Myanmar has one of the highest maternal and infant mortality rates in south-east Asia. The key challenge facing many mothers and their children, especially in rural areas, is limited access to healthcare. In Myanmar, over 70 per cent of deliveries are home births and of those 43 per cent are not attended by a skilled health worker. The more remote villages do not have access to health facilities at all.
Mu Thar village has three Red Cross community health workers, who have been trained at the local hospital for a month to help increase their health knowledge and build links with the local midwives and doctors. The community health workers help women in the village with ante- and post-natal care. This includes distributing iron and folic acid, and liaising with the regional government-trained midwife. The Myanmar Red Cross Society also provides cash grants to cover the cost of delivering at a hospital or rural health centre.
During the rainy season the access road turns into slurry of mud, an impasse that makes it impossible for people to travel in or out of this village. For Myanmar Red Cross’ community health workers who normally arrange health referrals in their community by motorbike or ox cart, boat is the only option during the rainy season.
Thirty-five-year old Cho Cho Win was lucky that the road was still accessible just a few months ago when she was taken into hospital for an anti-natal check-up.
“I was so worried when I was pregnant this time. I had such problems with my first child and I was scared about it happening again. I couldn’t sleep as I was worried I would feel the same pain again. So I went to see my community health worker for advice,” explains Cho Cho Win. “My first child was born at home, with a traditional birth attendant like most people,” she continues. “But I had a terrible pain inside me and I knew something was wrong.” The pain Cho Cho Win felt was due to problems with the placenta and her complicated delivery left her fearful for future pregnancies.
“This time my community health worker helped to organize for me to go to the hospital for a check- up. The doctor said because of the problems with my placenta during the first pregnancy, the second child must not be born at home. It should be born in hospital,” adds Cho Cho Win.
Before the Red Cross community health workers were present in the village, nearly everyone gave birth at home with the support of a traditional birth attendant. Now pregnant women are connected with the public health midwife who visits them at home for regular check-ups. If there is a problem and the midwife cannot be contacted, the community health worker arrange for the pregnant women to be taken to the nearest hospital, which is over an hour away by car.
“My second child was very easy for me. Every month during my pregnancy I got the community health worker coming to support me and my little boy was born in the hospital.” The support also continued for Cho Cho Win and her new born, after she returned home.
“After my baby was born, when he was just 1 week old he also suffered from jaundice. I came again to the community health worker who said I had to go back to the hospital where we stayed for another six days.”
Since the community health workers live in the villages they work in, they can be reached easily, provide health advice and support medical referrals. In addition to this, they also organize clean-up campaigns and go house-to-house to raise awareness about dengue fever. This includes warning people not to leave standing water around their homes, which are ideal breeding sites for the dengue mosquito that breed in pure water.
“The community health workers, they live in this village,” shares Cho Cho Win. “We believe them, we trust them.”
Join us in the conversation on 23 May, 12:30 pm (CET), as the discussion on the community health workforce gains momentum at the side event of the 67th World Health Assembly. Follow the hashtags #healthworkerscount and #WHA67.
Community health volunteers’ connections to the community and understanding of the context ideally places them as key resources in developing locally appropriate responses to health issues, encouraging community engagement and promoting sustainability towards reaching universal health coverage.
The Myanmar Red Cross Society’s programme, supported by the British Red Cross is improving services for mother and children in 75 remote communities.