A reproductive health needs assessment in Myanmar

A Reproductive Health Needs Assessment in Myanmar
In the assessment team’s collective judgement, the following are the high priority
interventions which should form a minimum core package of interventions to be implemented
in all the townships.
Community awareness and education
A number of activities are recommended for enhanced community awareness and education
to improve reproductive health care practices.
Advocacy with community leaders about the importance of reproductive health problems
including the magnitude of maternal morbidity and mortality is an important activity to enlist
the support of community leaders in reproductive health activities. The community also
needs to be mobilized to provide resources for transportation and other costs in the event of
the need for referral of pregnant women to hospital.
Health education is another essential activity. This needs to be supported by high quality
materials, and cover a range of reproductive health issues including: creating awareness of
the family and pregnant women on the risk of serious morbidity related to pregnancy
complications and abortions; IEC on birth spacing; greater awareness of RTI and STD
symptoms and HIV/AIDS; encouragement of prompt and appropriate health care. seeking
behaviour; and, the dangers of unsafe abortion. Appropriate peer interventions for adolescent
reproductive health must be developed and evaluated to address the needs of this currently
underserved group.
A number of counselling activities are critical to a successful reproductive health programme.
Community-level counselling, such as the life skills training efforts of the MMCWA and
MRCS through their reproductive health training and multiplier training activities, need to be
expanded. The provision of birth spacing counselling also needs to be strengthened and
backed by high quality IEC materials. Such counselling should be included as a routine
component of post-abortion care.
Training of all service providers
Both public and private sector providers need to be trained in all townships in the provision
of birth spacing methods with appropriate quality of care. This should include training to
improve the technical skills of GPs in the provision of birth spacing services and counselling,
and the skills of drug shop staff in the provision of contraceptive methods.
There is an urgent need to update the curriculum for training midwives, auxiliary nurse
midwives (AMWs), and traditional birth attendants (TBAs) to develop competency in the
provision of routine maternity care, as well as the recognition of complications and referral.
Efforts should also be made to train (or provide refresher training) in the emergency care of
obstetrical complications, including the performance of caesarean section, for to medical staff
at all township or station hospitals.
In addition, training should be organized for both public and private sector providers
(including GPs, STD clinic staff, and basic health staff) in the use of standardized case
management guidelines for RTIs. Health providers need to be trained to provide reproductive
health information and services to young persons in a non-judgmental and youth-friendly
manner.
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