The United States recognizes the ongoing reform efforts to build a modern, peaceful, and democratic country and welcomes the opportunity to deepen engagement with the people of Burma and their government.
Since 2003, USAID programs have addressed HIV, artemisinin resistant malaria, and multi-drug resistant tuberculosis (MDR-TB), but sizable challenges remain. Large gaps in equitable access to quality care in the hands of well-trained and equipped health care providers persist. Burma has achieved a marked decline in under-five mortality in recent years; however, at 62 deaths per 1,000 live births, it has the third highest rate of under-five deaths in the Asia and Pacific region. Of these deaths, 47 percent occur in the neonatal period. Maternal mortality is also high, at over 200 deaths per 100,000 live births. Burma recently signed UNICEF’s A Promise Renewed pledge to accelerate progress on maternal, newborn, and child survival. In addition, Burma has Asia’s highest malaria burden and is designated a high burden TB and multidrug-resistant TB country by WHO. HIV prevalence exceeds 7 percent in most-at-risk populations, and up to 22 percent for people who inject drugs.
USAID is helping to build technical capacity for service delivery and monitoring and evaluation, including collection of surveillance data. Aligned with the Lower Mekong Initiative, USAID is also supporting improved cross-border surveillance, prevention, and treatment for key infectious diseases. Building upon the Child Survival Call to Action, USAID will provide technical assistance to the Ministry of Health and its partners to scale up proven maternal, newborn, and child health interventions throughout Burma. Health system strengthening will be the foundation of USAID’s work. This will include improved health governance, as well as policy and strategy development and implementation. In Fiscal Year 2013, USAID will begin working with in-country partners to lay the groundwork for Burma’s first ever Demographic and Health Survey. USAID will join other stakeholders to promote the availability of accessible and acceptable health care services at township, district, and community levels. Finally, USAID will join other donors in supporting the Three Millennium Development Goals Fund aimed at reducing maternal and child mortality rate and fighting three diseases – HIV/AIDS, TB and malaria in the next five years.
IMPROVING MATERNAL AND CHILD HEALTH
USAID improves maternal and child health through a combined community and facility-based model that addresses family planning services and builds the capacity of auxiliary midwives, skilled birth attendants, and other community-based health care providers. USAID supports policies and interventions that overcome barriers to care, address infections and nutritional deficiencies during pregnancy, increase hygienic practices during delivery, and strengthen post-partum care and counseling. USAID is introducing two public private partnerships: Survive and Thrive and Helping Babies Breathe, which provide evidence-based training and high quality affordable resuscitation devices to birth attendants. The partnerships will also link pediatricians, midwives, and obstetricians from American professional associations to peer associations in Burma to build capacity in service delivery for priority health interventions.
ADDRESSING ARTEMISININ RESISTANT MALARIA
The President’s Malaria Initiative (PMI) in Burma focuses on filling gaps in training and equipping additional providers in malaria case management, including diagnostic testing; monitoring availability of commodities, and providing targeted technical assistance and/or logistics support as needed to support full coverage of malaria interventions. Special attention is paid to support community-level logistics in border areas. PMI has also begun training staff to prepare for a national baseline survey of antimalarial drug quality. USAID recently began procuring long lasting insecticide-treated nets, rapid diagnostic tests, and anti-malaria medication.
RESPONDING TO THE BURDEN OF TUBERCULOSIS
USAID’s support to the National TB Program’s (NTP) to address MDR-TB includes implementation of the national treatment protocol and improved laboratory capacity. USAID addresses TB/HIV co-infection by targeting both HIV and TB patients with testing and diagnostic services. USAID recently funded a nationwide TB prevalence survey that revealed TB prevalence three times the previous estimates. USAID supports control of multi-drug resistant TB through strengthening detection of suspected MDR-TB cases; supporting the roll-out of new diagnostics; and improving the skills of health care workers in prevention, case management and treatment of MDR-TB. USAID’s programs also develop TB communication materials that target communities and encourage screening, testing, and adherence to treatments.
PREVENTION AND SUPPORT FOR HIV/AIDS
Through the President’s Emergency Plan for AIDS Relief (PEPFAR), USAID’s program focuses on sexual prevention of HIV, largely though behavior-change communication, condom distribution, and increased access to voluntary HIV testing and counseling. Activities target most-at-risk populations in high prevalence areas, increasing their health-seeking behavior while reducing risk behaviors for HIV. Objectives include scaling up a comprehensive service package that includes prevention, screening and treating sexually transmitted infections, and improving linkages for case management and care and treatment services, including TB screening and treatment for people living with HIV.
ADDRESSING INFLUENZA AND OTHER EMERGING THREATS
Programs in Burma improve surveillance and response capacity for both human and poultry populations. USAID is working with the Ministry of Health and Ministry of Livestock and Fisheries to strengthen capacities to monitor and respond to H5N1 avian influenza in human and poultry populations. USAID is supporting laboratory diagnosis, field epidemiology, and operations research on live bird markets in order to decrease risk of disease transmission. With AusAID funding, USAID’s PREVENT project will work to characterize and mitigate behaviors and practices associated with the spillover of diseases from animals to people.
Health Fact Sheet (PDF, 173kb)
Last updated: October 29, 2013