- Baby Burma Project Background -

Field research

In the midst of Myanmar’s rapid economic and social development, there still remains a great need for improvements in the healthcare sector. 70% of Myanmar’s population resides in rural areas where access to maternal and child health care is scarce.

Compared to the United States, where the maternal mortality rate is 18.5/100,000, the maternal mortality rates in Myanmar are startlingly high with 200/100,000 births ending in a death, while the Neonatal Mortality Rate is 26/1,000 live births (UNICEF/WHO 2013) across the country. The annual number of neonatal deaths is 23,398 (WHO, UNICEF, WB, 2014).

Further, the prevalence of stunting (or low height-for-age) is alarmingly high with as many as 18% of children being underweight, 42% being stunted and 5% wasting in Southern Shan, all of which are caused by malnutrition and have irreversible damage on brain development. If not addressed in the first two years of life, stunting diminished the ability of children to learn and eventually earn throughout the lives (WHO, UNICEF).

There is an acute need for a more focused approach to improving maternal community health delivery across Myanmar. With the right tools and training, Tag hopes to help improve the lives of countless mothers and their children and-in turn-communities as a whole.

In 2016 & 2017, with the help of an OB/GYN and Child Development experts, Tag assessed the state of maternal and infant health in South Shan State and identified four key gaps in maternal and child healthcare

  • Poor hygiene practices in both community health delivery and especially during emergency obstetric surgeries
  • Lack of early detection of leading causes of pregnancy complications such as hypertension and gestational diabetes which is exacerbated by the lack of referral and history managements systems
  • No monitoring and tracking during antenatal care, with most women not receiving the internationally recommended 4 visits. Additionally, essential equipment such as basic fetal heart rate monitors means that even during the interaction between the health staff and the pregnant woman, clear risks signs can go undetected.
  • No provision of education to both health workers and communities to understand normal and abnormal child development and ways to asses and address developmental delays

Goals:

The project’s overarching goal is to improve the health outcomes of mothers and children in the Southern Shan State through:

  • Strengthening local capacities of maternal and child healthcare leaders and providers to deliver replicable, quality community-based health services through training and upgrading facilities
  • Educating midwives and community-based health providers on how to identify developmental delays in children under 5 years of age through seminars and the utilization of specially designed kits to screen for developmental delays
  • Strengthening village to hospital referral systems through improved patient history management and recordings by utilizing m-health technology.

Outcomes

Community health midwives, auxiliary midwives, and regional doctors will have improved capacity and resources to deliver community maternal and child healthcare.

Women who are pregnant, giving birth, or could become pregnancy during the project will benefit from the improved ANC and PNC quality service provisions and will receive direct supervised services during the 2 years of the project.

Children will benefit from integrated nutrition, breastfeeding and hygiene education sessions and information dissemination focused on children under 5 and women of reproductive age (we aim to directly reach an additional 600 participants to establish them as “community health mobilizers”.

Indirectly, regional hospitals and district hospitals will benefit from improved equipment, better skilled staff and improved referral system to manage risks that will lead to improved health outcomes.

The model:

Tag is using an affective and viable approach that has been working with tremendous success since 1922 in Israel – “Tipat Halav” (a milk drop).  By providing extensive and relevant training to midwives in maternal health and child development, each one of them could operate as a village/rural area center that provides health and medical services in the field of health promotion and prevention for pregnant women, infants and children (from birth to age 6 years) and their families.

These trained midwives are offering child health care like: immunizations, early detection of developmental delays or health issues, child growth, vision and hearing, guidance and direction regarding nutrition, play, hygiene, safety and more. They are also offering maternal health care like: monitoring pregnancy, screening test and early detection, day to day care and more.

This model has been proven to be working and showing resilience in hard conditions environments. It has been playing a key part in the transformation the health system in Israel has been going through and the fact the Israel has one of the lowers mortality rates (maternal and infant) in the world. This approach puts the mother in the center and gives her an active roll in assuring her family is getting the proper health care and furthermore gives her the knowledge that she could share with other mothers.

The Technology:

Data collecting and sharing is an unsolved issue for many health systems in rural parts of developing countries. In most of the rural areas the data about pregnancy monitoring, child birth, tests and immunization is still being written on papers and collected physically once a month from the midwife, and while suffering from poor conditions there is a growing percentage of the population using smart phones and 3G networks coverage.

MHealth (Mobile Health) technology refers to the practice of medicine and public health supported by mobile devices like smart phones. Using MHealth in our projects for collecting data and supporting the midwife work will provide accurate information and therefore a better functioning and reactive health system.

Midwives often encounter difficulties in identifying emergency symptoms and working within inadequate and complex referral systems. Using forms enable the midwives to use standardized, complex process to identify symptoms in mothers and babies that require emergency care. Case sharing enables midwifes to easily send medical information to clinic at the referral facility and improve the communication between field and clinical work.

The equipment:

Medical Kits and Medical Hospital equipment supplied to the hospital and local health workers include:

Hospital medical equipment includes: 3 Electronic fetal monitor,

30 Vacuum assistant delivery system (Kiwi),

6 Glucometers and 6 four pack of measuring sticks

Full medical kit for 80 MW and AMW each one includes:

fetal doppler heart monitor, glucometer and measuring sticks, stethoscope and manual blood pressure kit (traditional desktop mercury sphygmomanometer).

Full child development kits for 80 MW and AMW which includes basic toys/equipment to evaluate child development milestones.

 

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