Why are these papers important?

Timely access to quality emergency health care provision remains out of reach for many people in Myanmar. With 15% of women anywhere in the world experiencing an unpredictable obstetric emergency, care that is accessible when it is needed is crucial. Young children are particularly vulnerable to rapid deterioration in their health and established referrals pathways can be critical for survival during an illness episode. Support for emergency referrals is therefore a potentially lifesaving intervention, especially for pregnant women and children under five years of age.

The 2013 Ministry of Health policy that care for pregnant women and children at public hospitals is free-of-charge has been an important step forward in addressing barriers to accessing health care. Beyond the costs of treatment and medicines, primary barriers to accessing health services include distance to travel to hospitals and cost of transport.

3MDG support helps to ensure that basic health staff and community health workers are able to recognize seriously ill patients, that established criteria for referral and when to refer exist, that transport is available and its cost is covered, and that food is available for these women and young children and one attendant during a period of hospitalization.

These three papers lay out 3MDG experiences with emergency referrals, as well as showing a decrease in case fatality alongside growing usage of emergency referrals.

What are the papers about?

The first paper is an overall summary of 3MDG experiences with emergency referrals, including costs.

The second paper analyses the data gathered through these experiences to show the benefits of the emergency referral programme, including a real decrease in case fatality as outlined above.

The third paper uses the 3MDG experiences to model a scale-up of the programme to become institutionalized as part of the Ministry of Health’s work.

What are the next steps?

The findings in these three papers have been presented at various technical and strategic working groups, most importantly with the Ministry of Health. These discussions will continue with the aim of institutionalizing support for emergency referrals for pregnant women and young children in Myanmar. A way forward will present a major opportunity for extending timely access to lifesaving interventions and addressing the country’s existing commitments to bring down rates of avoidable maternal and under five mortality.