15-18 Nov 2011Child Health Programme Managers' Meeting 1 Meeting of South-East Asia Regional Programme Managers on Child Health, Kathmandu, 15 – 18 Nov 2011 Progress in Implementation of Child Health Programme Country: MYANMAR

15-18 Nov 2011Child Health Programme Managers' Meeting 2 Total population million ( , CSO) 11.7%- under five population DOH, MOH is mainly taking the responsibilities for promotive, preventive, curative and rehabilitative health care services for the people. WCHD is the main section for child health development. Child health related projects and program

15-18 Nov 2011Child Health Programme Managers' Meeting 3 EPIDEMIOLOGY / BURDEN OF CHILDHOOD DISEASES:

15-18 Nov 2011Child Health Programme Managers' Meeting 4 U5MRIMR MDG TRENDS IN CHILD MORTALITY RELATED TO MDG 4, MYANMAR DOH CSODOH MICS Deaths per 1,000 LB

15-18 Nov 2011Child Health Programme Managers' Meeting 5 Under weight Stunting Wasting LBW Percentage NUTRITION STATUS

15-18 Nov 2011Child Health Programme Managers' Meeting 6 MAIN CAUSES OF UNDER-FIVE DEATHS (Source: Cause specific under five mortality survey, DOH/UNICEF, 2003)

15-18 Nov 2011Child Health Programme Managers' Meeting 7 MAIN CAUSES OF NEONATAL MORTALITY (Source: Cause specific under five mortality survey, DOH/UNICEF, 2003)

15-18 Nov 2011Child Health Programme Managers' Meeting 8 IMCI IMPLEMENTATION

15-18 Nov 2011Child Health Programme Managers' Meeting 9 National adaptation of IMCI Training Package1998 IMMCI Implementation started in the country WCHD/IMMNCI Implementation started in the country 2001 upto now IMCI implementation started (If yes, year) Upto now Newborn included in WCHD (0-1 month)2001 Newborn Added to IMCI2011 Number and Proportion of districts implementing WCHD 200 Number and Proportion of districts implementing IMCI 18

15-18 Nov 2011Child Health Programme Managers' Meeting 10 Number and proportion of MOs trained for IMCI80 Number and proportion of Nurses/other workers trained for IMCI 810 Proportion of districts (out of IMCI districts) with 60 % or more health providers trained 18/18 IMCI supervisory checklists introduced Proportion of first-level health facilities that had at least one supervisory visit over a period of 6 month during previous year 7 tsp 47 RHC & SubRHC Proportion of districts (out of IMCI districts) covered with Follow-up IMCI training 18/18 IMCI Implementation

15-18 Nov 2011Child Health Programme Managers' Meeting 11 IMCI implementation review conducted (If yes, year; National and sub-national) 2009 IMCI Health Facility Survey conducted (If yes, year; National or sub-national) 2008 Proportion of first-level health facilities with at least one health worker who cares for children trained in IMCI 18 Pre-Service IMCI teaching/training: Number and proportion of Medical Schools teaching IMCI4 out 4 Number and proportion of Nursing Schools teaching IMCI23 Number and proportion of Midwifery Schools teaching IMCI 20/22 ICATT introduced (If yes, year and scale)Not yet

15-18 Nov 2011Child Health Programme Managers' Meeting 12 Key factors that helped scaling up: 1. Political and community commitment 2.Priority issue in National Health Plan 3.Existence of Child Health Development Strategic Plan and implementation plan 4.Strong coordination/cooperation/collaboration with UN agencies, NGOs, related departments and ministries and projects and program Key challenges to scaling up: 1.Policy shift 2.Funding gaps 3. HR gaps

15-18 Nov 2011Child Health Programme Managers' Meeting 13 NEWBORN HEALTH

15-18 Nov 2011Child Health Programme Managers' Meeting 14 ENC Course adapted: Year 2006 Other training courses: IMCI, PCPNC, WCHD, Management of Critically ill children Healthcare providers trained: in 30 Tsps out of 330 tsps Healthcare providers Total no. No. Trained % MO (public only) Negligible Nurses " Midwives19554 CHW500 Volunteersnil

15-18 Nov 2011Child Health Programme Managers' Meeting 15 IN-PATIENT (HOSPITAL) CARE OF SICK NEBORNS AND CHILDREN

15-18 Nov 2011Child Health Programme Managers' Meeting 16 WHO Pocket Book introduced: Year Training courses for Hospital care done: Yes Details: Four days training for doctors and nurses Number and proportion of Healthcare providers trained: –MOs: 864 /10927 –Nurses: 865/25644 –BHS: 16,172/19556 Proportion of hospitals providing pediatric care having oxygen: No exact data Hospital assessment using WHO tools carried out: not yet –Year/s: planned for –How many hospitals covered:

15-18 Nov 2011Child Health Programme Managers' Meeting 17 CHW APPROACH FOR CARE OF SICK NEWBORNS AND CHILDREN

15-18 Nov 2011Child Health Programme Managers' Meeting 18 District implementing CHW approach Total No. of Distt Implementi ng Districts % Home based newborn care Sick child package3301 Healthy child package (ECD) 330none Any review of the experience

15-18 Nov 2011Child Health Programme Managers' Meeting 19 PROGRAMME REVIEW AND MANAGEMENT

15-18 Nov 2011Child Health Programme Managers' Meeting 20 CH Short Programme Review introduced, if yes : –Year: 2009 –National or sub-national: both Programme Management Course introduced, Not yet. Planned for

15-18 Nov 2011Child Health Programme Managers' Meeting 21 HEALTH MANAGEMENT INFORMATION SYSTEM (HMIS) AND DHS/MICS

15-18 Nov 2011Child Health Programme Managers' Meeting 22 Indicators related to ARI/pneumonia NoKey indicatorsSource of data 1Morbidity and mortality rates of ARIHMIS 2Care seeking for ARIMICS

15-18 Nov 2011Child Health Programme Managers' Meeting 23 NoKey indicatorsSource of data 1Percentage of under five diarrhoea with severe dehydration and treated with ORT HMIS 2ORT use rateMICS 3Home management of diarrhoeaMICS Indicators related to diarrhoea

15-18 Nov 2011Child Health Programme Managers' Meeting 24 Indicators related to nutrition NoKey indicatorsSource of data 1LBW among MW deliveryHMIS 2LBW among AMW deliveryHMIS 3Under three years old under weight (%)HMIS MICS 4Stunting prevalenceMICS 5Wasting prevalenceMICS 6EBFMICS

15-18 Nov 2011Child Health Programme Managers' Meeting 25 Indicators related to nutrition NoKey indicatorsSource of data 7Continued BF rateMICS 8Timely complementary feeding rateMICS 9Children receiving Vitamin A supplementation MICS 10Iodized salt consumptionMICS

15-18 Nov 2011Child Health Programme Managers' Meeting 26 Indicators related to WASH NoKey indicatorsSource of data 1Sanitary latrine coverageHMIS MICS 2Use of drinking waterMICS

15-18 Nov 2011Child Health Programme Managers' Meeting 27 Indicators related to EPI NoKey indicatorsSource of data 1Immunization coverage (DPT,OPV, Hepatitis B, BCG, Measels) HMIS MICS 2Morbidity and morality of neonatal tetanus HMIS MICS 3Morbidity and mortality rates of vaccine preventable diseases HMIS 4Children protected against neonatal tetanus MICS

15-18 Nov 2011Child Health Programme Managers' Meeting 28 Indicators related to vital statistics NoKey indicatorsSource of data 1Early neonatal death rateHMIS 2NMR (2012)HMIS 3IMRHMIS MICS 4U5MRHMIS MICS 5Under five referral to the higher center (%) HMIS

15-18 Nov 2011Child Health Programme Managers' Meeting 29 Other Indicator related to NCH NoKey indicatorsSource of data 1New cases of ophthalmia neonatorum HMIS 2SBAHMIS MICS 3AN coverageHMIS MICS 4Post natal visitHMIS

15-18 Nov 2011Child Health Programme Managers' Meeting 30 Data collection and management in HMIS Data collection Data Collection System was well established Cover the whole country Statistician at state and regional level Integrated data set Standing order/clear instruction Data dictionary to reduce systemic error Processing and analysis Manual data editing Data entry by Epi data program Data analysis by SPSS program

15-18 Nov 2011Child Health Programme Managers' Meeting 31 Data collection and management in HMIS Dissemination &Use Monthly and quarterly report Annual statistics report Township health profile Quality Control of HMIS Data Monitoring and supervision –Desk monitoring and feedback at each and every level –Field monitoring and supportive supervision –Data quality assessment in selected township

15-18 Nov 2011Child Health Programme Managers' Meeting 32 FUTURE PLAN

15-18 Nov 2011Child Health Programme Managers' Meeting 33 Strengthening and scale-up plans for Next 2 years IMCI: IMNCI trainings to 2 more townships ICATT use: not planned yet CHW Packages: –Home Based NB Care package:10 townships –Sick child package: CCM-5 townships –Healthy Child (ECD) package from biennium Referral (Hospital) Care: F-IMNCI planned Programme Review and Management: –CH Short Programme Review: 2013 –Programme Managers Course:

15-18 Nov 2011Child Health Programme Managers' Meeting 34 Strengthening of HMIS at all levels e.g. training of HMIS with newly revised data set is urgently needed in Capacity building of information staff at various level is needed for data management.

15-18 Nov 2011Child Health Programme Managers' Meeting 35 THANK YOU