May Thandar Oo, a 34-year-old mother of five, had reasons why she decided against seeking antenatal care for her most recent pregnancy. Recently widowed, she was in mourning. Plus, she was worried about the risk of contracting COVID-19 if she visited a facility.
What she didn’t know was that this pregnancy—her sixth—likely put her at an increased risk of serious complications.
With the pandemic ongoing, May Thandar Oo was abiding by social distancing requirements in Yangon, the largest city in Myanmar. She was surprised when she heard a knock on her door, only to discover that a community volunteer had come for a home visit.
Trained by the Essential Health Project, the volunteer listened as May Thandar Oo explained her family situation, and then encouraged her to seek antenatal care at the clinic as soon as possible. Using standardized information, education and communication materials, the volunteer explained the danger signs as well as some dos and don’ts of pregnancy and the importance of a birth plan, which includes, among other things, what to do in case of complications. They discussed who would take care of May Thandar Oo’s children and be with her when she went into labor.
The volunteer also shared information about how the health center was keeping patients safe during the pandemic and precautions to follow prior to seeking care at the facility.
The Essential Health Project, funded by the U.S. Agency for International Development (USAID), is working with the Myanmar Ministry of Health and Sports (MOHS), the private sector, civil society and ethnic health organizations, to improve health outcomes in Myanmar by increasing the availability and quality of equitable maternal, newborn and child health (MNCH) and TB services for the poor and most vulnerable populations. The project is also working to increase demand for these services.
I did not seek antenatal care during this period because of my family issues and the COVID-19 pandemic. But, when I met with the volunteer and was encouraged, I went to the urban health center twice for antenatal care before I delivered the child.May Thandar Oo
Using MOHS resources, the project developed a community-based MNCH training package for an extensive network of community volunteers and worked with them through local organizations. Trainings covered, among other topics, antenatal care, including identification of high-risk pregnancies for institutional delivery, postnatal care and behavior change communication.
After talking with the volunteer, May Thandar Oo realized how important it was for her to have antenatal care from a skilled provider. “I did not seek antenatal care during this period because of my family issues and the COVID-19 pandemic,” she said. “But, when I met with the volunteer and was encouraged, I went to the urban health center twice for antenatal care before I delivered the child.”
With the advice of the volunteer and a consultation with her health care provider, she agreed to give birth at the hospital and made alternate birth plans, including for an emergency delivery. Fortunately, May Thandar Oo went into labor at 37 weeks and, following her prepared plan, gave birth at the hospital to a healthy, seven-pound baby girl.
“We can now help the most needed families in our ward because of the project,” said Kyi Kyi, a community volunteer who shared a story similar to that of May Thandar Oo’s: “When I met with a mother in her sixth pregnancy, she was not aware of the danger signs and risk factors of pregnancy and all her five children were delivered with a traditional birth attendant. I encouraged and educated her to seek antenatal care and urged her to deliver her child in the hospital, as it is risky for a mother in her sixth pregnancy.”
With appreciation for the training she received, Kyi Kyi explained, “I feel so happy when I see a mother take care at the heath center after I have advised and explained to them. That is my achievement as well as the project’s.”
The USAID Essential Health Project is implementing community-based MNCH activities in five townships of Yangon Region jointly with volunteers and general practitioners. In the past three months, these efforts resulted in the identification of 178 high-risk pregnant mothers—like May Thandar Oo—who sought antenatal care from skilled providers.
Thyra Kyaw is the Senior Knowledge Management Learning and Documentation Manager for Jhpiego in Myanmar.