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Myanmar first aid classes

Myanmar primary health care - phase 2

People in conflict-affected southeast Myanmar face many challenges in accessing quality essential health care. Christian Aid works to empower the most marginalised groups, such as women, youth, elderly, people with disability and ethnic minorities, to assess  their health needs and work with health care providers, to improve service delivery. 

This four-year programme, funded by the Swiss Agency for Development Cooperation (SDC), is implemented by a consortium of national and international partners in four townships in Kayin State where health care is delivered by government or ethnic organisations.

The programme is in line with Myanmar’s National Health Plan 2017-2021 (NHP) which aims for Universal Health Coverage (UHC) ensuring the entire population has access to essential health services by the year 2030.

Our aims

To strengthen governmental and ethnic health care systems, foster coordination between these systems and empower people to demand the quality health care they need. Building bridges between the two systems, we aim to improve the quality and accessibility of health care for all.

Key information

Location

4 townships in Kayin State, Myanmar (Kawkareik, Kyaingseikgyi, Myawaddy & Hlaingbwe)

Timescale

2019 – 2022

Target population

677,937 people

Implementing Partners 

Partners for Health Access in the Southeast of Myanmar (PHASE-M) works as one implementation team

Consortium partners

  1. Consortium Partners for Health Access in the Southeast of Myanmar (PHASE-M): Save the Children, Christian Aid & Karen Baptist Convention
  2. Consortium for Health in Eastern Burma (CHEB): Community Partners International, Karen Department of Health and Welfare, Burma Medical Association, BackPack Health Worker Team & Mae Tao Clinic

 Funded by

Swiss Agency for Development and Cooperation (SDC)

Our approach

Kayin State has a long history of conflict between the national government and ethnic groups, and the state is currently divided in areas that are controlled by either the government or ethnic organisations. The programme aims to improve people’s health status in both areas by strengthening the health systems in delivering responsive and quality services, by empowering the communities – especially vulnerable groups – to demand their rights to lifesaving health services. 

We deliver training and technical support to the health providers. We also set up and support 165 Village Health Committees (VHC) and introduce feedback and coordination initiatives between them. The PHASE-M consortium, including Christian Aid, works in the government controlled area and CHEB works in areas controlled by ethnic organisations.

Kayin State, with just over 1.5 million inhabitants, is home to different ethnic groups, such as the Karen, Mon and Pao. Ethnic groups and the Myanmar government have been in armed conflict for decades. This led to instability, lack of trust and hundreds of thousands of displaced people. A ceasefire agreement was signed in 2012, but tensions and mistrust between the government- and ethnic controlled areas still remains.

This programme builds upon Christian Aid’s previous experience from a border crossing Emergency Health Care Programme, supported by DFID from 2011 to 2014. It is the first in Myanmar to simultaneously work with both organisations in government controlled areas and ethnic health organisations, towards a common objective. 

Key achievements

This programme builds on the results of a first phase that was implemented from 2015 to 2018:

  • Access to health care nearly doubled from 171,025 to 331,019 people
  • The uptake of skilled birth attendance grew to 71,5%
  • 83% of pregnant women received appropriate antenatal care, an increase of 10% 
  • Contraceptive use rose from 1 to 17% 
  • In four years 86 auxiliary midwives were trained, over 200 village health volunteers received refresher training and 49 health care facilities were renovated or renewed equipment.

VHCs were set up and met with health care staff to discuss health issues and plan services every three months, providing the opportunity for people to voice their needs and concerns. The activity level of the VHCs doubled from 41 to 83% and that women’s participation in the committees increased. Our innovative ‘citizen report card’ to measure community satisfaction with health services proved to be a successful accountability assessment tool for authorities and communities to openly engage in health issues during public workshops.

And significant steps were made towards more trust and cooperation between governmental and ethnic health care providers. Health dialogue platforms and joint training led to an increase in referrals from the ethnic to the governmental health system and successful joint vaccination programmes.