From 19th July to 4th August, JOICFP conducted a JICA-supported "Country-focused Training for the Community-oriented RH Project in Myanmar," (Healthy Mother Project) for four health personnel from the Department of Health, Ministry of Health, and project townships in Myanmar.

The training aimed to identify strategies to be applied at the township level with support from central government and the state, especially for:

* Improving safe motherhood and quality maternal child health care services

* Strengthening community-operated strategies

* Developing an action plan to be implemented at the township level

Through lectures, discussions and field observations, the counterparts learned about Japan's community-operated health care services, collaboration between NGOs and government, and successful transfer of technology to other developing countries through JOICFP.

Field observation

Wakayama prefecture is a large and mountainous area, and suffered greatly from maternal and child mortality after WW II. Through the dedicated efforts of community volunteers with support from local government, great progress was made in reducing the mortality rates.

In Kudoyama Town,
the commitment of the mayor and local authority
has been invaluable in promoting community health care

In Wakayama prefecture, the Myanmar doctors met with members of Kudoyama MCH Promoters Council to see how these volunteers perform activities such as home visits, assisting public health nurses with health checks, educating the public, and collecting health data.

Client-friendly services help ensure that people use health services, and the trainees received a lecture from Mayumi Katsube, JOICFP, on the JOICFP-JICA RH project in Vietnam for the improvement of quality RH services and establishment of client-friendly services. The participants heard how retraining of health personnel, home-based maternal records, and support for Commune Health Centers had contributed to the success of the project.

They also visited two maternity homes and Katsushika Red Cross Maternity Hospital to see how client-friendly services are put into action at all levels, and the training of staff for this.

Two of the doctors from Myanmar
check out a tub for water births at a maternity home

Action plan

The action plan developed by the Myanmar project counterparts addresses three key areas through lessons learned and development of strategies.

1. Low utilization of RH services

Key lessons learned:

Use of MCH handbooks, prenatal care system for referrals and risk case management, establishment of MCH centers, introduction of health checks for all pregnant women.

Strategies to be implemented:

Training and refresher training for health staff, including midwives and auxiliary midwives;
Effective utilization of home-based maternal records to promote communication between mothers and health service providers;
Introducing MCH promoters system into the project:
Improvement of facilities and basic equipment/supplies:
Establishment of an effective and appropriate referral system.

2. Low awareness and knowledge of RH

Key lessons learned:

Use of MCH handbooks, pregnancy registration, coordinated child health care between public health nurses and MCH promoters.

Strategies to be implemented

Advocate for local authority support
Training for MCH promoters
Effective IEC/BCC training for all levels of health staff
Development and effective utilization of IEC/BCC materials and home-based maternal records
Identify key personnel to enhance IEC/BCC on safe motherhood (role of public health nurse)

3. Poor management of existing resources

Key lessons learned

Commitment of local authority, health personnel and MCH promoters, coordination among all levels, decentralization in decision making, needs oriented approach, public health nurse system to bridge between communities and administration, and promote health

Strategies to be implemented

Monitoring system for data and health management
Human resource development to improve effectiveness of existing systems and services

Mayumi Katsube (back left) and Ryoichi Suzuki,
Deputy Executive Director, JOICFP,
talk about the successful introduction
of client-friendly services
in the JICA-supported RH project in Vietnam

All of these strategies are expected to receive support from the government at central and state levels.

During their stay, all the Myanmar medical professionals showed a high level of commitment to improve the maternal child health status in Myanmar, and they stated that the course had been extremely valuable and they were eager to apply what they had learned on their return to Myanmar.