JOICFP has been supporting the UNFPA Country Program in Myanmar with community-operated reproductive health (CoRH) activities since 2001. Since then, twenty-three out of the targeted 100 townships have been receiving intensive intervention for behavior change communication (BCC) with community initiative in improving RH..

From 28th to 31st January, an Annual Review and Experience Sharing Workshop on CoRH Activities was held in Myanmar for ten project townships from lower Myanmar.

A township comprises of a population between 100 to 400 thousand people, and one Township Medical Officer (TMO), one representative each from the Youth Information Corners (YICs) and Community Support Groups (CSGs), and one Health Assistant (HA) attended the workshop from each township, along with Health Education Officers from state and division levels.

The workshop participants interview CSGs
from Yeyki Township during the field observation

Project successes

Most townships reported a positive impact on health indicators as a result of the interventions, with antenatal care and contraceptive prevalence increasing, and maternal mortality rates (MMR) and induced abortion declining. In some townships, MMR was reported to have fallen to near zero.

CSG members have been equipped with and trained to use educational tools and materials, and there has been an increase in referrals made by CSGs. In some cases, CSG members have taken to asking pregnant women they meet on the road if they have been to the rural health center for antenatal care.

In other cases, CSGs have obtained support from local and religious leaders in areas such as transportation.

The commitment of CSG members can also be seen as many are conducting income generating activities to gather funds for emergency cases needing referral, and YIC members have also found ways to generate income.

These include running a library, selling noodles and renting bicycles.

Furthermore, both TMOs and HAs are committed to the project and are supervising and monitoring CSG and YIC activities, though in some cases there has been a high turnover of personnel among the participating groups.

A Health Assistant from a different township
interviewing YIC members
from Chaung Phyar YIC as a part of a field observation
during the review workshop

Recommendations

Recommendations form the meeting included:

• Further promote the CoRH concept with a view to sustainability
• Increase awareness of health staff on the role of BCC
• Continued advocacy, especially targeting community stakeholders
• Good communication among TMOs, CSGs/YICs and local authorities so that community needs are reflected in activities
• Referral not only in emergency cases, and preparation of funds for referral
• Refresher training for CSGs/YICs as this maintains motivation
• Implementation of a systematic reporting system

The BCC intervention will be extended one more year, and another four townships included, bringing the total to 27 out of 100. By the end of 2006, it is expected that there will be 30,000 CSG members and 1,150 YIC members to bring reproductive health closer to the people.