MYANMAR

How can local citizens take action to improve public health?

The Dry Zone is a impoverished rural area of central Myanmar where micro-finance programs were failing because of premature deaths among loan recipients. Discussions with the implementing partner (an international NGO specializing in micro-finance) revealed that tuberculosis was a primary cause of death among loan defaulters.

The NGO lacked experience in health programs, but with assistance from a corporate sponsor, a team created an innovative blend of micro-finance, tuberculosis control, nutrition, and later, women’s health initatives.

Working at the local level, the program was offered to small communities able to match start-up grants of under 100 USD. Serial engagements with each village built capacities for managing a village fund while tackling tuberculosis as a public health threat, improving hygiene and nutrition, and empowering women’s health and income-generating groups.

Over a dozen years, 1.2 million citizens were reached, growing both technical skills and a general capacity for self-determination. Among one large cohort, a 92% tuberculosis treatment completion rate was documented. Independent external auditors gave strongly positive reviews of the effectiveness and sustainability of the program.

In light of this success, and as political conditions allowed, USAID and other international donors then invested over 40MM USD to scale up the program, employing local and international NGOs to extend implementation in new regions across Myanmar.