Elizabeth Goodburn, Senior Technical Advisor for Soapbox, attended and participated in a workshop in Myanmar as part of the ‘Supporting Safe Births in Myanmar’ project. Liz reports on her experience at the workshop…
At the end of March, I visited Yangon, the capital of Myanmar, to participate, along with Jhpiego, in a workshop led by WaterAid. The workshop was an exploratory exercise to identify potential activities which could best support the goals of the Myanmar Ministry of Health and Sports (MoHS) in relation to Water, Sanitation & Hygiene (WASH) and Infection Prevention and Control (IPC). WaterAid, building on a short-term grant, are seeking funding for a 5-year project through the Australian DfAT Water for Women (WfW) programme. The project focus would be to support the MoHS in their aim of improving IPC in the maternity units of township health care facilities. The project would be guided by the findings (currently being finalised) of a MoHS Needs Assessment of WASH in Health Care Facilities undertaken last year in collaboration with UNICEF, WHO, WaterAid, Burnet Institute and Soapbox.
The tree-lined streets of Yangon were as beautiful and vibrant as on my last visit (for the RCGP) two years ago though there are many new modern buildings and more traffic including fortunately numerous taxis making it easy to get around town. During my visit, there was a public holiday and one of the nearby parks was lit up with the most amazing light installations.
The day workshop, led by the WaterAid Health Advisor and the Country Director, was an excellent opportunity to meet various members of the WaterAid and Jhpiego technical teams.
Jhpiego has been working closely with the MoHS in Myanmar since 2014 to improve maternal, newborn and child health including a major programme for in-service emergency obstetric training based at the Yangon General Women’s Hospital (YGWH). They are also supporting the rollout of competency-based in-service capacity building approaches and facility-based Quality Improvement (QI) for maternal and newborn health in 5 township hospitals.
Workshop participants agreed that, if the project is approved, WaterAid would lead on support for the MoHS in the WASH components of the project, maintaining a strong focus on gender equity. Jhpiego would be the lead partner for supporting the development of IPC training for health and managerial staff and associated QI development while Soapbox would lead on supporting training for health facility cleaners. Soapbox, in partnership with NHS Grampian, has already had considerable experience in other countries supporting delivery of an innovative Cleaners Training Package (including a Training the Trainers course) which is interactive and designed for participants who may have low literacy skills.
While in Yangon I had the opportunity to meet several other groups who have been active in support for improving IPC in health facilities. I was able to visit the Yangon General Hospital and meet the staff involved in improving IPC in the ICU following previous collaboration with an NHS Improving Global Health Fellow (IGHF). They had developed a programme led by Hand Hygiene Champions which had clearly been extremely successful. I was also able to visit the YGWH where I met with professors and senior staff. A quick tour around the hospital demonstrated an impressively strong focus on IPC including hand washing instructions on the wall in every ward and hand gel easily available throughout the facility and at the end of every bed in some units.
During my visit, I was also was able to meet with the Country Director of THET (Tropical Health Education Trust) who oversees a number of UK partnership projects, many of which include a strong IPC component. Through my RCGP links, I also met up with a group of innovative Myanmar GPs who, with input from another IGHF and following a survey, have decided to focus on improving IPC in GP Clinics as part of a wider QI project in partnership with Myanmar Medical Association GP Society and the RCGP.
The final meeting of the week was with the scientist from the Dept of Medical Research who led the MoHS WASH Needs Assessment study and also supports a focus on improving IPC in health facilities.
My conclusion after these visits and discussions was that there is incredible interest and drive in many sectors of the Myanmar health system to support improvements in IPC and help reduce hospital-acquired infections particularly among mothers and newborn babies. Working with WaterAid and Jhpiego during the workshop was an energising experience. The team member’s knowledge of local health systems, as well as the technical skills and understanding of the issues around infections in health facilities, was inspiring.
We look forward to future close collaboration with the MoHS for project approval before implementation is initiated and to subsequent work with all the partners in the Myanmar team as well as with the UK based Soapbox experts.