In Myanmar, noncommunicable diseases are on a rising trend and recognized as a public health problem. According to 2018 data, 68% of mortality and 24% of premature deaths are attributed to NCDs1. The 2014 STEPS survey revealed that among those above the age of 25 years, 27% had hypertension and 10.5% had diabetes2.
In the aftermath of COVID-19 pandemic and the on-going political crisis, people living with NCDs face numerous challenges for accessing public health service - escalating conflicts, economic crisis and resulting higher price of drugs and increased out-of-pocket expenditures.
People suffering from NCDs require long term regular treatment. Lack access to diagnosis, treatment, and care lead to increased disease severity and even death, especially for underserved and underprivileged population living in rural and peri-urban areas.
With the support of Norwegian Flagship program for NCDs, WHO Myanmar in collaboration with People’s Health Foundation, implemented the project “The community based integrated NCD services for improving access to services through community-based volunteers” in Kyaung-gone and Ein-me Townships of Ayeyarwady Region for two years until February 2024.
Volunteers refer patients to basic health staff for continuation and adherence of NCD treatment. Photo Credit: People’s Health Foundation |
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WHO provided technical oversight in planning, implementation and monitoring of the project. The central and regional public health departments of the health authority also supported in training and evaluation of the project. Main activities of the project are-
- Recruitment and training of youth leaders and health promoters in project townships
- Services and health promotion, particularly for hypertension and diabetes
- Screening for hypertension and diabetes and referral to health centers through established network comprising of health staff and community volunteers to ensure uninterrupted treatment and follow up care
- Health education on prevention and control of NCDs and risk factors, health literacy campaign for the community, focusing on cessation of smoking, alcohol drinking and betel chewing, and healthy lifestyle with regular physical activity.
“I am very grateful to the health volunteers for assisting our basic health staff in their activities. These volunteers fill the gaps in services wherever it exists. When the Basic Health Staff are preoccupied with some urgent tasks and when the people are in need of health care and do not know what to do or whom to turn to, these trained health volunteers render services, provide advice or support. I am thankful to this project. People in the community can depend on these volunteers trained by the project”. (Township Medical Officer, Kyaung-kone Township)
Dedicated and motivated community health volunteers can help overcome inaccessibility and unaffordability of health care services for NCD patients in their villages. Their passion, commitment, dedicated effort, discipline, creative thinking and goodwill towards health development are reasons for the success of this project.
“Now, voluntary health workers in our ward come and monitor my blood pressure, check my blood sugar and supervise physical exercise activities. Because of them, diseases can be detected early and treated, enhancing the health of the families”. (Lady - Vendor, NCD patient)
The project has facilitated NCD services through community health volunteers in remote and underserved villages. 45 393 people aged 40 and above were screened for hypertension and Diabetes. 6 019 people were diagnosed with hypertensive, 788 with diabetes and 448 patients with both hypertension and diabetes and put on treatment, and 17 981 people received NCD health education.
Services are continuing even after the end of project. Recognizing the role of health volunteers, local community and Township Health Department establishment community trust fund to sustain the NCD project.
In 2025, WHO is planning expansion of the project sites and activities, including health education and screening services on cervical cancer and breast cancer by using PEN guideline and expanding referral network to secondary and tertiary level health facilities in four more townships.
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