Myanmar

In Myanmar, many rural communities lack easy access to the public health system. The mortality rate among children under five is as high as 80 deaths per 1,000 live births in rural settings. Childhood illnesses, such as acute respiratory infection and diarrhoea are leading causes of death. The country has also experienced an average of more than 17,000 dengue cases each year since 2010, most of which occur in children under 10. We have worked with the Department of Health to strengthen the health system through vector control and disease surveillance, using integrated community case management for effective programme delivery 

Expanding rural communities' access to health services in Myanmar

Rural communities in western Myanmar are often poorly served by the country’s public health system. After training volunteers to diagnose and treat common childhood illnesses in children under five and screen for malnutrition, Malaria Consortium scaled up the integrated community case management approach from three to six townships of Sagaing region.

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Strengthening an integrated iCCM pilot implementation

From June 2016 to June 2017, Malaria Consortium implemented a pilot project that integrated and scaled up Myanmar's two community case management components to ensure the health system has the capacity to respond to all major childhood illnesses.

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Myanmar malaria indicator survey

The Malaria indicator survey project in Myanmar aimed to provide national baseline data on malaria intervention coverage, malaria prevalence, population awareness and availability of malaria services in a representative sample of the population.

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Malaria Consortium in Myanmar

Malaria Consortium has been active in Myanmar since 2005 and established an office in Yangon in 2013, following an invitation from the Minister of Health to establish a presence in the country to provide technical assistance for malaria control — primarily through monitoring and evaluation (M&E) activities. We have since forged strong relationships with in-country and regional partners and government bodies and offer a wealth of technical expertise drawn from our programmes and research.  

We have worked closely with the Department of Public Health via the Vector Borne Disease Control Programme, the National Malaria Control Programme (NMCP) and the Dengue Prevention and Control Programme. We have added tackling common childhood illnesses to our portfolio and currently support three further health department divisions: child health, nutrition and school health. We assist with strategic planning; data collection and use at national, regional, state and township levels; monitoring and evalutation of malaria programmes; operational research on vector control; and behaviour change interventions, especially among women and children in remote communities, mobile migrant forest goers and ethnic minorities. 

Areas of focus 

Integrated community case management Vector control Health system strengthening

Malaria Consortium uses the integrated community case management (iCCM) approach to deliver primary healthcare services across our programmes. Our iCCM experience demonstrates that, with the correct training and supervision, community members can successfully improve access to care for common childhood illnesses, such as pneumonia, diarrhoea, malaria and malnutrition — and deliver a range of health services to children under five, including accurately and safely prescribing antibiotics. 

 

Our project in Sagaing in 2016–2017 increased the provision of health services in rural areas through the country’s existing network of malaria volunteers (MVs), whom we trained to diagnose and treat common but potentially fatal childhood illnesses in under-fives, and to screen for malnutrition. This was then expanded to six townships to further develop MVs’ skills, improve supervision by basic health staff (BHS), and enhance supply chain management of rapid diagnostic tests and medicines. We further developed the capacity of MVs and BHS to increase demand for health services through community dialogues — participatory sessions that allow communities to explore health issues and identify potential solutions most appropriate to them. We pioneered the development, testing and scale up of an innovative social behavioural change communication approach called Positive Deviance (PD) in Cambodia and Myanmar, which led to the formulation of evidence-based public health recommendations. 

 

Improved training and supervision have effectively and substantially reduced the service gap for the most vulnerable communities and eased the burden on health systems. At the policy level, our work has informed the development of the community-based health workers policy in Myanmar, a monumental achievement towards universal healthcare goals.  

In Myanmar, we have conducted a wide range of vector control activities, operational research and capacity development. We also provide technical assistance to governments to develop integrated vector control strategies and insecticide resistance management. We are supporting the country to overcome the final hurdles to malaria elimination: outdoor and residual malaria transmission. We drive research that addresses knowledge gaps and ensures that vector control strategies are evidence-based, highlighting how tools and delivery approaches should adapt based on transmission dynamics.

 

In 2011, Malaria Consortium worked with the Ministry of Health’s Department of Medical Research to support the first artemisinin resistance containment baseline survey in Myanmar, which looked at growing resistance to antimalarial drugs as well as supporting its implementation and subsequent analyses.  We are also driving the development of alternative tools to reduce outdoor transmission, such as insecticide-treated clothing (ITC) among mobile and migrant populations and night-time workers, who often miss out on core malaria interventions. 

To help prevent the spread of vector-borne diseases in Myanmar, we sought to strengthen health systems through targeted surveillance and monitoring and evaluation efforts. Comprehensive data collection and analysis at all levels of the health system not only allow for the early detection of trends and outbreaks, but also help to target malaria services to those areas most affected by the disease. 

 

In 2015–2016, we led the first ever national malaria indicator survey in collaboration with the National Malaria Control Programme (NMCP), the Myanmar Medical Association, the MoHs’ Department of Medical Research and the London School of Hygiene & Tropical Medicine to capture baseline data, which supported the assessment of the impact of malaria-related activities nationwide. The survey results encouraged the effective prioritisation of malaria services in areas experiencing the greatest malaria burden and informed the development of the National Strategic Plan and the National Malaria Elimination Plan.