The "Healthy Mother Project" in Myanmar promotes safe motherhood through community initiatives to increase utilization of quality RH services.

From 3rd to 21st July, a team of two representatives each from the Myanmar Department of Health, Central Level, and Shan State Health Department, and one from each of the two project townships visited Japan for a study visit entrusted to JOICFP by JICA.

This was the third study visit conducted by JOICFP, delivering high quality, needs-oriented, practical training, utilizing resources from several divisions to give a comprehensive approach to the issues of community-based health initiatives.

The goal of the study visit was to assist in implementation of a more effective project by identifying township level strategies to support the central and state levels by:

1. Strengthening community- oriented Maternal and Child Health (MCH) strategy

2. Improving safe motherhood quality care services

3. Developing an action plan to be implemented in the project townships

The project has already seen 1,672 Maternal and Child Health Promoters (MCHPs) trained, and integration of these trained personnel into health care activities needs to be strengthened.

In addition to lectures and case studies, the participants observed local government and community level health activities in Wakayama Prefecture .

In the 1980s, Wakayama had the worst neonatal mortality rate in Japan ; now it is in the top three prefectures.

The participants learned that decentralization, and good coordination among the prefectural government, municipal governments and MCHP associations, along with a systematic health information system had been a key to improving health.

Public health nurses (PHNs) play a key role, too, delivering Information, Education and Communication (IEC) , and preventive services other than maternal health.

Arida City

In Arida City , Wakayama , the participants saw how PHNs collaborate with MCHPs, and MCHPs with nutritionists, as a good example.

They also saw ways how MCHPs were motivated and realized the importance of a strong volunteer spirit.

Observing a maternity class in Arida City

At the “Chick Club” in Kudoyama Town, a playgroup for two- to three-year-olds, MCHPs and PHNs take part and observe the physical, mental and social development of the children.

MCHPs work closely with PHNs, assisting with, for example, health checks, record keeping and health education.

A puppet show at the Chick Club

The strong commitment of the local government has also been a key in raising health standards.

The participants also observed a hospital and a maternity home, which are coordinated through a comprehensive referral system at all levels.

The participants of study visit accompany a MCHP on a home visit in Kudoyama Town

Action plan

Based on the lectures and observations, the Myanmar team compiled an action plan to tackle issues such as lack of trained personnel, low proportion of delivery attended by skilled birth attendants , and lack of referral system.

Actions to be taken include refresher training, more supervision and monitoring, developing community support, and increasing MCHP capacity.

Participants' comments

All the six participants were very pleased with what they had learned, saying that some activities and Japanese experiences could be adapted to suit Myanmar .

Furthermore, the value of the MCHPs system was well understood, and the participants indicated they would strengthen the role of MCHPs in the project area.