1. Han Win Htat
Marketing Director
PSI/Myanmar
December 3, 2013, Kochi
GHC-SM&F
OVERVIEW OF PSI’S
WORK IN MYANMAR
Demonstrating the Private Sector Approaches to
Deliver Health Services at Scale in Difficult
Operating Environments

2. Myanmar
• Population – 52.8 million1
• Out-of-pocket health expenditure >80%1
• History of government under-investment in
health (<2% of GDP)1.
• Maternal Mortality 200/100,000 live births2
• Under 5 Mortality 62/1000 live births2
• 35% children under 5 stunted3
• ¼ of population live in poverty4.
• 149/186 UNDP Human Development Index5
Source:
1. World Bank, 2012
2. WHO, 2011
3. MICS, 2010
4. ADB, 2010
5. UNDP HDI, 2012

3.  PSI has worked in Myanmar since 1995 and is one of
the largest non-state providers of health products and
services in the country.
PSI NETWORK

4. PSI/Myanmar is…
A non-profit, non-political and non-religious organization
that uses social marketing and social franchising
techniques to empower low-income and vulnerable
people to lead healthier lives.

5. HIV

6. TUBERCULOSIS

7. MALARIA PREVENTION, DIAGNOSIS AND TREATMENT

8. REPRODUCTIVE HEALTH

9. PNEUMONIA
DIARRHOEA
NUTRITION

10. Channels to deliver
health impact….

11. HEALTH MARKET
CHANNEL - SQH

12. HEALTH MARKET
CHANNEL - SPH

13. HEALTH MARKET
CHANNEL – TOP

14. HEALTH MARKET
CHANNELS – SCD

15. Sun Quality Health Sun Primary Health TOPSubsidized
Commercial
Distribution
282 Townships
25 Sales Reps
213 Townships
1,555 SQH Providers
82 Townships
2,030 SPH Providers
Retail / Wholesales
Outlets
Private General
Practitioners
Community Health
Workers
PSI Staff
Peer Educators
HIV, Malaria, Diarrhea,
RH
HIV,STI, Malaria,
Diarrhea, RH, TB,
Pneumonia
Malaria, Diarrhea, RH,
TB, Pneumonia
HIV, STI, RH
Scale: Coverage of PSI Myanmar’s Program
18 Cities
300 Peer Educators

16. Health Impact
Quality
Cost
Effectiveness
Equity

17. EVIDENCE
• SPH Network increased optimal treatment of childhood diarrhoea with ORS and Zinc
in rural Myanmar
Can an expanded social franchising program improve appropriate
treatment of childhood diarrhea in rural Myanmar?
• SPH providers’ ability to correctly diagnose and treat pediatric malaria improved.
Improvement were maintained after 6 and 12 months.
What is the quality of SPH providers’ care after training
and can it be maintained?
• Distribution of ORASEL through SPH is a cost effective intervention, according to the
threshold set by the WHO-convened Commission on Macroeconomics and Health.
What are the costs of managing acute diarrhea with distribution of
ORASEL through the SPH franchise?
• SQH providers serve a predominately urban population since most doctors have
practices in urban areas. SQH providers success fully reach low-income TB patients
in urban areas
Does the SQH network achieve its equity goal of serving the
poor?

18. Relative Ratio of QA ACT to oAMT Sold in the
‘pure’ Private Sector Priority Outlets 2012 - 2013
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2012 2013
Relativemarketshare(excludingotherantimalarials)
Oral artemisinin monotherapy

19.  Aligning provider and
consumer needs
 Securing ongoing financial
inputs from donors
 Local complexities and
constraints
 Ensuring and measuring
quality is resource intensive
Challenges to Success
page 19

21. In 2012, PSI/Myanmar contributed
 21 million male condoms
 88,000 STI treatment
 24,000 TB cases (16% of national TB case registration)
 600,000 malaria treatment
 1.5 million RH consultation (15% of national BS)
 100,000 pneumonia treatment for Children under 5
 680,000 diarrhea treatment
Impact

22. thank you!hwhtat@psimyanmar.org