By: Madeline Taskier, Partnership Coordinator at Women Deliver
Decades of conflict between the military junta and ethnic minority groups in Burma have internally displaced approximately 440,000 people from their homes and forced them into informal settlements, but a network of community health workers are working to make a difference. With support from the Bill and Melinda Gates Institute for Population and Reproductive Health, Planet Care/Global Health Access Program (GHAP) and organizational leaders from four ethnic minority groups, The Mobile Obstetrics Maternal Health Workers (MOM) Project provides high-impact and mobile emergency obstetric care, family planning, and essential pre-natal care to women and families in these settlements.
Although accessing maternal health services is a challenge for women all across the world, women in post-conflict settings are especially vulnerable to the dangers of high-risk pregnancies and lack of emergency obstetric care. Within informal settlements, pregnant women face unique challenges as the health services they need are unavailable and exacerbated by poor sanitation and nutrition.
In Burma, where there are approximately 240 maternal deaths per 100,000 live births, the regions affected by the conflict have a maternal mortality ratio that is estimated to be as high as 1,200 per 100,000 live births. A significant amount of these deaths can be attributed to sepsis and postpartum hemorrhage. To reach women from ethnic minorities in the post-conflict zones, the MOM Project uses a network of three different tiers of community health workers: maternal health workers, local health workers, and traditional birth attendants.
Each worker level is trained in antenatal care, labor and delivery, basic emergency obstetric care, and postpartum interventions. Maternal health workers receive an intensive seven-month training in Thailand, learning all the activities in each maternal health area and how to manage the other tiers of health workers. Local health workers and traditional birth attendants work at the local level, going to women’s homes to monitor pregnancies, provide family planning, and offer antenatal care. When the time comes for labor and delivery, the maternal health workers are responsible for the emergency interventions, such as providing misoprostol to treat postpartum hemorrhage or IV magnesium sulfate to treat eclampsia.
Since 2005, more than 135,000 people living in the western, northern, and eastern border regions of Burma have been reached by the MOM project and 736 local health workers and traditional birth attendants have been trained. In 2009, 2,726 women had a trained GHAP MOM Project health worker assist with their deliveries.
The long-term goal of the program is to increase the number of women delivering in medical facilities with full access to skilled birth attendants and emergency obstetric care. In the meantime, the MOM Project is a highly functional model of mobile maternal health care for women in regions of political instability. The three tiered approach acts as a spider network—reaching remote women in their villages and homes with the health workers they trust.
- Check out GHAP’s MOM Project here.