A reproductive health needs assessment in Myanmar

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A Reproductive Health Needs Assessment in Myanmar appears that these activities are not currently reaching a broad range of youth in some townships. As mentioned above, a recent evaluation of the UNICEF life skills training programme does suggest that there has been a significant multiplier effect from friend-tofriend counselling in programme townships, however, the selection of participants for the training programme has resulted in some variation between programme effects in various townships. Mass media represents one of the most powerful influences of all. Comic books, magazines designed for young, radio and television programmes, publicity in the cinema, newspaper articles and posters are being used. In some magazines, information is provided about physical, psychological and social aspects of young people’s development, including the rights and responsibilities of young people. There are currently many popular magazines designed for young girls that combine education with entertainment. Ensuring that these provide accurate and sensitive reproductive health information could be a highly effective way to reach these girls. Various different formats were discussed for new information materials. There was some objection to the standard format of written information in brochures and posters, feeling that the young did not take time to read and study such things. Video, however, was a very common suggestion. Visiting video houses is a popular pastime for the young boys, particularly in the urban areas. Providing short, informative, and eye-catching videos to be shown in the intervals was felt to be an effective way to reach youth. This information channel would not be as effective for girls, as they tend to frequent the video houses on a less regular basis. Television spots would also reach a large adolescent audience, particularly girls who tend to spend much of their time in the home. Most people have access to television, either in their own home, or in the home of friends and relatives. 56
A Reproductive Health Needs Assessment in Myanmar Conclusions and Recommendations The previous four chapters have discussed the teams observations on maternal health, birth spacing, RTI/STDs, and adolescent reproductive health. This chapter identifies the cross cutting issues across these four areas and makes specific recommendations to improve reproductive health in Myanmar. CROSS-CUTTING ISSUES IN REPRODUCTIVE HEALTH SERVICES The assessment team observed that several issues concerning the availability and utilization of reproductive health services emerged across all programmatic areas. While specific issues detailed in the latter part of this chapter need to be addressed for each reproductive health programme area, the cross-cutting issues discussed immediately below are critical to the successful achievement of integrated reproductive health services and an improvement of reproductive health status. Community involvement Our discussions with community leaders (mainly men) revealed that they were both inadequately informed and insufficiently concerned about STDs, birth spacing or adolescent reproductive health issues. They were better informed about maternal health issues and more aware of HIV/AIDS, although even for the latter their understanding was often quite superficial. Their level of concern was significantly greater in regard to other health problems, such as malaria and dengue. This is perhaps not surprising, as there have been few specific attempts in the past to involve community leaders in reproductive health issues other than safe motherhood. MCWA members in the community are generally quite knowledgeable and concerned about a broader range of reproductive health problems. These women are active in providing birth spacing education, as well as organising assistance at delivery through MCH centres and maternity shelters. The MCWA has also been actively involved in the UNFPA-supported birth spacing programme townships and UNICEF’s life-skills training project. In many townships, the MCWA members provide an important linkage between the community and the full range of reproductive health programme activities. During the assessment, and in discussions with key reproductive health stakeholders, it was observed that some members of the Myanmar Red Cross Society are also involved in activities that impact reproductive health. For example, in some townships the Myanmar Red Cross has been instrumental in setting up transportation networks to the township hospital. They also maintain lists of blood donors, a critical resource for women experiencing obstetrical complications, such as postpartum haemorrhage. Given their decentralized structures, the potential role that the Mynamar Maternal and Child Welfare Association and the Myanmar Red Cross could play in enhancing reproductive health in Myanmar is highly dependant on the motivation of the township level organisation and can be increased through greater community involvement. Quality of care Several important issues arose with respect to the quality of reproductive health care. The effectiveness of service delivery programmes in achieving an improvement in reproductive health status will be contingent on significant improvements in quality of care. For example, 57
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