End of Program Report: USAID Essential Health Project in Myanmar

The project's goal was to improve maternal, newborn, and child health (MNCH) and tuberculosis (TB) outcomes by increasing availability and quality of equitable MNCH and TB services for the poor and most vulnerable populations in Myanmar. The project initially focused on nine selected townships across three states and regions, but ultimately focused intensively on five townships in Yangon region with a light touch approach supporting three townships in Ayayerwady region. The project's approach was based on three intermediate results: IR1, IR2, and IR3. IR1 focused on strengthening the health system to improve the enabling environment for increased coverage of essential health services. This included strengthening non-government and community organizations to support and sustain increased equitable access to essential health services. IR2 focused on improving the efficient delivery of quality responsive essential health services by public and private service providers at the township level and below. IR3 focused on increasing effective demand for quality essential health services. The project achieved notable results, including a decrease in maternal mortality ratio (MMR) from 149 to 128 per 100,000 live births in five Yangon townships and from 259 to 196 per 100,000 live births in three Ayeyarwady townships. The project also contributed to a decrease in neonatal mortality from 20 to 18 per 1,000 live births in five Yangon townships and from 26 to 20 in three Ayeyarwady townships. These declines in mortality were achieved through key outcome-level results, including improved quality of care, increased access to services, and enhanced community engagement. The project's implementation was supported by a range of tools and guidelines, including the Common Elements Treatment Approach (CETA) and the Comprehensive Emergency Obstetric and Newborn Care (CEmONC) package. The project also established a network of community health funds to support access to essential health services. In addition, the project engaged with private laboratories to enhance access to antenatal care (ANC) services. The project's impact was modeled using the Lives Saved Tool (LiST), which estimated that the project contributed to a significant reduction in maternal, newborn, and child mortality. The project's results were also influenced by the COVID-19 pandemic and Burma's political crisis, which presented significant challenges to the project's implementation. The project's success was due in part to its ability to adapt to changing circumstances and to engage with a range of stakeholders, including community leaders, healthcare providers, and government officials. The project's approach to quality improvement was also a key factor in its success, as it helped to improve the quality of care and increase access to essential health services.