A reproductive health needs assessment in Myanmar

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,
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