February 8, 2017

Reproductive Health

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Reproductive Health Departments: Inpatient and Outpatient Department

The Reproductive Health team delivers around 6 babies every day. They also provide comprehensive reproductive health services including family planning, neonatal and post-abortion care, as well as prevention of mother to child transmission of HIV (PMTCT).

 

The Reproductive Health Programme’s goals are to keep mothers strong and give all children a healthy start. The MTC Reproductive Health Department’s inpatient and outpatient sections provide comprehensive women’s services including family planning, gynaecology, normal and complicated labour and delivery, neonatal care, and post-abortion care. Its antenatal care programme offers screening for malaria, anaemia, blood group typing, HIV and syphilis. We safely deliver about 6 babies per day.

Most Common Treatments / Services 

Antenatal visits / Postnatal visits / Family planning visits / Delivery / Neonatal care / Post-abortion care / STI treatment 

Reproductive Health Stats 2017

History

The need for reproductive health services at the clinic was identified after the establishment of Mae Tao Clinic in 1989, when expectant mothers began coming to the clinic to deliver their babies at all hours of the day and night.

In 1995, the clinic set up a maternal and child health programme with a separate delivery room.  It offered tetanus vaccination, family planning, gynaecological services and antenatal care. The following year, 156 babies were born at the clinic. As the number of deliveries increased annually, the clinic added a second delivery room. In 2001, the clinic added programmes for safe motherhood, sexually transmitted infections and HIV/AIDs, adolescent health care and gender-based violence prevention.

Today, the Reproductive Health Inpatient Department is located in the new Mae Tao Clinic compound, having 52 beds that are enough to accommodate all patients. The Reproductive Health Department’s inpatient and outpatient sections provide comprehensive women’s services.

Challenges

Maternal mortality rates are as high as 721 per 100,000 live births in conflict zones of Eastern Burma (EBRMS, 2013). This compares to a rate of 230 in the rest of Burma, which is the second highest in ASEAN. This demonstrates the huge need for the safe, free services provided our reproductive health department.

An ongoing challenge is managing pregnant women and mothers with HIV. We provide HIV screening during the first visit of antenatal care (ANC) and every pregnant woman who comes for delivery but did not attend ANC. The prevention of mother to child transmission of HIV (PMTCT) is a comprehensive programme, which includes ARV treatment, prophylaxis against infections, free laboratory investigations, delivery in a safe environment, milk formula and follow-up after birth. MTC referred more patients to Myanmar’s government programme to ensure continuity of ARV after delivery. MTC supports women with ARV, delivery costs in Mae Sot hospital, milk formula and follow-up. For early diagnosis of whether PMTCT babies are HIV-positive, we register the babies in the Thai government hospital where they can get regular PCR tests. Of 21 babies tested in 2017, only 1 turned out to be HIV-positive.

Another huge challenge comes in the form of small swaddled bundles – some newborns orphaned and abandoned at the clinic every year. Some mothers die in childbirth; other mothers leave their infants because poverty or other circumstances prevent them from providing a good home. In the case of abandoned children, medics care for the infants in the in-patient department for several months in case family members return to claim them. After that, the clinic works with community-based organisations to find safe local homes for these children.

Collaboration with Partners

Mae Tao Clinic refers patients in need of advanced emergency obstetric care to Mae Sot Hospital, women in need of PMTCT are referred to Mae Sot hospital or Myawaddy hospital.

Mae Tao Clinic is a key partner in the Ethnic Health Systems Strengthening Eastern Burma network, a network that aims to ensure access to maternal and child health services in ethnic areas of Eastern Burma. This is done by providing Traditional Birth Attendant (TBA) training, Maternal and Child Health (MCH) training and workshops, and providing TBAs with safe delivery kits. Health staff from our partner organisations are trained at MTC and deployed to clinics in remote areas to provide high quality reproductive health care to their respective communities.

(last update: 5 April 2018)

Reproductive Health Outpatient Department (RHOPD)


Our reproductive health team provides care to women of reproductive age through multiple services:

Antenatal care: Women are encouraged to come at least four antenatal visits during pregnancy, although the average number of visits per women is three. Pregnant women receive counselling, pre-natal laboratory screening (blood group, haemoglobin, malaria, HIV, VDRL, urine), ultrasound investigation, immunisation, prophylactic antihelminth treatment and dietary supplements (iron, folic acid and vitamin B). All women are assessed based on our protocol which is in line with WHO standards and which is regularly reviewed.

Family planning: Mae Tao Clinic offers emergency, short, and long acting reversible contraception (LARC) family planning options. Most women prefer injections and need to come to the clinic every 3 months. The reproductive health team is trying to change this trend towards long-acting contraception methods such as implants and intrauterine devices (IUD).

MTC Antenatal Record and Delivery Record

Challenges

According to our annual client survey, many women indicated they find it hard to regularly attend antenatal care services. This is mainly due to the distance between their residence and the clinic, i.e. transportation cost and risks of traveling without documentation in Thailand.

Over the years, our funding has been decreasing and we had to assess and scale down some of our existing programmes. Although we closely work together with our partner organisations to provide our clients with quality health service, we cannot fully cover costs of maternal and child health care.

Staff

8 medics including 1 in-charge and 1 supervisor are providing reproductive health services at our RH-OPD.

(Last update: 8 June 2018)

Meet Our Patients here: http://maetaoclinic.org/our-services/our-patients/

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