Q&A: Making Health a Community Affair

Below we speak with Dr. Khin Swe Swe, Executive Director of Lan Pya Kyel (LPK).

PSI: Welcome to the PSI network! Tell us about your background.

Dr. Khin Swe Swe: I graduated with a M.B., B.S. from the University of Medicine here in Yangon — Myanmar’s largest city — in 2004. I began my career as a Demonstrator in the Pharmacology Department in the University of Medicine in Yangon, where I worked until 2007.

As I wanted to expand my career and decided to work in a public health field, I joined the Master of Public Health program in Mahidol University in Thailand and received my master’s degree in public health in 2008. Since graduating from Mahidol, I have made it my life’s work to combat HIV/AIDS and Tuberculosis in my country.

Dr. Khin Swe Swe
Dr. Khin Swe Swe

I started working as an ART Doctor to provide direct services to the people living with HIV and AIDS in Francois Xavier Bagnaud (AFXB) for a year. Then I joined the United Nations Fund for Population as a Training Coordinator under a German Funded Project from 2009-2011, where I provided quality reproductive health training to basic healthcare staff including mid-wives. I began to hone my program management of HIV/TB projects with the NGO Consortium, where I held the role of National Program Coordinator for nearly seven years. As I would like to have more experience on providing technical assistance to national programs, I joined ICAP at Columbia University and closely worked with National AIDS Program to provide technical assistance for more than two years.

Prior to joining Lan Pya Kyel, I worked as Head of HIV/TB Program (GFATM) at Save the Children International in Myanmar; I supported GFATM programs, including PSI/Myanmar’s, to achieve targets in accordance with the approved work plans and provided technical assistance to the HIV and TB programs.

That’s all to say, I joined LPK as I wanted to apply what I’ve learned in the past while continuing to contribute and work with vulnerable communities.

PSI: What is Lan Pya Kyel (LPK)? How did it evolve out of PSI Myanmar?

KSS: Our vision is to create a world free of stigma for vulnerable individuals to access quality health and related social services with dignity. And through a community-led environment in Myanmar, we’re working to ensure that HIV-vulnerable individuals have access to inclusive, tailored services to improve their health and well-being.

Herein lies LPK Association.

LPK Association operates as a fully independent local entity to receive direct social contracts or strategic purchasing of primary healthcare services from the private providers and community clinics by the government and with an expectation of continued engagement of health and human rights issues through participation of community leaders from local entities.

But let me take a few steps back.

PSI Myanmar launched the Targeted Outreach Program (TOP) and its network of drop-in centers (DICs) in 2005 with the aim of reaching and supporting the health needs of female sex workers (FSWs) and men who have sex with men (MSM) in Myanmar for HIV prevention, care and treatment.

I share PSI’s belief that development is best when it is nationally driven while drawn from global best practices to meet consumers’ needs. PSI Myanmar managed the TOP Business Unit since its inception and focused on building its capacity in finance, procurement, administration and human resources.

As part of a long-term plan for localization in 2019, PSI Myanmar successfully supported the registration of LPK as a local NGO in Myanmar. In January 2020, PSI Myanmar appointed a National Director for TOP with the mandate to begin this transition and take on the role as Executive Director of the new entity, reporting to a local board. On March 1, 2021, LPK launched working as an entirely separate, local entity.

LPK is truly a community-led organization and delivers prevention, care and treatment services to vulnerable populations mainly for key populations: female sex workers, men who have sex with men and transgender women (TG) who have higher rates of HIV and AIDS through 12 Key Population Service Centers (KPSC) across Myanmar with more than 200 staff and 190 volunteers. LPK’s KPSC also provide not only HIV related health services but also provide reproductive health service, laboratory services including viral load monitoring for HIV patients and mental health support counseling, including Common Elements Treatment Approach (CETA). KPSC are located in HIV high burden states and regions, which are the highest congregation of key affected populations (MSM, TG women and Sex Workers). In addition, LPK has dedicated social media teams covering 34 townships in Myanmar in six states and regions. Moreover, LPK sites offer a PPM DOTS facility, to provide TB diagnosis and treatment.

PSI: As Executive Director, what do you hope LPK achieves over the next five years?

KSS: As an Executive Director, I will apply my experience and knowledge to expand the scope of LPK’s operation including implementation of innovations that can promote UNAID’s 95/95/95 targets for a cascade of HIV care. Moreover, LPK will build the capacity of KP led CBO to take a lead role as an implementer in HIV prevention, care and treatment services.

PSI: What lessons can governments and partners apply leading similar work in other contexts?

KSS: My three lessons:

  • Need thorough preparation for transition; it is not good to do a complicated transition in a rush!
  • Invest in building staff capacity including human resource, administration and financial management. Leaders should ensure that members of the key populations are working at all levels of the organization.
  • Supportive coaching and mentoring needs to be long-term.

PSI: How has COVID-19 demonstrated the need for integrated, holistic health services in Myanmar? How have LPK programs adapted?

KSS: The general view of the pandemic is that it spread rapidly across the globe and the perception remains that it is a serious threat to the population including key populations in Myanmar. Key Populations under the care of LPK cannot readily access our healthcare and social welfare systems, and they are also burdened by high costs of treatment. They are finding it challenging to access to COVID-19 prevention including vaccination and treatment. As LPK is community-led organization for MSM/TG women and SW providing HIV prevention, testing and treatment services through 12 key population centered clinics, the integration of COVID-19 activities in existing HIV program would lessen the burden of increased administration costs and securing additional human resources. In this regard, LPK would like to implement COVID-19 activities including risk communication, vaccination information and treatment to provide services to KP, their family members and contacts.

PSI: What does consumer-powered healthcare mean to you?

KSS: In my understanding, the decision on healthcare choices should be made at the patient and consumer level once they have a complete understanding of all the available provider options.

PSI: What inspires you to do this work?

KSS: I am enjoying the challenges as an Executive Director, especially since the organization has newly transitioned into a community-based organization. I want to apply my technical and program management expertise to enable LPK to provide better quality of care to the community by harnessing the strength from the community. Moreover, I would like to prepare LPK not only as an implementer but also as a technical assistance leader for KP led CBO.

PSI: What’s your favorite quote?

KSS: I have two favorite quotes!

“Every Accomplishments starts with the decision to try!” —John F. Kennedy

“In a gentle way, you can shake the world.” —Mahatma Gandhi

Banner photo credit: Justin Kong, GEMS

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