Maternal and Childcare Program
Healthy Family for Healthy World.
1. Mothers are healthy from their pregnancy till their child delivery.
2. Children are healthy from their conception to their 5 years old.
3. Mothers and children from the mother’s womb to child growth are in safety.
Our Project Background:
Chin State is home to some of the poorest maternal mortality rates, access to basic health services, and nutrition outcomes in Myanmar (Myanmar Demographic and Health Survey (DHS): 2015-16). High levels of poverty, and linguistic diversity, coupled with remote villages in difficult terrain and poor infrastructure mean physical access to health facilities and information is challenging, especially for pregnant women. According to the Demographic and Health Survey (DHS) 72.2% of women aged 15-49 experience having at least one problem accessing health care, more than in any other state or region. For women in Chin, significant social/cultural and geographical barriers to accessing health care are prevalent with more than 50% reporting distance to the health facility as a barrier, and close to 20% reporting that getting permission to go for treatment as a barrier.
These barriers to access basic health care contribute to almost all newborns (94.8%) in Chin State not receiving any postnatal check-ups in the first two days after birth (DHS: 2015-16), while an equally concerning 79% of women (aged 15-19) in Chin who gave birth in the past two years did not have a postnatal checkup in the first two days after birth. Some 62% of new mothers in Chin don’t receive a postnatal check-up at all (DHS:2015-16). It is therefore not surprising that Chin State has the highest number of home births with 85% of women (in the five years leading up to DHS) giving birth at home. Consequently, Chin State also has the highest maternal mortality rate with 104 deaths per 1,000 live births (DHS: 2015-16).
In Chin State, even when people can reach a health facility, there is no guarantee that there will be a qualified or suitable staff member to meet them there with more than half the health posts in Chin State vacant (Myanmar Institute for Integrated Development: 2014). Where staff do exist, they often lack the skill and or equipment to deliver beyond basic services. The health centers are not just remote from communities, but also far from medical depots for supplies and goods, a sample of 12 Health Facilities by UNFPA in Chin State found that more than 70 per cent of health facilities were located more than 45kms from the nearest medical depot (UNFPA: 2016).
High staff turnover is prevalent leading to gaps in service delivery and making inroads in sustained capacity building of township and state health staff difficult. At a township and State level the magnitude of need coupled with lack of human resources and capacity means tasks like township planning and budgeting are often poor.
Outreach staff, such as Auxiliary midwives and Village Health Workers (VHWs) play a vital role in delivering services to the otherwise unreachable, however similar to other layers of the health system there is also a high turnover of volunteers, while there is significant variability of their ability to feed into the government system.
In Chin State, health seeking behaviors and behavior change are also impacted by strong cultural and religious beliefs and customs which hinder positive practices such as birth spacing and accessing the formal health system (Collective Voices: 2015). Women often have little agency over health seeking behaviors such as accessing contraception, or decisions around number of children (Collective Voices: 2015).