Avian and Human Influenza Pandemic Preparedness and Response in Myanmar

Objectives

The strategic framework seeks to reduce morbidity and mortality by strengthening the health-system response to influenza threats, while using communication, education and community mobilisation to improve public awareness and protective behaviour. Strategy 5 has a stated resource requirement of US$1,436,000.[1]Strategy 7 centres on a national communication and health-education campaign addressing avian influenza and human influenza.[2][3]

• Develop guidance for case detection and clinical management, adapted from World Health Organization guidance, to support a consistent health-sector response.[1]
• Define the roles of provincial, district and health-centre facilities in managing suspected or confirmed cases.[1]
• Protect frontline personnel through seasonal influenza vaccination and strengthen infection-control capacity.[1]
• Strengthen border quarantine arrangements, including at border crossings and the international airport, to support prevention and early response.[1]
• Conduct research on viruses and antiviral resistance to inform disease-control activities.[1]
• Increase public and stakeholder awareness through national campaigning, stakeholder sensitisation, risk communication and community mobilisation.[2][3]
• Improve health education through stronger information, education and communication infrastructure, locally appropriate materials and school-based hygiene promotion.[2][3]

Implementation

Implementation combines health-service preparedness, border health measures, workforce development, research and multi-channel public communication. Delivery is intended to operate across provincial, district and health-centre levels, supported by national ministries, international agencies, local authorities, non-governmental organisations and other supporting bodies.[1][2][3]The supplied text does not specify a single lead governance structure, legal authority or consolidated operational plan beyond the activities, partners and coordination mechanisms identified.[1][2][3]

• Adapt and disseminate case-detection and clinical-management guidance at each level of the health system, supported by printing and implementation meetings.[1]
• Clarify facility responsibilities at provincial, district and health-centre levels to support management of influenza-related risks.[1]
• Upgrade quarantine rooms at borders and the international airport, provide essential supplies and train quarantine officers.[1]
• Recruit one hospital consultant through the World Health Organization and strengthen staff skills in planning, quarantine, field and laboratory work through meetings, workshops and training.[1]
• Coordinate implementation through the Ministry of Health, World Health Organization, Ministry of Livestock and Fisheries, Ministry of Education, Food and Agriculture Organization, United Nations Children's Fund, non-governmental organisations, concerned ministries, local authorities and supporting agencies.[1][2][3]
• Establish an information, education and communication taskforce and formulate a communication policy framework to organise campaign delivery.[2][3]
• Develop, translate and distribute communication materials in minority and local languages; train facilitators; engage the media; and use frontline workers, mobile teams and interpersonal communication for outreach.[2][3]
• Mobilise communities in 17 provinces and one special zone, and incorporate pandemic-related hygiene education into the national school health programme through curriculum development, workshops, dissemination, soap provision and hand-washing facilities.[3]
• Undertake situation assessments, rapid surveys and audience segmentation, including baseline, midline and endline activities planned through December 2007.[2]
• Review communication channels, report through ongoing meetings with supporting agencies and donors, and assess campaign effects through knowledge, attitudes and practices surveys, field interviews, project documentation and dissemination meetings.[2][3]
• Use monitoring and evaluation, supportive-supervision workshops, research and consultation as continuing improvement mechanisms.[3]

Monitoring & Evaluation

Monitoring and evaluation combine formative assessment, campaign monitoring, supervision and post-campaign review, but no unified results framework or quantified performance targets are specified.[2][3]

• Conduct situation assessments, rapid surveys and audience segmentation to inform communication planning, with baseline, midline and endline activities scheduled through December 2007.[2]
• Analyse communication channels and use findings to guide the national communication and health-education campaign on avian influenza and human influenza.[2]
• Monitor implementation through ongoing meetings, including reporting to supporting agencies and donors.[2]
• Evaluate campaign effects through post-campaign knowledge, attitudes and practices surveys, field interviews, project documentation and dissemination meetings involving policymakers and experts.[2][3]
• Support quality assurance through supportive-supervision workshops, ongoing monitoring and evaluation, research, and consultation.[3]
• Strengthen accountability through coordination and reporting involving the Ministry of Health, World Health Organization, other government ministries, United Nations agencies, local authorities, non-governmental organisations and supporting agencies.[1][2][3]

The document does not specify a consolidated indicator set, numerical targets, data-quality procedures, routine reporting format, surveillance reporting timetable, responsible evaluation unit or formal consequences for non-performance.[2][3]

Costing & Financing

Strategy 5, which seeks to strengthen the health-system response and reduce morbidity and mortality, requires US$1,436,000; US$359,900 had been received, leaving a stated funding shortfall of US$1,076,100.[1]

• Allocate US$20,000 to adapt guidance on case detection and clinical management, and US$5,000 to define avian-influenza management roles for provincial, district and health-centre facilities.[1]
• Provide US$10,000 for seasonal influenza vaccination of frontline people.[1]
• Fund recruitment of one hospital consultant through the World Health Organization at US$20,000 between June 2006 and December 2007; this activity received US$20,000 from the Asian Development Bank.[1]
• Invest US$50,000 in border quarantine rooms, upgrading and supplies between December 2006 and March 2007.[1]
• Provide US$50,000 to strengthen staff capacity for disease-control activities from December 2006 to December 2007.[1]
• Allocate US$10,000 for research on viruses and US$10,000 for research on antiviral resistance from December 2006 to December 2007.[1]

Communication, health education, community mobilisation and school-hygiene activities identify implementing partners and delivery periods, but the supplied material provides no explicit budgets, funding sources, financing gap or economic assumptions for these components.[2][3]

The document does not specify a full financing plan for closing the Strategy 5 shortfall, annual budget allocations, domestic-resource mobilisation measures, cost-effectiveness analysis, expenditure controls or disbursement arrangements.[1]