A reproductive health needs assessment in Myanmar

A Reproductive Health Needs Assessment in Myanmar
Establishing standards and guidelines
Quality of care is a serious issue to be addressed in Myanmar. Therefore, standards and
guidelines need to be developed, widely disseminated to all relevant providers, and
mechanisms including supervision put in place for (a) standard of maternal health care, (b)
referral guidelines adapted to the local transport, resource, and facility setting for
complications of pregnancy, (c) birth spacing services provided by private GPs, (d)
standardized guidelines for the case management of men and women with STD and other RTI
symptoms and (e) on the importance of administering ophthalmia neonatorum prophylaxis
for all newborn infants.
CRITICAL INPUT S FOR OPERATIONALIZING REPRODUCTIVE HEALTH PROGRAMMES
Three critical inputs are required to operationalize reproductive health programmes: a policy
framework for creating a facilitating implementation environment, resources to enable
implementation, and organizational arrangements for its implementation.
Policy framework
After the International Conference on Population and Development (ICPD), several countries
in the region have initiated policies and programmes for reproductive health. For instance, in
1997, Thailand articulated a reproductive health policy to guide the achievement of
comprehensive reproductive health services. In Bangladesh, the reproductive health services
are a part of Essential Services Package that is an integral part of the Health and Population
Sector Strategy. In India, the government is currently implementing a Reproductive and
Child Health Programme. The assessment team recommends that Myanmar consider
promulgating a policy on reproductive health.
Organizational arrangements for reproductive health programme
To implement effective reproductive health services programme, an unified organization is
needed that links programmes addressing different components of reproductive health in the
Ministry of Health as well as promotes involvement of NGOs and communities. This would
ultimately require some organizational restructuring. However, as a first step, the linkages
between various programmes need to be strengthened. The team identified two such actions:
An expanded role for the district O/G specialists should be explored. These specialists have
the potential to provide a much broader range of technical support for maternal health care
services in the district through (a) establishing referral mechanisms and strengthening the
referral chain for management of obstetrical complications; (b) developing and utilizing the
checklists for essential equipment and supplies at different levels of basic health services; (c)
orienting TMOs and other practitioners to the national standards of care; (d) training all levels
of maternal health care providers; and (e) periodically reviewing the maternal health situation
in the district, including maternal deaths, and identifying appropriate actions.
Wherever STD teams exist, they should closely coordinate with the TMO (a) to develop and
disseminate standardized guidelines for the case management of men and women with STD
and other RTI symptoms, and (b) to train both public and private sector providers (including
GPs, STD clinic staff, and basic health staff) in the use of standardized RTI case management
guidelines.
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