253927 Safe Motherhood in Eastern Burma: The MOM Project

Tuesday, November 1, 2011: 3:30 PM

Chris Beyrer, MD, MPH , Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Background: Access to essential maternal and reproductive health care is poor throughout Burma, but is particularly lacking among internally displaced communities in the eastern border conflict regions. Innovative strategies for accessing vulnerable populations and delivering basic public health interventions are urgently needed.

Methods: Four ethnic health organizations from the Shan, Mon, Karen, and Karenni regions collaborated between 2005 and 2008 to examine the feasibility of an innovative three-tiered network of community-based providers for promotion of maternal health interventions in unstable settings of eastern Burma. Two-stage cluster sampling surveys among ever-married women of reproductive age (15-45 yrs) conducted before and after program implementation enable evaluation of changes in coverage of essential antenatal care interventions, skilled attendance at birth, postnatal care, and family planning service.

Among 2,889 and 2,442 women of reproductive age in 2006 and 2008, respectively, population characteristics (age, marital status, ethnic distribution, literacy) were similar. Compared to baseline, women whose most recent pregnancy occurred during the implementation period were substantially more likely to receive antenatal care and focused interventions such as urine testing, malaria screening, and deworming. Postnatal care visits within 7 days doubled. Attendance at birth by those trained to deliver elements of emergency obstetric care increased almost ten-fold.

Conclusions: Community-based providers substantially improved coverage of maternal health interventions in eastern Burma. The MOM Project's focus on task-shifting, capacity building, and empowerment at the community level may serve as a model approach for similarly constrained settings.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Public health or related public policy

Learning Objectives:
Describe the mobile approaches to maternal health challenges in conflict settings.

Keywords: Maternal Health, Community Health Promoters

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Director of the Johns Hopkins Center for Public Health and Human Rights and Johns Hopkins Fogarty AIDS International Training and Research Program. I have worked in Burma since 1994 using population-based methods to assess health outcomes, reproductive health, and human rights among Burma’s ethnic populations and those who are displaced outside of Burma. I have used these findings on several occasions to provide congressional testimony on the current health situation in Burma.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.