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UNFPA Strategic Partnership Programme with WHO implemented
key activities in 2006-2007 on "Strengthening Continuum of Maternal and
Newborn Health Services" . One of
these was expansion of referral system of essential obstetric and newborn
care. To facilitate timely transfers in emergency maternal and newborn
management, especially for the hard to reach villages, UNFPA/WHO/DoH had
distributed 25 trawlergies, a mini truck tractor, as part of program activity
to strengthen Reproductive Health.
These were provided to the five programme townships, Myaung, Monywa,
Salingyi, Khin U and Wetlet
Townships in Sagaing
Division in December 2006. An assessment on the usefulness, drawbacks, gaps
and constraints on this form of assistance was conducted between 1st to 5th
July by Department of Health, Department of Medical Research (Lower Myanmar),
UNFPA and WHO in collaboration as a team.
Objectives of the study
1. To determine
the usefulness, drawbacks of existing trawlergies given for maternal and
newborn care transport in the five townships of Sagaing Division.
2. To find means
to improve access to quality skilled care during pregnancy, childbirth and
postpartum.
3. To procure appropriate
essential transport vehicle for referral of mothers and infants for the
future.
Evaluation process
The study used qualitative assessments. A total of 16
trawlergies were visually assessed in the 13 villages where site assessments
were conducted. 26 focus group discussions, 27 key informant interviews and
35 in depth interview sessions were conducted for 20 RHCs which had received
trawlergies.
Results
All
beneficiaries appreciated receiving a trawlergy in their main RHCs for
emergency transport of maternal and infants. The most usefulness was seen in
places where roads that lead to health facility are present. Villages near
river banks and railroad sides preferred either boat or train for transport.
Underuse and misuse were also noted. Some were because of geographic location
but a few depend on empowerment and motivation. Misuse was noted in two
villages.
The trawlergies did not give engine trouble but their main
disadvantages were frail joint, low headlamp irradiance, bumpiness, roofless
chassis and absent side-rails. All lacked license plates and due to this
vehicles encountered trouble especially when driving in Monywa city. RHCs had
difficulty in getting experienced drivers.
All RHCs reported that they had maintenance and
utilization committee but most were not fully functioning. Some of the RHCs
also had difficulty in getting funds for providing free transport,
maintenance and sustainability.
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