainintharyi Magway 14 S/D Yangon Mandalay Ayeyarwady Tanintharyi Shan (E) Shan (N) Mandalay Magwe Shan (N) Shan (N) Rakhine Ayeyarwady Pregnant women Pregnant women Pregnant women AMW Pregnant mothers Women, Children <5 Men & women of reproductive age
325 townships Mawlamyine Pathein Pyay 5 MCDC towns, Myingyan Thaketa, Thingangyun Launglone Pakokku 112 townships * Hlaingtharyar, S.Dagon, Hmawbi Chanmyathazi, Pyigyitagun, Amarapura Thabaung, Pathein, Hpan Dawei, Myeik, Kawthaung Kyaington, Tachileik Laokai Meikhtila, Nyaung U Pakokku Kyaukme, Naungcho Kyaukme, Naungcho Maungdaw Laputta/ Pyinsalu
JICA, DOH JICA, DOH DOH DOH 1,500/month 350,000 DOH 30,000
MMCWA MSI
All S/D Mon
D8 Syphilis screening and treatment
D9 Treatment of intestinal parasites
AMI JICA JOICFP MMCWA UNFPA AMDA 3 + 350 150 350,000 100
General Population AMW Pregnant mothers
FHAM DOH DOH DOH JICA, DOH JICA, DOH DOH
Malteser Merlin N.Okkalapa, Insein, Thingangyun Dala
Ayeyarwady Bago Mandaly Yangon Yangon Shan (N) Shan (N) All S/D 14 S/D Mandalay Magwe Rakhine Ayeyarwady
Pathein Pyay 5 MCDC towns, Myingyan Thaketa, Thingangyun Dala Kyaukme, Naungcho Kyaukme, Naungcho 325 townships 112 townships * Meikhtila, Nyaung U Pakokku Maungdaw Laputta/ Pyinsalu
YWCA
Yangon
AMI
Yangon
Pregnant mothers Pregnant women Pregnant women Women, Children <5 Men & women of reproductive age All (especially children) General Population Pregnant mothers Partners 653 75
FHAM
D10 Voluntary counselling and testing for HIV
MMCWA SC
Mandalay
Delivery Care Organization State/Division AMI 181 300 / month 350,000 9,903 DOH 76 Pregnant women Women Pregnant mothers Pregnant mothers 181 300 / month 9,903 DOH ECHO, UNFPA, DOH ECHO JICA JOICFP Malteser Merlin Rakhine Shan (N) Shan (N) Rakhine Ayeyarwady Shan (N) / Wa Mong Pawk, Wein Kao, Mong Maw Buthidaung Kyaukme, Naungcho Kyaukme, Naungcho Maungdaw Laputta Pregnant women AMW Pregnant mothers Women Men & women of reproductive age Pregnant women Pregnant mothers Pregnant mothers Pregnant women Pregnant women Township(s) Target Group Implementing Partners ECHO, UNFPA, DOH ECHO DOH DOH DOH
Code No.
Activities
E1
Clean delivery practices
Number beneficiaries covered 76
E2
E3
MMCWA UNFPA Administration of oxytocic drugs MMCWA in the third stage of labour UNFPA Routine placenta examination AMI
All S/D 14 S/D All S/D 14 S/D Shan (N) / Wa
E4 MMCWA Merlin MMCWA UNFPA All S/D 14 S/D Ayeyarwady All S/D Laputta
Malteser MMCWA UNFPA UNFPA
Rakhine Rakhine All S/D 14 S/D 14 S/D
91 Maternity Homes 112 townships 91 Maternity Homes 112 townships Mong Pawk, Wein Kao, Mong Maw Buthidaung Maungdaw 91 Maternity Homes 112 townships 112 townships
DOH DOH
E5
E6
Administration of parenteral anticonvulsants to treat preeclampsia and eclampsia Administration of oral and/or parenteral antibiotics Use of the partograph
Men & women of reproductive age 91 Maternity Homes 112 townships Pregnant mothers
350,000 9,903
DOH DOH
E7
Surgery
Neonatal Care Township(s) Neonates 181 300 / month 350,000 9,903 1,002 1,036 76 181 300 / month 350,000 Pregnant women 9,903 76 181 300 / month 350,000 ECHO, UNFPA ECHO DOH DOH DOH ECHO, UNFPA ECHO DOH DOH DOH Pregnant women AMW Women of reproductive age Women Men & women of reproductive age Target Group Implementing Partners ECHO, UNFPA ECHO DOH DOH DOH
Code No. Shan (N) / Wa Rakhine Shan (N) Shan (N) Rakhine Ayeyarwady All S/D Tanintharyi Magway Shan (N) / Wa Rakhine Shan (N) Shan (N) Rakhine Ayeyarwady All S/D Shan (N) / Wa Rakhine Shan (N) Shan (N) Rakhine Ayeyarwady Pakokku 91 Maternity Homes Launglone
Activities
Organization State/Division
F1
Prevention and management of hypothermia
AMI
Number beneficiaries covered 76
JICA JOICFP Malteser Merlin
Mong Pawk, Wein Kao, Mong Maw Buthidaung Kyaukme, Naungcho Kyaukme, Naungcho Maungdaw Laputta
MMCWA SC
F2
Prevention and management of infections
AMI
Neonates AMW Women of reproductive age Women Men & women of reproductive age Newborns Pregnant mothers, Birth attendants Pregnant mothers, Birth attendants Neonates Neonates AMW Women of reproductive age Women Men & women of reproductive age
JICA JOICFP Malteser Merlin
Mong Pawk, Wein Kao, Mong Maw Buthidaung Kyaukme, Naungcho Kyaukme, Naungcho Maungdaw Laputta
F3
Immediate initiation of breastfeeding (within first hour)
MMCWA AMI
JICA JOICFP Malteser Merlin
91 Maternity Homes Mong Pawk, Wein Kao, Mong Maw Buthidaung Kyaukme, Naungcho Kyaukme, Naungcho Maungdaw Laputta
MMCWA SC Magway Yangon Shan (N) Shan (N) Rakhine Ayeyarwady 300 / month 350,000 9,903 1,002 1,255 All S/D Tanintharyi Magway Shan (N) Shan (N) Ayeyarwady All S/D Shan (N) Shan (N) Rakhine Ayeyarwady All S/D Tanintharyi Magway Shan (N) / Wa Rakhine Shan (N) 91 Maternity Homes Launglone 91 Maternity Homes Kyaukme, Naungcho Kyaukme, Naungcho Maungdaw Laputta 91 Maternity Homes Launglone 3,500 EC DOH DOH DOH 1,255
All S/D Tanintharyi
91 Maternity Homes Launglone
9,903 1,002
F4
Promotion of exclusive breast feeding (first 6 months)
AMI JICA JOICFP Malteser Merlin
Pakokku Minbu Dala Kyaukme, Naungcho Kyaukme, Naungcho Maungdaw Laputta
Pregnant mothers, Birth attendants Pregnant mothers, Birth attendants General population AMW Women of reproductive age Women Men & women of reproductive age
MMCWA SC
F5
Resuscitation of the newborn
JICA JOICFP Merlin
Pakokku Minbu Kyaukme, Naungcho Kyaukme, Naungcho Laputta
Pregnant mothers, Birth attendants Pregnant mothers, Birth attendants AMW Women of reproductive age Men & women of reproductive age
350,000
DOH DOH DOH DOH DOH 300 / month 350,000 1,002 1,255 76 181 DOH
F6
Umbilical cord care
MMCWA JICA JOICFP Malteser Merlin
AMW Women of reproductive age Women Men & women of reproductive age
MMCWA SC
F7
Early detection and management of neonatal jaundice
AMI
Pregnant mothers, Birth attendants Pregnant mothers, Birth attendants Neonates Pakokku Minbu Mong Pawk, Wein Kao, Mong Maw Buthidaung Kyaukme, Naungcho Neonates AMW
JICA
ECHO, UNFPA, DOH ECHO DOH
JOICFP Malteser Merlin 300 / month 350,000 DOH All S/D 91 Maternity Homes
Shan (N) Rakhine Ayeyarwady
Kyaukme, Naungcho Maungdaw Laputta
Women of reproductive age Women Men & women of reproductive age
DOH
MMCWA
Postnatal Care Township(s) Target Group
Code No. Mandalay Meikhtila, Nyaung U Magwe Pakokku Shan (N) / Wa Mong Pawk, Wein Kao, Mong Maw Rakhine Shan (N) Rakhine Ayeyarwady Kyaukme, Naungcho Maungdaw Laputta/ Pyinsalu Buthidaung
Activities
Organization State/Division
G1 Development of birth- AMDA spacing plan services provision AMI
Number Implementing beneficiaries Partners covered 240 + 120 JICA, DOH 398 JICA, DOH 4,316 ECHO, UNFPA, DOH 1,580 ECHO DOH 300 / month 350,000 DOH
JOICFP Malteser Merlin
Mothers Mothers Women in reproductive age Women in reproductive age Pregnant mothers Women Men & women of reproductive age
MMCWA WV
MOH
G2 Early detection and management of puerperal complications
AMI
All S/D Yangon Mandalay Ayeyarwady Tanintharyi Shan (E) Shan (N) / Wa
ECHO ECHO DOH
G3 Detection and treatment of malaria
JOICFP Malteser MMCWA AMDA
JICA, DOH JICA, DOH
Malteser
Rakhine Shan (N) Rakhine All S/D Mandalay Magwe Rakhine
91 Maternity Homes 9,903 Hlaingtharyar, S.Dagon, Hmawbi Mothers 9,615 Chanmyathazi, Pyigyitagun, Amarapura Thabaung, Pathein Dawei, Myeik, Kawthaung Kyaington, Tachileik Mong Pawk, Wein Kao, Mong Maw Women in 796 reproductive age Buthidaung Child bearing women 692 Kyaukme, Naungcho Pregnant mothers Maungdaw Women 300 / month 91 Maternity Homes 9,903 Meikhtila, Nyaung U Pregnant women 3000 + 2000 Pakokku Pregnant women 1200 Maungdaw Women 300 / month
Merlin 9,903 3,500 796 1,126
Ayeyarwady
Laputta/ Pyinsalu
Men & women of reproductive age General population Child bearing women Child bearing women Pregnant mothers Child bearing women Child bearing women Women Men & women of reproductive age Postnatal mothers Mothers
350,000
DOH
G4 Advice and support for breast feeding, nutrition and healthy life style JOICFP MMCWA G5 Provision of iron / AMI folate supplement Malteser Merlin 9,903 5,107
MMCWA AMI
All S/D Yangon Shan (N) / Wa Rakhine Shan (N) All S/D Rakhine Shan (N) / Wa Rakhine Ayeyarwady
91 Maternity Homes Dala Mong Pawk, Wein Kao, Mong Maw Buthidaung Kyaukme, Naungcho 91 Maternity Homes Buthidaung Mong Pawk, Wein Kao, Mong Maw Maungdaw Laputta/ Pyinsalu
EC ECHO ECHO DOH 9,903 1,126 ECHO 796 ECHO, 300 / month 350,000 DOH
MMCWA UNFPA WV
DOH MOH
G6 Detection and treatment of anaemia
JICA JOICFP Malteser Merlin
All S/D 14 S/D Yangon Mandalay Ayeyarwady Tanintharyi Shan (E) Shan (N) Shan (N) Rakhine Ayeyarwady 14 S/D 112 townships * Rakhine Buthidaung Shan (N) / Wa Mong Pawk, Wein Kao, Mong Maw Shan (N) Shan (N) Rakhine Kyaukme, Naungcho Kyaukme, Naungcho Maungdaw
91 Maternity Homes 112 townships * Hlaingtharyar, S.Dagon, Hmawbi Chanmyathazi, Pyigyitagun, Amarapura Thabaung, Pathein Dawei, Myeik, Kawthaung Kyaington, Tachileik Kyaukme, Naungcho Kyaukme, Naungcho Maungdaw Laputta/ Pyinsalu
DOH DOH 300 / month 350,000 DOH DOH ECHO 354 220 AMW Pregnant mothers Women ECHO, UNFPA, DOH
AMW Pregnant mothers Women Men & women of reproductive age Postnatal mothers Child bearing women Child bearing women
UNFPA G7 Provision of postnatal AMI care within the first week JICA JOICFP Malteser
DOH DOH 300 / month
Merlin 350,000 DOH
Ayeyarwady
Laputta/ Pyinsalu
Men & women of Reproductive age Child bearing women Child bearing women AMW Pregnant mothers Men & women of reproductive age Postnatal mothers Under 1 children 350,000 9,903 59 9,903 354 220
G8 Through review at 6 weeks postpartum
MMCWA AMI
All S/D 91 Maternity Homes Rakhine Buthidaung Shan (N) / Wa Mong Pawk, Wein Kao, Mong Maw Shan (N) Shan (N) Ayeyarwady All S/D 91 Maternity Homes All S/D 112 townships * Shan (N) / WA Mong Pawk Shan (N) Shan (N) Ayeyarwady All S/D Mandalay 325 townships Kyaukme, Naungcho Kyaukme, Naungcho Laputta/ Pyinsalu Laputta/ Pyinsalu Kyaukme, Naungcho Kyaukme, Naungcho
JICA JOICFP
ECHO ECHO, UNFPA, DOH DOH DOH DOH
Merlin
MMCWA UNFPA G9 Immunization against AMI tetanus
JICA JOICFP Merlin
AMW Pregnant mothers Men & women of reproductive age
350,000
DOH ECHO, UNFPA, DOH DOH DOH DOH
G10 Syphilis screening MMCWA and treatment G11 Voluntary counselling MMCWA and testing for HIV
Post-abortion Care Organization State/Division Malteser MMCWA 3,690 DOH 3,000 Women of reproductive age 6,500 DOH MMA, DOH UNFPA All S/D 14 S/D Yangon Bago Ayeyarwady N.Okkalapa, Shwepyitha Daik U, Phyu Maubin 91 Maternity Homes 112 townships 14 S/D 112 townships Rakhine All S/D Maungdaw 91 Maternity Homes Women Post abortion cases Women of reproductive age Township(s) Target Group Number beneficiaries covered Implementing Partners
Code No.
Activities
H1
Post-abortion birth-spacing service provision
H2
Counselling on birth spacing and MMCWA other RH issues for post-abortion UNFPA clients MRCS
H3
H4
Manual vacuum aspiration for management of incomplete abortion Prevention and management of sepsis, tetanus, injury, shock and haemorrhage Malteser Rakhine Maungdaw
Women
5 / month
Men’s Role in/and Reproductive Health Township(s) Youth, PLHAs 28 11186 + 967 + 629(12,772) Target Group Implementing Partners
Code No. Yangon Mon Shan (N) Yangon Mandalay 15-24 youths both male and female 15,000 1,234 Dala, Twantw, Seikkyi 16 townships Mawlamyine, Kyaikhto, Kyaikmaraw, Paung Laokai Village Health Volunteers HRM, MSM, CSW
Activities
Organization State/Division
M1
Promotion of AFXB awareness of sexually transmitted infections/HIV/AIDS AMDA
Number beneficiaries covered 4,000
AMI
JICA, NATALA FHAM
CARE
JOICFP
DOH, MMA
Malteser
Shan (N) Yangon Bago Shan (N) / Wa
Aungmyaythazan, Mahaaungmyay Muse S.Dagon Bago Pang Kham
Merlin
Ayeyarwady
Laputta
MMA MMCWA SC
Men of reproductive age Police, Military, Teachers, Students, PLWHA, Bar/Hotel owners, Truck drivers Men & women of reproductive age All
350,000 1,212,900 2,683 4,699 Reproductive age men Reproductive age men Men of reproductive age Youth, Women 16,523
DOH DOH, UNFPA
UNFPA
WV Mandalay Ayeyarwady Taninthayi Shan (E)
8 S/D All S/D Tanintharyi Magway Yangon Bago Yangon
45 townships 325 townships Launglone Pakokku Laydauntkan, S.Dagon Bago Hlaingtharyar, S.Dagon. Hmawbi Chanmyatharzi, Pyigyitagun, Amarapura Thabaung, Pathein Dawei, Myeik, Kawthaung Kyaington, Tachileik
MOH
M2 Youth, PLHAs General population 15-24 youths both male and female 350,000 2,683 4,699 598 MOH 600 EC 4,000 Yangon Mandalay Shan (N) Ayeyarwady
Promotion of men’s role in support of reproductive health
AFXB
Yangon Mon
AMI CARE
Merlin
16 townships Mawlamyine, Kyaikhto, Kyaikmaraw, Paung Dala Aungmyaythazan, Mahaaungmyay Muse Laputta DOH
MMA SC
DOH, UNFPA
UNFPA
WV Mandalay
8 S/D Tanintharyi Magway Yangon Bago Yangon
Men & women of reproductive age All Reproductive age men Reproductive age men Men of reproductive age Youth, Women
M3
MMA SC
DOH, UNFPA 2,683 4,699 30,795 MOH
Promotion of community awareness about violence against women Mandalay Ayeyarwady Taninthayi Shan (E)
WV
Ayeyarwady Taninthayi Shan (E) 8 S/D Tanintharyi Magway Yangon
45 townships Launglone Pakokku Laydauntkan, S.Dagon Bago Hlaingtharyar, S.Dagon. Hmawbi Chanmyatharzi, Pyigyitagun, Amarapura Thabaung, Pathein Dawei, Myeik, Kawthaung Kyaington, Tachileik 45 townships Launglone Pakokku Hlaingtharyar, S.Dagon. Hmawbi Chanmyatharzi, Pyigyitagun, Amarapura Thabaung, Pathein Dawei, Myeik, Kawthaung Kyaington, Tachileik All Reproductive age men Reproductive age men Youth, Women
* JOICFP’s ‘Adolescent Reproductive Health’ Townships (UNFPA Intensive townships) State/Division 1. Yangon 2. Bago 3. Ayeyarwady 4. Mandalay 5. Magway 6. Sagaing 7. Shan (N) 8. Shan (S) 9. Rakhine 10. Tanintharyi 11. Mon Townships 1. Kungyangone 2. Thongwa 3. Dala 4. Daik U 5. Oattwin 6. Gyobingauk 7. Pyay 8. Zalun 9. Yekyi 10. Nyaungdone 11. Myanaung 12. Hinthada 13. Singaing 14. Myitthar 15. Nahtogyi 16. Wundwin 17. Aunglan 18. Taungtwingyi 19. Yenanchaung 20. Chauk 21. Myaung 22. Monywa 23. Lashio 24. Pindaya 25. Ponnagyun 26. Dawei 27. Kyaikhto *** PSI’s Project Townships State/Division 1. Yangon Townships 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 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 1. Kangyidaung 2. Laputta 3. Myaungnya 4. Pathein 5. Hinthada 6. Wakhema 7. Nyaungdone 8. Pantanaw 1. Kalay 2. Ayaydaw 3. Chaung U 4. Kantbalu 5. Khin U 6. Monywa 7. sagaing 8. Shwebo 9. Wetlet 10. Ye U 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 1. Sinpaungwe 2. Aunglan 3. Magway 4. Minbu 5. Natmauk 6. Pwintphyu 7. Salin 8. Taungtwingyi 9. Yenanchaung 1. Bilin 2. Kyaikhto 3. Kyaik-khami 4. Mawlamyine 5. Mudon 6. Paung 7. Thanbyuzayat 8. Thaton 1. Kawkareik 2. Hlainbwe 1. Hsipaw 2. Kyaukme 3. Lashio 4. Muse 5. Namkham 6. Naungkhio 1. Kalaw 2. Nyaungshwe 3. Taunggyi 4. Yaksauk
2. Mandalay
3. Ayeyarwady 4. Sagaing 5. Bago
6. Magway 7. Mon 8. Kayin 9. Shan (N) 10. Shan (S)
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) Location Number of Duration (State/Division - Training of Township) Training Main Topics /Subjects Training Manual available
SN Name of Training Trainee (Category and Number)
Trainers
Findings of Monitoring & Evaluation of training
1 Participatory type Peer group training small group training Yangon (16 townships) Mon (Mawlamyine, Kyaikhto, Kyaikmaraw, Paung) 200 1 hr 15 1 hr 15 1/2 hr 15 1/2 hr 15 1/2 hr Male Yes involvement STIs Yes 200 1 hr HIV/AIDS Yes Trained trainers (5)
Youth from vocational training centers (375) People from work place (200) Bus and Truck drivers (2918) Police staff (788) Vendors and families of police (703) Peer educator (54) HIV infected and affected people (800)
Participants have more knowledge on HIV/AIDS compare to birth spacing. They were quite happy to get the training and they got the chance to make some clarifications on RH. males come to understand that they do have the role in RH. They really welcome future trainings on RH.
2
3
4
Anti Human Yes Trafficking Birth Yes Spacing Abortion Yes
5
6
Association of Medical Doctors of Asia (AMDA) Location (State/Division Township) Number of Training Duration of Training Main Topics/Subjects Training Manual available
SN
Name of Training
Trainee (Category and Number)
Trainers
Findings of Monitoring & Evaluation of training
1 Awareness of STI/HIV/AIDS Shan State Shan State Shan State Mandalay/Magwe
19, WFP volunteer
one two one one one three six 2 days Emergency care/ methodology
3 days 5 days 2 days 5 days 2 days 3 days delivery stage/RH diseases delivery stage/RH diseases personal hygiene/first aid
information/prevention yes yes yes yes yes yes AMDA staff AMDA staff/DOH AMDA expatriates AMDA expatriates AMDA expatriates AMDA expatriates
yes
AMDA staff
80% 80% 90% 90% 100% 100% 90%
2 Basic health knowledge Emergency care Emergency care
56 AMDA volunteer
3 First aid training
21 AMDA volunteer
4 Mandalay/Magwe Mandalay/Magwe
Rural Health Management & First aid
28 VHV
5 Safe Motherhood & Childbirth
15 AMDA staff
6 Safe Motherhood & Childbirth
62 MW/AMW
7
First aid & effective Health education
114 VHV/MW/AMW Mandalay/Magwe
Aide Medicale Internationale (AMI) Main Topics/Subjects Training Manual available
SN
Name of Training
Trainee (Category and Number)
Location Number Duration of (State/Division of Training Township) Training
Trainers
Findings of Monitoring & Evaluation of training
1
"Safe Motherhood" Health educators YGN Division, (3) and Nurses Dala Township (4)
1
1 day
Advices for the daily life of a pregnant woman Training Manual AMI (National available medical officer) (details on the personal hygiene, the rest, the following WHO good balance diet, the light exercises) / guide-lines importance of the ante-natal care performed 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. Same as above but for the level of nonmedical trainees
7
2
"Safe Motherhood" Peer educators (8 YGN Division, to 9 per training) Dala Township
6
1 day
Training Manual AMI (National Among 51 trained, available medical officer 45 are still active following WHO and health guide-lines educators) 7
3
"Family Planning"
Health educators YGN Division, (3) and Nurses Dala Township (4)
1
1 day
Advantages of family planning / Presentation Training Manual AMI (National available medical officer) of 4 different alternative methods ( male and following WHO female condoms, contraceptive pill, 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. Same as above but for the level of nonmedical trainees
4
"Family Planning" Peer educators (8 YGN Division, per training) Dala Township
5
1 day
Training Manual AMI (National Among 45 trained, available medical officer 44 are still active following WHO and health guide-lines educators)
5
"Infant feeding"
Health educators YGN Division, (3) and Nurses Dala Township (4) 5 1 day Same as above but for the level of nonmedical trainees
1
1 day
Advantages of an exclusive breast-feeding at Training Manual AMI (National least during the 4 first months of life (MoH available medical officer) recommendation) and then, introduction of the following WHO weaning diet guide-lines
7
6
"Infant feeding"
Peer educators (8 YGN Division, per training) Dala Township
Training Manual AMI (National Among 44 trained, available medical officer 44 are still active following WHO and health guide-lines educators) Training Manual Mong Pawk 18 were passed for available in TMO & AMI- the first batch, 12 DOH trainer are still under training AMI-LHV Among them around 140 are still active AMI-midwife
7
AMW training
32 AMW (18 in WA(Shan state) 1st batch +14 in 2nd) 20/ training 15/ training 5 days 2 weeks According to Government TBA training manual
2
6 months
According to Government AMW training manual
8 TBA training-basic*
TBA (157 in total)
Buthidaung (Rakhine state)
9
TBA trainingrefresher
TBA (140)
Buthidaung (Rakhine state)
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) Location (State/Division Township) Number of Duration of Main Topics/Subjects Training Training Training Manual available
SN
Name of Training
Trainee (Category and Number)
Trainers
Findings of Monitoring & Evaluation of training
1 1 1 1 3 days 3 days organization 3 days organization
HIV/AIDS
1
3 days
HIV/AIDS
organization
24 Outreached Workers 25 Outreached Workers 26 Outreached Workers
2
Reproductive Health
3
4
Gender and DME (Design, Monitoring and Evaluation) Peer Education and Participation
Outreached Workers (24) Outreached Workers (24) Outreached Workers (24) OW(12) and Peer Educators(20) Northern ShanMuse 1 3 days HIV/AIDS and RH Not available
Northern ShanMuse Northern ShanMuse Northern ShanMuse Mandalay
Not available RH Not available HIV/AIDS and RH Not available HIV/AIDS and RH Not available
National freelance Training completed only 1 consultant, month ago organization National freelance Training completed only 1 consultant, month ago organization
5
Peer Education and Participation
OW(12) and Peer Educators(20)
Japan International Cooperation Agency (JICA) Location (State/Division Township) Number of Duration of Training Training Main Topics/Subjects Training Manual available
SN
Name of Training
Trainee (Category and Number)
Trainers
Findings of Monitoring & Evaluation of training
1 AMW Refresher Training
AMW (120)
Shan (Kyaukme & Naungcho)
6
3 days
Available at Organization DOH (JOICFP), +DOH
NA
Japanese Organization for International Cooperation in Family Planning (JOICFP)
SN Main Topics/Subjects
Name of Training
Trainee (Category and Number)
Location (State/Division - Township) Number of Training Duration of Training Training Manual available
Trainers
Findings of Monitoring & Evaluation of training
1
Participatory analysis of RH situation in the community, with focus on safe motherhood
PCM method manual available used by JICA DOH/MOH Manual with additional IEC materials provided by the Project
Japanese PC Expert with assistants from DOH trained by the expert DMO/TMO and medical officers/ HA/ LHV at the township level with technical input from Japanese Expert on Community Health
Outcome reflected in the plan of operations for the project
2
DOH/ JICA/ JOICFP Community-oriented Reproductive Health Project Project Cycle Community 2 3 days Management Representatives, Training was live-in Workshop for incl. BHS conducted in Naungcho and (each Tsp. 20 Mandalay Kyaukme participants) (one each township) in Aug. 2005 AMW Refresher AMWs (active) Naungcho, 6 total 3 days Training Each 20 Kyaukeme 3 for from Feb. up to participants Townships each August, 2006 Up to now 120 in Tsp. for 2 model townships total (To be continued) (plan to cover all and new ones) comprehensive training on midwifery skills based upon DOH/WHO manual incl. communication skills, use of Home-based Maternal Record and clean delivery kits
Midwifery knowledge improved based upon the pre and post tests; Contributions to the improvement of the DOH training manual Improvement in the training methods Presentations prepared by DOH and DMO/TMO DMO/TMO Focal point medical officers Project objectives and directions shared and roles of the project personnel confirmed; and community support ensured
3
Advocacy meetings, June 2006
Community Representatives, incl. midwives
Naungcho, Kyaukeme Townships
2 one for each Tsp.
half a day
Orientation on the Project: roles and functions on the Tsp & Village Tract Working Group; Plan on activities and enhancing community support
1
Information, Education for Behaviour Change (MYA/02/P02) Advocacy Training 35 Local 25 townships 25 authorities in 10 States and NGOs and Divisions
1 day
1. Community-operated RH 2. UNFPA activities 3. Health and RH concepts
Yes
Resource persons from CHEB/
Community Participation
4. Problem Identification on RH 5. Micro Planning 25 townships in 10 States and Divisions 25 3 days 1. Health education methodology 2. Effective Communication and BCC 3. Counselling 4. Influence of Behaviour 5. Health and Health education concepts 6. Adult learning Yes Resource persons from CHEB Yes UNFPA/ JOICFP Resource persons from CHEB
2
RH/BCC TOT for BHS
About 1,600 BHS
Improvement of training skill
3
About 1,600 BHS
25 townships in 10 States and Divisions 8 townships in 10 States and Divisions 1 day 1 day 1. RH topics 1. RH topics 8 2-3 days
25
2 days
Improvement of training and communication skills
4
BHS TOT for Community Support Group (CSG) multiplier training BHS TOT for CSG refresher training Yes
About 500 BHS
1. Microteaching on RH 2. CSG selection and functions 3. Identification of RH Problems 4. RH topics 1. RH topics 2. Strength and weakness of CSG
5 8 townships in 10 state and division Training was conducted in Bagan and ChaungThar 4 2 days
BHS
Improvement of knowledge on RH
6
CSG Multiplier training CSG Refresher training
About 25,000 CSG About 8,000 CSG
About 1700 About 600
7
RH/BCC Management Training
180 - TMO, Health Staff from 77 non intensive townships, Health Education Officers & UNFPA field officers
Yes
Resource persons from DHP/CHEB/ UNFPA/ JOICFP
Improved management in BCC intervention
8
Youth Training
920 youths
23 townships in 10 States and Divisions
23
5 days
1. Introduction to Co-RH activities 2. RH activities 3. Evaluation indicators 4. Result Based Management 5. BCC/COMBI concept 6. Materials Utilization 7. Project Cycle Management 8. Adult Learning principle 9. Micro planning 1. RH topics 2. Life skills
Yes
Improvement in knowledge on RH & life skill
Increasing Male Involvement in RH through Effective BCC Strategies (RAS5R304) Yangon Bago 7 2 1 day 1. Project Cycle Management 2. Adult Learning Principle 3. Behaviour Change 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 Yes GPs Yes Resource person from UNFPA, JOICFP Training skill of GP improved
1
Central TOT for GPs and BHS
GPs - 27
2 1 day
Multiplier Trainings
252 Frontline Health Promoter (Male Volunteers)
Bago
24 trainings 4 refresher
1 day
Better score in post test Many FHPs are involved in local activities
1. Men's role in RH 2. Men's role in prevention of STI/HIV 3. Basic Communication Skill 4.AN, Delivery, PN and men's role 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 ARH and life skills with a focus on safe motherhood
3
Youth Training life skills training
38 youths from project sites
Bago
4 days 1 day
1 training 1 refresher
Yes
Resource persons from UNFPA, JOICFP and MMA
Better score in post test
Malteser International (Malteser) Number of Training Duration of Training Main Topics/Subjects Training Manual available
SN
Name of Training
Trainee (Category and Number)
Location (State/Division Township)
Trainers
Findings of Monitoring & Evaluation of training
1
Regular refresher training for TBAs
55 TBAs
NRS/Maungdaw
12/year
2 days
ANC, PNC, delivery assistance, nutrition
designed by Malteser
Malteser midwifes refresher trainings, and Malteser staff twice per year
MERLIN MYANMAR (Merlin) Location (State/Division Township) Number Duration of of Training Training Main Topics/Subjects Training Manual available
SN
Name of Training
Trainee (Category and Number)
Trainers
Findings of Monitoring & Evaluation of training
1 Community-Based Health Merlin local staff Yangon Activities (CBHA) (14); DOH staff from Laputta (10) Yangon 1 11 days IMCI, IMPAC
1
5 days
Health promotion around YES - DOH maternal and reproductive health YES - DOH
DOH
NA
3 Women Child Health Development (WCHD) TOT Pathein 1 6 days IMCI, IMPAC
Merlin medical staff (7) and DOH staff (22)
DOH
Merlin staff now training CHWs; unsure of DOH YES - DOH DOH Merlin staff now training CHWs; unsure of DOH YES YES Merlin (Dr. Merlin staff now training Asmatullah Khan) CHWs Merlin local staff and DOH staff Still within 1st few months of 1st batch completion
4 Women Child Health Development (WCHD) 1 2 21 days 3 days
Merlin medical staff (2) and DOH staff (~20)
5 Safe Motherhood/Birth Preparedness Ayeyarwaddy Div - Laputta Ayeyarwaddy Div - Laputta 2
Merlin local staff (9) Ayeyaerwaddy Div - Laputta
6 CHW Basic training
CHWs selected by VTHCs (76 across 3 RHCs)
Safe motherhood, birth planning, danger signs approach IMCI and Safe Motherhood focus 8 days IMCI and Safe Motherhood focus
7 CHW Refresher
CHWs/AMWs selected by VTHCs (85 across 3 RHCs)
YES
Merlin local staff and DOH staff
Still within 1st few months of 1st batch completion
Myanmar Medical Association (MMA) Location (State/Division Township) Number of Training Duration of Training Main Topics/Subjects Training Manual available Trainers Findings of Monitoring & Evaluation of training 10
SN
Name of Training
Trainee (Category and Number)
1 2 1 Workshop on role of GPs in promotion of reproductive health (1999) Pathein and Mawlamyaing Mandalay and Taunggyi 25 townships 25 2 2 days each Adolescent Health, Antenatal care, Contraception Participant Manual 2 2 days each Adolescent Health, Antenatal care, Contraception
3 GPs (86)
4 Toungoo and Pyay
5 2
6 7 2 days each Adolescent Health, Antenatal care, Contraception
8
9 MMA/DOH
2 Workshop on role of GPs in promotion of reproductive health (2000)
GPs (103)
MMA/DOH
3 Workshop on role of GPs in promotion of reproductive health (2002)
GPs (73)
MMA/DOH
4 Training of GPs on RH (2003)
GPs (358)
MMA/DOH
5 Training of GPs on RH (2005)
GPs (199)
20 townships
20
Participant Manual
MMA/DOH
6 RH training for workers from Ministry of Industry (2), Myanmar (2006)
Workers from Yangon and Thaton Ministry of Industry (2) (1600)
40
5 days each Client-oriented quality of care, Client-oriented communication and counseling, Contraception, Post-abortion care, Antenatal care, Newborn care, Postnatal care, RTIs, VCCT 5 days each Client-oriented quality of care, Client-oriented communication and counseling, Contraception, Post-abortion care, Antenatal care, Newborn care, Postnatal care, RTIs, VCCT 1 day each Anatomy, AN care, PN care, Post abortion care, Contraception, Male involvement, Youth development
RH modules
MMA
Myanmar Maternal Child Welfare Association (MMCWA) Location Number (State/Division - Township) of Training Duration of Training Main Topics/Subjects Training Manual available
SN
Name of Training
Trainee (Category and Number)
Trainers
Findings of Monitoring & Evaluation of training
1 Central Training 1/2005 on RH,BCC, TOT Training Kauktan, Tikekgyi, Hmawbe, Thongwa, Khayan, Hlegu Central Office 1 in each township 1 1 in each township 1 1 in each township 1 5 days 5 days 5 days 5 days 5 days 5 days 5 days RHTM 1 5 days RHTM 1 in each township 5 days
Central Office
1
5 days
2 Township Trainings and respective townships
4 Ladies+ 1Gent from each PTS 36 Ladies+ 9 Gent each at each township Same as 1/9 Same as 2/9
RH training ECM, ED, OGs manual of MMCWA RHTM 5 central trainees for each township
3 Central Training 2/2005 on RH,BCC, TOT Training 4 Township Trainings and respective townships RHTM RHTM
Similar as 1/3
Similar as 2/3 Kunchangon, Kawthmue, Tontay, Htantabin, S/Dagon,Dala Similar as 1/3 Central Office
Keys person for RH, Female genital organs and menstruation, Pregnancy, Signs of Pregnancy, Ante natal care, Natal care, Post natal care, Birth spacing, Sterilization, Abortion, Female Cancer, RTI's, Menopause, infertility, HIV/AIDS, Male involvement, Reproductive organs (anatomy and physiology), BCC Same as 1/9 Same as 2/9
5 Central Training 3/2005 on RH,BCC, TOT Training 6 Township Trainings and respective townships
Similar as 2/3 Myeik, Kawtthaung, Dawe, Taunggyi, Kalaw, Pindaya Similar as 1/3 Central Office
RHTM RHTM
Same as 1/9 Same as 2/9
7 Central Training 4/2005 on RH,BCC, TOT Training Township Trainings and respective townships
Similar as 2/3 Magwe, Thayetchaung, Thanbuzayat, Kyawktaw, Maubin, Kyaikmayaw Similar as 1/3 Central Office
RHTM RHTM
Same as 1/9 Same as 2/9
9 Central Training 1/2006 on RH,BCC, TOT Training 10 Township Trainings and respective townships
11 ARH training 1/2006 ECHO: Training in each
Similar as 2/3 Shawpyitha, Hlaingthayar, 1 in each Lapbatan, Oakpho, Phu, township Tha natpin All STD S/D
Myanmar Red Cross Society (MRCS) Location (State/Division Township) Number Duration of of Training Training Main Topics/Subjects Training Manual available
SN
Name of Training
Trainee (Category and Number)
Trainers
Findings of Monitoring & Evaluation of training
1 Training of Trainers
25 Red Cross MRCS, Yangon Volunteers
2
6 days
1. Reproductive Health 2. Life skills for Youth 3. Behavior change communication 4. Birth Spacing 5. STI/HIV/AIDS 6. Abortion care 7.Project Activities Managements 1. Reproductive Health 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 ARH-SRH counseling 1.Definication and Step of Project 2.SWOT analysis 3.Needs assessment 4.Assess project impact 5.Monitoring &Evaluation Depend on their needs Assess for Business, Planning for activities
MRCS's resource person, OG Professor, Counseling Team, STD Team, NAP, Counseling-International consultant from Planned Parenthood Federation of America International
2 Youth Peer Educators Training
350 Red Cross MRCS, Yangon Volunteers
8
5 days
3 Peer Counselor Training 1 4 days
2
5 days
4 Project Cycle Management training
44 Red Cross MRCS, Yangon Volunteers 6 Red Cross MRCS, Yangon Volunteers
5 Refresher Training For Youth Peer Educators 6 Project Sustainability Business Planning 2 3 days
350 Red Cross MRCS, Yangon Volunteers 35 MRCS, Yangon
8
3 days
International consultant of NGOs Sustainability & Business Planning from Planned Parenthood Federation of America International
Marie Stopes International Myanmar (MSI) Location (State/Division Township) Number of Training Duration of Training Main Topics/Subjects Training Manual available
SN
Name of Training
Trainee (Category and Number)
Trainers
Findings of Monitoring & Evaluation of training 10
1
2
3
4
5
6
7
8
9
1 Youth Peer Educators InductionTraining Ayeyarwady (Pathein) Bago (Pyay) Mandalay (Pyigyitagun) 1 1 1 3 days 3 days Not available 3 days Mandalay (Myingyan) Yangon (Tharketa, Thingangyun) 1 3 days 1 3 days
Peer Educators (13)
Mon State (Mawlamyine)
1
3 days
Adolescent Reproductive Health
Handouts for ARH Training Module available
ARH Project Team
Peer Educators (21)
Peer Educators (18)
Peer Educators (6)
Peer Educators (21)
Peer Educators (8)
Family Planning Victoria, Australia Not available Family Planning Victoria, Australia
2 Communication skills training Yangon (Tharketa, Thingangyun 1 1 3 days
MSIM staff (38)
Yangon (Tharketa, Thingangyun)
1
2 days
Interpersonal communications, Health communications Provision of ARH services
3 Service Provider Training
MSIM staff (12)
Not available
Family Planning Victoria, Australia 2 days Life skills Not available Training Consultant
4 Life Skill Training Peer educators (8) Youth Yangon Volunteer Trainers (8) (Tharketa, Thingangyun Yangon (Tharketa, Thingangyun 2
5 STI Training
Peer Educators (6)
1 day
STI risks, signs and symptoms, complications, prevention, treatment
Handouts available
ARH Project Team
Mon (Mawlamyine) Induction and yearly refreshers Mon (Thaton) Ayeyarwady (Pathein) Bago (bago) Bago (Pyay) Mandalay (Pyigyitagun) Mandalay (Myingyan) Yangon (Thaketa) Yangon (Thingangyun) 3 days Communication skills, Counselling JPIEGO FP services training manual MSIM clinical services and training team
6 Training on Family MSIM Center in Charge Planning Services and Nurse (2) and STI MSIM Center in Charge Management and Nurse (1) MSIM Center in Charge and Nurse (3) MSIM Center in Charge and Nurse (3) MSIM Center in Charge and Nurse (3) MSIM Center in Charge and Nurse (3) MSIM Center in Charge and Nurse (3) MSIM Center in Charge and Nurse (3) MSIM Center in Charge and Nurse (3)
3 days for CIC 5 days for Nurse
FP services, Clinical Standards, Infection Prevention, STI Management, Service Providers responsibilities, Counselling, Communication skills,
MSI Operations MSIM clinical Manual, MSI services and Clinical Training training team Manual, WHO STI Manual
7 Training on Communication and Counselling
Mon (Mawlamyine) Induction and Community Based yearly Contributing Agents (10) refresher Ayeyarwady Community Based Contributing Agents (41) (Pathein)
Mandalay Community Based Contributing Agents (10) (Pyigyitagun)
Mandalay Community Based Contributing Agents (18) (Myingyan) Yangon (Thingangyun)
Community Based Contributing Agents (8)
Population Services International (PSI) Duration of Training Main Topics/Subjects Training Manual available
SN
Name of Training
Trainee Location Number of (Category and (State/Division - Township) Training Number)
Trainers
Findings of Monitoring & Evaluation of training
1 Skills building training on RH
670
34 times
3 days/ each training
birth spacing, Counseling contraceptive methods and contraceptives - pills, injections, IUDs, condoms
Available
Franchising team
2 STI training
198
Yangon, Mandalay, Sagaing, Bago, Ayeyarwaddy, Mon, Magway, S. Shan, N. Shan Yangon, Mandalay, Sagaing, Bago, Ayeyarwaddy, Mon, Magway, S. Shan, N. Shan 15 times day/ each training STI and syndromic treatment Available
Franchising team
Save the Children (SC) Location (State/Division Township) Number of Training Duration of Training Main Topics/Subjects Training Manual available
SN
Name of Training
Trainee (Category and Number)
Trainers
Findings of Monitoring & Evaluation of training
1 Safe motherhood training Training notes available, Flip chart available SC staff
village health Magway/ team members, Pakokku, Minbu, TBA Tanintheryi/ LaungLone
55
2days
Anatomy of reproductive organs, physiology of menstruation, AN care, intranatal care, post natal care, danger signs during pregnancy, delivery and post natal period. Six cleans Mode of transmission, preventive methods, risky behaviour, Clinical signs and symptoms of AIDS/ STI. Condom demonstration Training notes available, Flip chart available SC staff
The trainees disseminate their knowledge to the pregnant mothers. Pregnant mothers are practicing six cleans, early recognition of danger signs and early referral. Pregnant mothers taking iron tablets more than 180, and receiving 2 TT immunization The trainees disseminate their knowledge to the reproductive age men and women including youth groups, increased condom demand and usage, avoidance of risky behaviors and reduce stigma and discrimination on HIV/AIDS
2 Prevention of HIV/AIDS Village health teams, Youth groups
Magway/ Pakokku, Minbu, Tanintheryi/ LaungLone
77
1day
3 Training on contraceptives
Village health teams
Magway/ Pakokku, Tanintheryi/ LaungLone 28 1day
45
1day
Types of contraceptives, how to use it
Training notes available, Maggie's Apron Training notes, training module and Flip chart available
SC staff
Increase in CPR in project area, reduced abortion among teen age
4 PMCT
village health team, AMWs, TBA, BHS
Magway/ Pakokku, Minbu, Tanintheryi/ LaungLone
Primary prevention, Mode of transmission, importance of VCT, how to stay fit for HIV + mothers, infant feeding options, exclusive breast feeding, measures to reduce MTCT, Home based care.
SC staff, Increased in VCT among pregnant STD team mothers and their husband., trained BHS increased in CPR in collaboration with SC
5 Newborn care SC staff
village health team, AMWs, TBA
Magway/ Pakokku, Minbu, Tanintheryi/ LaungLone 55 2 days Communication skills, Training problem solving skills, module value, negotiation skills, available decision skills, self esteem, Fledgling 1&2 SC staff (Proj. Asst., Out Reach Workers) SC staff
75
2 days
Danger signs of new born, Training Breast feeding, Care of notes new born, resuscitation of available birth asphyxia at community level
early initiation of breast feeding, early recognition of danger signs, early referral
6 Life skills training
village health team, youth groups
Magway/ Pakokku, Minbu, Tanintheryi/ LaungLone 1884 1 or 2 days HIV/AIDS; ARH; STIs; Life skills
increased age of marriage, proper utilization of leisure time
7 Life skills workshop on Out of school ARH youth
Kayin, Mon, Shan (N)
United Nations Population Fund (UNFPA) Location (State/Division Township) Number of Training Duration of Training Main Topics/Subjects Training Manual available
SN
Name of Training
Trainee (Category and Number)
Trainers
Findings of Monitoring & Evaluation of training
1 Training on PCPNC (Pregnancy, Childbirth, Postnatal and Neonatal Care) All states/divisions (112 townships) All states/divisions (112 townships) All states/divisions (112 townships) 2 days All states/divisions (112 townships) 4 days 4 days available available 5 days available 5 days available 5 days available DOH MCH section DOH MCH section DOH MCH section OGs DHP DHP
BHSs
All states/divisions (112 townships)
5 days
available
DOH MCH section
2 Training on RH Programme Management
TMOs
3 Training on RH Counselling
BHSs
4 Training on ARH Counselling
BHSs
5 Training on insertion of IUD
BHSs
6 Training on RH MIS
BHSs
7 Training of Statisticians on RH MIS
Statisticians
Annex D
RESEARCH STUDIES
1. 2. 3. 4. 5. 6. 7.
CARE International in Myanmar (CARE) Japan International Cooperation Agency (JICA) Japanese Organization for International Cooperation in Family Planning (JOICFP) Merlin Myanmar Maternal and Child Welfare Association (MMCWA) Myanmar Red Cross Society (MRCS) Save the Children (SC)
CARE International in Myanmar Research When Where Topic (year) (State/Division – Townships) A KABPP 2006 Northern Shan Study on State (Muse) Sexual and and Reproductive Mandalay Health of Division Young (Mandalay People (1524 years) in Mandalay and Muse
Study Population 231 young men and 229 young women
Key Findings - Young people knew more of reproductive health than HIV/AIDS and STIs. Youth in both study areas had more or less the same level of SRH. - They revealed 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
Published (Yes/No) As we have just finished, it is not published yet.
Japan International Cooperation Agency (JICA) Research Topic RH Services Facility Assessment Midwifery-trained Personnel’s Performance for Antenatal Care Midwifery-trained Personnel’s Ability Communication with Clients Midwifery-trained personnel’s performance delivery care Midwifery-trained personnel’s knowledge obstetric complications Midwifery-trained personnel’s performance postnatal care When (year) 2005 2005 Where (State/Division – Townships) Shan (N) Kyaukme & Naungcho Shan (N) Kyaukme & Naungcho Shan (N) Kyaukme & Naungcho Shan (N) Kyaukme & Naungcho Shan (N) Kyaukme & Naungcho Shan (N) Kyaukme & Naungcho Study Population Key Findings Published (Yes/No) No No
2005
No
2005
No
2005
No
2005
No
Japanese Organization for International Cooperation in Family Planning (JOICFP) Research Topic When (year) 2005 Where (State/Division – Townships) - Bago Division/ Bago Township - Yangon Divsion/ South Dagon Township Study Population Key Findings Published (Yes/No) Inadequate knowledge and practice of men on RH in spite of a generally favourable attitude Being printed
Baseline Data Collection and Behaviour Study on Male Involvement in RH (JOICFP executed UNFPA funded Increasing Male involvement in RH through Effective BCC Strategies RAS5R304) Health Infrastructure and Quality of RH Services Qualitative study Baseline survey Part I (DOH/ JICA/ JOICFP Community Oriented Reproductive Health Project)
Total 1021 - 856 reproductive aged men (Baseline data collection in) - 60 married men and 26 married women (IDI) - 12 service providers and - 12 influential (IDI) - 55 community men (FGD) - All RHCs + 5 selected Sub RHCs - 8 FGDs (4 urban and 4 rural) - 114 service providers interviewed (59 in Kyaukme and 55 in Naungcho)
2005
- Shan State/ Kyaukme and Naungcho Townships
Needs in the Being current printed situation of health infrastructure especially in RH services identified
Merlin Research Topic KPC survey Formative research When (year) November 2005 March 2006 Where (State/Division – Townships) Ayeyarwaddy Division – Laputta Township Ayeyarwaddy Division – Laputta Township Study Population 476 mothers of children under 2 years 104 mothers of young children; 64 Motherin-laws; 70 fathers; 16 TBAs Key Findings See notes below Published (Yes/No) Report available upon request Report available upon request
Study highlights a critical lack of awareness of maternal, newborn and child health issues among communities of Laputta 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 Anaemia in pregnancy Safe motherhood Safe motherhood Safe motherhood PMCT AN Care When (year) 2006 2006 2006 2006 2006 2006 Where (State/Division – Townships) Kayin State Chin State Mon State Yangon Division Mandalay Division Shan East State 1498 Study Population Key Findings Published (Yes/No)
530 608
Myanmar Red Cross Society (MRCS) Research Topic Rapid survey for Youth to Youth: Peer Education for Reproductive Health Program in the selected Townships When (year) 2001 Where (State/Division – Townships) Yangon Division 1. North Okkalapa 2. Shwe Pyi Thar Ayeyarwaddy Division 1. Maubin Study Population - Youth (15-24 years) Key Findings Published (Yes/No)
End-line survey for Youth to Youth: Peer Education for Reproductive
2004
Yangon Division: 1. North Okkalapa 2. Shwe Pyi Thar: Ayeyarwaddy
Youth (15-24 years)
No 1.Knowledge of STDs, Pregnancy 2.Sexual experience and STDs 3.Premarital sexual activity 4.Attitudes towards an use of condoms 5.Contraceptive use among married females 6.Knowledge about puberty an sexuality 7.Other risk behaviors 1.Knowledge No about Sexually Transmitted Infections among young
Health Program in the selected Townships
Division: 1. Maubin Bago Division: 1. Phyu 2. Daik-U
people 2.Premarital sex activity among male youth 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 Topic Behavioural Surveillance Survey Youth Behaviour Survey When (year) 2002 2004 Where (State/Division – Townships) Northern Shan Kayin State Mon State Study Population 576 6002 Key Findings Published (Yes/No) No No
Annex E
Opinions, Perceptions and Attitudes on Organization Performance in Reproductive Health
Opinions, perceptions and attitudes on organization performance in reproductive health Very much % Moderate Slight Uncertain % % % Don’t know %
Opinions, perceptions and attitudes Interest in RH Gives priority to RH among others Gives priority to base-line studies before service implementation (n=15)* Gives priority to draw a training curriculum (n=14)* Interest in health promotion (n=15)* Interest in improved quality and access to services (n=15)* Interest in partnership and networking (n=15)* Interest in capacity building (n=15)* Interest in sustainability (n=15)* The plan and scope of the organization The goal set for RH activities is strong. Targets set are achievable. The present scope of RH activities is broad. (n=15)* Organization efforts in implementation Our organization can build a rapport with public sector services in RH (n=15)*. Our organization can build a rapport with other local NGOs in RH. (n=14)* Our organization can build a rapport with other international NGOs in RH (n=15)*. Our organization can build a rapport with other faith-based organizations in RH (n=15)*. Our organization has open discussions on RH plans with donor agencies. Advocacies on RH by our organization to community members are adequate (n=15)*. Advocacies on RH by our organization to other stake holders are adequate (n=14)*. Budgetary allocation of our organization for RH activities is adequate. (n=14)* Capacity building of staff in our organization to implement RH activities is adequate (n=14)*.
56.3 66.7 35.7 60.0 60.0 53.3 73.3 80.0
25.0 20.0 35.7 33.3 26.7 20.0 26.7 6.7
18.8 13.3 14.3 6.7 13.3 26.7 0.0 13.3
0.0 0.0 14.3 0.0 0.0 0.0 0.0 0.0
0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0
43.8 37.5 25.7
43.8 56.3 40.0
12.5 6.3 25.7
0.0 0.0 6.7
0.0 0.0 0.0
46.7 42.9 46.7 13.3 50.0 40.0 21.4 26.7 13.3
33.3 28.6 40.0 53.3 37.5 33.3 35.7 26.7 73.3
6.3 14.3 13.3 20.0 6.3 20.0 28.6 20.0 6.7
12.5 7.1 0.0 6.7 0.0 6.7 7.1 26.7 6.7
0.0 7.1 0.0 6.7 6.3 0.0 7.1 0.0 0.0
Efforts of our organization in capacity building of the target audience in RH are adequate (n=15)* Dissemination of RH information/feedback by our organization to partnership networks in Myanmar is adequate.
33.3 12.5
53.3 43.8
13.3 12.5
0.0 31.3
0.0 0.0
Efforts in management decision-making, monitoring and supervision Top-down decisions in management of RH activities in our organization is adequate (n=15)*. Bottom-up decisions in management of RH activities in our organization is adequate (n=15)*. We have a built-in monitoring system for RH activities (n=15)*. Supervisions in implementation of RH activities by our organization are adequate (n=15)*. Power of the organization Our organization has influence on other 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)* • Current (n=14)* • Future (n=14)* Gaps and constraints Gaps between capacity of our staff and 0.0 their performances in RH Gaps between targets and actual 0.0 implementation of RH Sometimes delays in implementation are due to problems in: 26.7 • Funds (n=15)* 23.1 • Commodities (n=13)* *Total does not add up to 16 due to missing values. 20.0 40.0 80.0 60.0 0.0 0.0 0.0 0.0 6.7 33.3 20.0 20.0 20.0 20.0 40.0 46.7 46.7 40.0 33.3 33.3 26.7 20.0 13.3 6.7 26.7 6.7 0.0 13.3 0.0 13.3 13.3 0.0 0.0
25.0 28.6 57.1
37.5 57.1 21.4
12.5 7.1 0.0
6.3 7.1 14.3
0.0 0.0 7.1
26.7 23.1
26.7 30.8
20.0 23.1
0.0 0.0
Annex F
Questionnaires FORM A FORM B FORM C FORM D FORM E : Profile of the Organization : Current activities on Reproductive Health : Information on Capacity Building in Reproductive Health : Information on Research in Reproductive Health : Opinions, perceptions, and attitudes on organization performance
FORM A: PROFILE OF AN ORGANIZATION Name of Organization:…………………………………………………………. SN 1. 2. Questions When did your organization start activities in Myanmar? What is the mission of your organization? Code /____/
3. 4.
When did your organization start activities in reproductive health in Myanmar? 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. 7.
Number of staff in RH activities (Top officials to township level): /__ __/ Future plan for RH activities (scaling up / tail off / same):
FORM B: Current Activities on Reproductive Health by Organization
Name of Organization: State/Division Col. 2 Col. 3 Col. 4 Col. 5 Township(s) Target Group No.beneficiaries covered Implementing Partners Col. 6
Code No.
Activities Package
Col. 1
ARH
Provision of sexual and RH information for young people
Youth friendly clinics/centers
Birth spacing and contraceptives
Emergency contraception Oral contraception Monthly and/or three monthly injectables IUDs
Female sterilization
STI/RTI/HIV/AIDS
Condom promotion Diagnosis and tretament of RTIs and STIs VCCT for HIV
Syphilis screening and treatment
PMTCT
Prenatal care
Home based records (preparation of birth plans) Immunization against tetanus Detection and treatment of hypertensive disorders in pregnancy Detection and treatment of malaria Advice on early detection of complications and danger signs Provision of iron and foliate supplement Detection and treatment of anaemia
Syphilis screening and treatment
Treatment of intestinal parasites
VCCT for HIV
A A1 A2 B B1 B2 B3 B4 B5 C C1 C2 C3 C4 C5 D D1 D2 D3 D4 D5 D6 D7 D8 D9 D10 E E1 E2
Delivery care
Clean delivery practices Administer oxytocic drugs in the third stage of labour
E3
Routine examination of placenta
E4
Administer parenteral anticonvulsants to treat pre-eclampsia and eclampsia Use of the partograph Administer oral and/or parenteral antibiotics
Perform surgery
Neonatal care
Prevention and management of hypothermia Prevention and management of infections Promotion of initiation of breastfeeding within 1 hour Promotion of exclusive breastfeeding (first 6 months) Resuscitation of the newborn Care of the umbilical cord
Early detection and management of neonatal jaundice
E5 E6 E7 F F1 F2 F3 F4 F5 F6 F7 G G1
Postnatal care
Development of birth spacing plan and birth spacing service provision
G2
Early detection and management of complications of puerperium Detection and treatment of malaria
Advice and support for breast-feeding, nutrition, and healthy life style Provision of iron/folate supplement Detection and treatment of anaemia Provision of postnatal care within the first week Thorough review at 6 weeks post partum Immunization against tetanus (if not done during ANC) VCCT for HIV (if not done during ANC)
G3 G4 G5 G6 G7 G8 G9 G10 G11 H
Syphilis screening (if not done during ANC)
Post-abortion care
H1
Post-abortion birth spacing service provision
H2
H3
H4
Counselling on birth spacing and other reproductive health issues for postabortion clients Manual vacuum aspiration for management of incomplete abortion Prevention and management of sepsis, tetanus, injury, shock and haemorrhage
Gynaecological cancer
J J1 J2
Cervical cancer screening and treatment
Breast cancer screening and treatment
Subfertility Please specify Postmenopausal reproductive health
Counselling, including lifestyle and nutrition
Men's reporductive health
K K1 L L1 M M1 M2 M3
Promotion of awareness of STI/HIV/AIDS
Promotion of men's role in support of RH Promotion of community awareness about violence against women
FORM C: Information on Capacity Building in Reproductive Health
Name of Organization:
SN Main Topics/Subjects 7 8 9 3 4 5 6
Name of Training
Trainee (Category and Number) Location (State/Division - Township) Number of Training Duration of Training Training Manual available
Trainers
Findings of Monitoring & Evaluation of training 10
1
2
FORM D: Research Topic
INFORMATION ON RESEARCH IN REPRODUCTIVE HEALTH (conducted in last 3 years) When (year) Where (State/Division – Townships) Study Population Key Findings Published (Yes/No)
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 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. Questions and filters Our organization gives priority to RH among others. To my opinion, the goal set for RH activities of our organization is strong. Targets set for specific RH activities by our organization are achievable. Present scope of our organization in RH activities is broad. Our organization can build a rapport with public sector services in RH. Our organization can build a rapport with other local NGOs in RH. Our organization can build a rapport with other international NGOs in RH. Our organization can build a rapport with other faith-based organizations in RH. Top-down decisions in management of RH activities in our organization is adequate. Bottom-up decisions in management of RH activities in our organization is adequate. Our organization has open discussions on RH plans with donor agencies. Advocacies on RH by our organization to community members are adequate. Advocacies on RH by our organization to other stake holders are adequate. Budgetary allocation of our organization for RH activities is adequate. Capacity building of staff in our organization to implement RH activities is adequate. Efforts of our organization in capacity building of the target audience in RH are adequate. Our organization gives priority to base-line studies before service implementation. We have a build-in monitoring system for RH activities. Supervisions in implement ation of RH activities by our organization are adequate. Our organization gives priority to draw a training curriculum. There are gaps between capacity of our staff and their performances in RH activities. There are gaps between targets and actual implementation of RH activities by our organization. Sometimes delays in implementation are due to problems in: • Funds • Commodities • Other (please specify) Dissemination of RH information/feed-back by our organization to partnership networks in Myanmar is adequate. 1 1 1 1 1 1 1 1 Codes 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4 5 5 5 5 5 5 5 5
1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 1 1 1 2 2 2 2 3 3 3 3 4 4 4 4 5 5 5 5
24.
25. Our organization has influence on other partners in carrying out RH 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 • Current • Future 27. The interest of our organization in RH is in: • Health promotion. • Improved quality and increase access to services • Partnership and networking • Capacity building • Sustainability • Other (please specify) SECTION II: EXPECTATIONS AND SUGGESTIONS
1 2 3 4 5
1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 1 1 1 1 1 2 2 2 2 2 2 3 3 3 3 3 3 4 4 4 4 4 4 5 5 5 5 5 5
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.)