A volunteer in integrated community malaria improves services in her community in Myanmar

Bu Sein, a trained community health worker, shares her story

As malaria cases in Myanmar are decreasing, the National Malaria Control Program (NMCP) has recognized the need to sustain motivation among the large cadre of trained malaria volunteers in country. In an effort to maintain the community health malaria volunteer cadre, the NMCP initiated a pilot to test a new integrated community malaria volunteer (ICMV) approach.

Through this initiative, the existing malaria volunteers are trained on an additional five diseases, including tuberculosis, HIV, dengue hemorrhagic fever, filariasis and leprosy.

Two townships, Mindat in Chin State and Myawaddy in Kayin State, were selected as the sites for the first pilot of this new approach. A new training module was developed by the World Health Organization with technical support from JSI through the Maternal and Child Survival Program that was then used in the training of 74 newly-minted ICMVs.

The ICMV training occurred in Kyat Oo Tin village in Mindat Township, a district located in the southern part of Chin State. Situated at 4,860 feet above sea level, Mindat Township has a total population of 42,600 (with 31,095 people living in rural environments and 11,505 people in urban environments). The township has an uneven terrain that makes access difficult, and has generated a slight difference in languages spoken between regions. Kyat Oo Tin Village an agricultural community that is 16 miles away from the center of Mindat Township, with 31 households and a total population of 122 individuals. 

Daw Bu Sein, age 49, is the only community health volunteer in her village, Kyat Oo Tin Village in Mindat Township. She was recently trained in the ICMV approach. Her background as a community health volunteer includes three years as a malaria volunteer and over 20 years serving as an auxiliary midwife (AMW). She is also a member of her village’s health committee and assumes volunteer responsibilities for three neighboring villages as well.

Her community and township MOHS teams agree: Daw Bu Sein is highly valued due to her commitment and strong volunteer spirit, particularly in raising awareness of health care education. On her own initiative, she has used religious gatherings as opportunities to widen social networks and distribute information on health care.

About three months ago, she was invited to attend the six-day ICMV training in Mindat Township. At the time of her ICMV training, Bu Sein was concerned that addressing the additional diseases would significantly increase her workload, as she also works on her family’s farm for income. Over the past three months, however, she says she has not felt overburdened with the additional responsibility and was easily able to put her ICMV training into practice. She referred 10 patients and through her efforts has helped to raise awareness in the community about TB more broadly. She also took initiative and provided health education on the ICMV diseases at local community gatherings on Sundays, following religious services.

Bu Sein thinks fondly of the training saying, "The ICMV training was a good opportunity for us as we have gained more knowledge about additional diseases and feel more confident in dealing with the community’s health issues. Additionally, people in the village have gained more trust in the volunteers and come more often to discuss suspected signs and symptoms".

Furthermore, she recognizes that she has become more engaged as a link between the basic health staff and the community to improve community-based health services. She learned that her community is eager to learn more about the diseases and that they appreciate the information that she can provide so they can address alarming signs and symptoms. As she is also an AMW, she can link the case detection of these diseases with vulnerable women and children.

She has found the ICMV approach worthwhile and willingly shares her experience with other malaria volunteers, encouraging them learn more about the ICMV approach. Daw Bu Sein stands out as a role model for success-a trusted and dedicated community health worker in Kyet Ou Tin Village.

USAID’s flagship Maternal and Child Survival Program supports high-impact health interventions with a focus on 25 high-priority countries with the ultimate goal of ending preventable child and maternal deaths within a generation. JSI leads the work in the areas of child health, immunization, and pediatric HIV. JSI staff also contribute technically to the program’s cross cutting functions of measurement, monitoring, evaluation and learning, community health, and health systems strengthening, with a focus on the strengthening of routine health information systems and supply chain management.