Across Myanmar, there is a need both to get more out of limited resources for health, and to scale up existing health services to reach more people. The process of improvement and scaling up of services needs to be based upon sound local strategies for quality so that the best possible results are achieved from new investment.

Following a review of 3MDG financing for maternal, newborn and child health services, the Ministry of Health and the 3MDG Fund have agreed to focus on improving quality within the health sector as an explicit area of work. This will build upon work already being undertaken by the Fund. Examples of such work include:
 

• Financing to improve quality of midwifery services
• Strengthening of township health department supervision and monitoring of services across areas where 3MDG is providing financing support
• On-the-job training and capacity building of basic health staff
• Strengthening linkages between skilled midwives and auxiliary midwives to enhance quality and strengthen the continuum of care

The Fund will be working with the Ministry of Health to identify resourcing requirements to expand upon this work.

Across Ayeyarwady, Magway and Chin regions and states, ‘supply and demand side interventions’ are being used to address the challenges people face in accessing essential services. On the supply side, the 3MDG Fund is providing financial and capacity building support to the public sector to strengthen service delivery. An essential part of the approach to improve service provision for hard to reach areas is through enhancing the planning capacity of the township health departments. On the demand side and through the public sector as well as the implementing partners, the 3MDG Fund is strengthening communitybased health services, the referral of emergency cases and private sector health care services.

AYEYARWADY REGION

In the Ayeyarwady Region, five partners whose work was extended from the Joint Initiative on Maternal, Newborn and Child Health (JIMNCH) were awarded new grants that harmonize with 3MDG ’s approach. In 2014, these partners supported the townships in the assessment and prioritization of needs and the planning of activities for the period 2014 to 2016.

CHIN STATE

In Chin State, support to the four townships of Mindat, Madupi, Tedim and Falam began at the end of 2013. Support to the remaining five townships of Hakha, Tonzang and Thantlang and Paletwa and Kanpetlet started in 2014. In all areas, support began with an inception and planning period of three to five months, followed by the implementation of activities. Some delays were experienced due to access issues during the rainy months and the high turnover of township health department staff.

MAGWAY REGION

In Magway Region, since February 2014, the 3MDG Fund supports the three townships of Seikphyu, Pauk and Myaing were granted to Marie Stopes International (MSI) and the two townships of Ngape and Gangaw to Save the Children (SCI). Activities began in July 2014 in the two SCI-supported townships, but in the other three did not start until September 2014 due to delays in the start-up of those programmes. There are areas of Gangaw, Myaing and Pauk townships that are geographically difficult to access and it will be particularly difficult to implement activities during the monsoon season.

CONSTRUCTION OF HEALTH FACILITIES

Across many remote areas of the country, there is a need for new and improved health facilities, particularly for rural health centres and sub-rural health centres. Wherever a health facility is to be constructed, housing is also built for basic health staff. Through this approach, a wider range of services can be provided and health staff can be better motivated and retained. The 3MDG Fund supports the construction of health facilities via an infrastructure team established as a separate unit within UNOPS Myanmar. The project is managed by a project board that includes the Ministry of Health.

PRIVATE SECTOR: STRENGTHENING SERVICE DELIVERY

In Myanmar, many people currently access health care services through the private sector. The 3MDG Fund supports interventions that both improve the quality and availability of private sector services and are complementary to public health services.
Population Services International (PSI) was contracted to provide complementary support for maternal and child health to the townships. This includes a franchised network of local doctors called the Sun Quality Network. PSI also uses a network of health care volunteers who sell quality-assured products at subsidized prices. Products for maternal and child health are made available through retail points. Finally, trained staff members work to create demand in 3MDG supported townships. PSI is also engaged in a public-private partnership with township health departments to support them in the provision of long term contraceptives and cryotherapy for cervical cancer.
Marie Stopes International (MSI) was awarded a grant to support 15 townships with static and mobile clinics, where they provided a full range of sexual and reproductive health services, as well as short-term contraceptives through retail outlets and demand creation. MSI also stated that they found that the demand for short-term contraceptives is lower than anticipated while the demand for long-term methods is higher than planned. Due to these challenges as well as difficulties in staffing the offices in the remote townships, MSI achievements have also been lower than their targets.
 

 MORE INFORMATION

• 2014 Annual Report
• List of grants awarded since inception (at December 2014)