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Community-based delivery of maternal care in conflict-affected areas of eastern Burma: perspectives from lay maternal health workers.

Publication ,  Journal Article
Teela, KC; Mullany, LC; Lee, CI; Poh, E; Paw, P; Masenior, N; Maung, C; Beyrer, C; Lee, TJ
Published in: Soc Sci Med
April 2009

In settings where active conflict, resource scarcity, and logistical constraints prevail, provision of maternal health services within health centers and hospitals is unfeasible and alternative community-based strategies are needed. In eastern Burma, such conditions necessitated implementation of the "Mobile Obstetric Maternal Health Worker" (MOM) project, which has employed a community-based approach to increase access to essential maternal health services including emergency obstetric care. Lay Maternal Health Workers (MHWs) are central to the MOM service delivery model and, because they are accessible to both the communities inside Burma and to outside project managers, they serve as key informants for the project. Their insights can facilitate program and policy efforts to overcome critical delays and insufficient management of maternal complications linked to maternal mortality. Focus group discussions (n=9), in-depth interviews (n=18), and detailed case studies (n=14) were collected from MHWs during centralized project management meetings in February and October of 2007. Five case studies are presented to characterize and interpret the realities of reproductive health work in a conflict-affected setting. Findings highlight the process of building supportive networks and staff ownership of the MOM project, accessing and gaining community trust and participation to achieve timely delivery of care, and overcoming challenges to manage and appropriately deliver essential health services. They suggest that some emergency obstetric care services that are conventionally delivered only within healthcare settings might be feasible in community or home-based settings when alternatives are not available. This paper provides an opportunity to hear directly from community-based workers in a conflict setting, perspectives seldom documented in the scientific literature. A rights-based approach to service delivery and its suitability in settings where human rights violations are widespread is highlighted.

Duke Scholars

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Published In

Soc Sci Med

DOI

ISSN

0277-9536

Publication Date

April 2009

Volume

68

Issue

7

Start / End Page

1332 / 1340

Location

England

Related Subject Headings

  • Violence
  • Security Measures
  • Public Health
  • Pregnancy Complications
  • Pregnancy
  • Obstetrics
  • Myanmar
  • Mobile Health Units
  • Midwifery
  • Maternal Health Services
 

Citation

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ICMJE
MLA
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Teela, K. C., Mullany, L. C., Lee, C. I., Poh, E., Paw, P., Masenior, N., … Lee, T. J. (2009). Community-based delivery of maternal care in conflict-affected areas of eastern Burma: perspectives from lay maternal health workers. Soc Sci Med, 68(7), 1332–1340. https://doi.org/10.1016/j.socscimed.2009.01.033
Teela, Katherine C., Luke C. Mullany, Catherine I. Lee, Eh Poh, Palae Paw, Nicole Masenior, Cynthia Maung, Chris Beyrer, and Thomas J. Lee. “Community-based delivery of maternal care in conflict-affected areas of eastern Burma: perspectives from lay maternal health workers.Soc Sci Med 68, no. 7 (April 2009): 1332–40. https://doi.org/10.1016/j.socscimed.2009.01.033.
Teela KC, Mullany LC, Lee CI, Poh E, Paw P, Masenior N, et al. Community-based delivery of maternal care in conflict-affected areas of eastern Burma: perspectives from lay maternal health workers. Soc Sci Med. 2009 Apr;68(7):1332–40.
Teela, Katherine C., et al. “Community-based delivery of maternal care in conflict-affected areas of eastern Burma: perspectives from lay maternal health workers.Soc Sci Med, vol. 68, no. 7, Apr. 2009, pp. 1332–40. Pubmed, doi:10.1016/j.socscimed.2009.01.033.
Teela KC, Mullany LC, Lee CI, Poh E, Paw P, Masenior N, Maung C, Beyrer C, Lee TJ. Community-based delivery of maternal care in conflict-affected areas of eastern Burma: perspectives from lay maternal health workers. Soc Sci Med. 2009 Apr;68(7):1332–1340.
Journal cover image

Published In

Soc Sci Med

DOI

ISSN

0277-9536

Publication Date

April 2009

Volume

68

Issue

7

Start / End Page

1332 / 1340

Location

England

Related Subject Headings

  • Violence
  • Security Measures
  • Public Health
  • Pregnancy Complications
  • Pregnancy
  • Obstetrics
  • Myanmar
  • Mobile Health Units
  • Midwifery
  • Maternal Health Services