PSI Myanmar works to demonstrate how the private sector can help make universal healthcare a reality. PSI Myanmar runs various initiatives, including pilots for social health insurance delivery at PSI Myanmar’s Sun Quality Health clinics, expanding access to self-administered injectable contraceptives in remote and rural areas and using digital and social media as tools for good.
Our Presence in
PSI Myanmar was founded in 1995 to focus on HIV prevention and quickly expanded into reproductive health and treatment for sexually transmitted infections. In 2001, malaria prevention products were added to its portfolio, which has now grown to include pneumonia, diarrhea and malaria treatment. PSI Myanmar is based in the former capital of Myanmar and the country’s commercial center, Yangon, and has seven smaller project offices across the country.
In 2018, PSI Myanmar reached 2,136,728 people with its products and services, which include:
users reached with modern contraception
users reached with malaria testing
people living with HIV put on antiretroviral therapy
people cured of tuberculosis
non-communicable disease screenings
We Focus On
In May 2019, the government of Myanmar finalized a health financing strategy that set out pathways for transforming how the government pays for and delivers quality primary health care and sexual and reproductive health services under the vision set out in its National Health Plan (2017-2021) to achieve universal health coverage by 2030. The health financing strategy will support the roll-out of an essential package of health services that includes the continuum of care for reproductive, maternal, newborn, child and adolescent health, as well as nutrition, to be delivered through a wide range of state and non-state health providers.
In support of this initiative, PSI Myanmar is piloting a new payment system with its providers at Sun Quality Health Clinics in Yangon and Chin State, which determines fees based on the number of clients served instead of the previous fee-for-service payment model. With this model, the pilot aims to create the healthcare conditions and systems that are necessary to create a national strategic purchasing body, while demonstrating how this model can motivate qualified health service providers outside the public sector to deliver quality-assured services for under-served communities to fulfill their basic healthcare and reproductive health needs.
PSI Myanmar’s HIV and sexually transmitted infection program, called the Targeted Outreach Program (TOP), is a comprehensive model that addresses the health and well-being of low-income populations that are at risk of infection. It offers a package of services for the prevention, care, treatment and support of HIV positive persons, as well as those at risk of HIV infection.
TOP is the largest community-led intervention in Myanmar. In 2018, the project reached more than 22,000 female sex workers and 22,000 men who have sex with men and performed nearly 30,000 HIV tests for most-at-risk populations. The program also operates 10 drop-in centers for female sex workers and men who have sex with men, which provide an extensive range of free clinical services, including counseling, testing and treatment for sexually transmitted infections, HIV, TB and other opportunistic infections, as well as reproductive health services.
In addition to TOP, PSI Myanmar distributes six condom types under the brand Aphaw (meaning “companion”). In 2018, it sold more than 7.8 million condoms through the private sector, accounting for 60% of the commercial condom market.
PSI Myanmar is at the forefront of Myanmar’s national malaria elimination effort. It targets populations that are most vulnerable to contracting malaria, providing quality case management, behavior change communication, applied operational research and innovative surveillance solutions.
Health impact and quality malaria case management are achieved through four primary channels:
- A formal network of Sun Quality Health general practitioners providing healthcare through their own pre-existing clinics.
- A network of village-level primary health workers who are trained, supervised and directly supplied by PSI Myanmar.
- A diffuse network of non-formal providers, such as pharmacies, travelling drug vendors and general retail stores. Pharmaceutical distributors with extensive reach across Myanmar supply subsidized treatments to these providers.
- A network of programs that aim to reach mobile migrant workers at worksites such as rubber plantations, mines and dams. Volunteers provide an integrated basket of health products, including malaria “test and treat” services, to the workers. The worksite program was launched in 2015 with a mapping survey to locate all worksites across the country in order to assess the number of workers and the availability of health services onsite. PSI Myanmar trains and stocks a permanent worker at each site.
In 2018, through PSI Myanmar’s comprehensive network of malaria health providers, more than 650,000 febrile cases were tested and more than 11,500 confirmed cases were treated.
In October 2012, PSI Myanmar began to work in the informal sector to replace monotherapy—therapy that only uses one type of treatment for malaria—with access to quality combination treatment. Availability of quality combination treatments increased from 4% in 2012 to 52% in 2018 among non-formal private sector providers. And monotherapy decreased from 67% in 2012 to 5% in 2018 among targeted non-formal private sector providers.
In 2013, PSI Myanmar conducted a pilot in six townships to determine the plausibility of using rapid diagnostic tests in the private sector to diagnose malaria. The results of this pilot informed the strategy a nationwide scale-up for these tests among informal outlets, such as pharmacies, travelling drug vendors and general retail stores. The scale-up is expected to reduce drug waste, alleviate the risk of resistance to artemisinin-based combination therapy (the gold standard for malaria treatment) and improve overall case management practices.
For more than a decade, PSI Myanmar has provided a wide range of sexual and reproductive health products and services to women across the country through its network of private health providers, village health workers and pharmacies. In partnership with the government and local organizations, PSI Myanmar continues to increase access to quality short- and long-term contraceptive methods to women who need them and to build the capacity of the private sector in more than 200 townships to offer contraceptive products. In 2001, when PSI Myanmar started its Sun Quality Health social franchise network, the contraceptive prevalence rate in Myanmar was 37%. At the time, the provision of contraception in Myanmar’s private sector was very limited, and most sexual and reproductive health services were provided through public health centers and government extension workers–and only to married women in very few areas. By 2015, the contraceptive prevalence rate in Myanmar had increased to 51.3%. PSI Myanmar’s programming provides modern contraceptives to more than 500,000 people each year.
In 2018, PSI Myanmar also began working with the Ministry of Health and Sport to introduce a new injectable contraceptive, DMPA-SC (also known as Sayana® Press). Since its introduction, 1,579 units of DMPA-SC have been distributed in remote and rural areas.
In response to the rising mortality rate from cervical cancer, PSI Myanmar has piloted a cervical cancer prevention program. In the program, women of reproductive age are screened using a low-cost, but highly effective method: visual inspection with acetic acid. If the visual inspection reveals pre-cancerous lesions, the client is referred for appropriate treatment and follow-up.
PSI Myanmar provides TB diagnosis and directly observed short-course treatment, the international standard of care for TB treatment. TB medications are available free of charge from select Sun Quality Health private provider clinics throughout Myanmar. To further promote active case detection, community health workers refer suspected cases to nearby Sun Quality Health clinics and serve as observers to ensure that clients adhere to treatment. Providers are also encouraged to initiate testing and counseling to increase the number of suspected and confirmed TB cases that go on to be tested for HIV.
PSI Myanmar also leverages the active detection rate for cases of TB in urban slums through interpersonal communication and 2,500 pharmacies.
In 2018, nearly 100,000 individuals with suspected tuberculosis were screened for the disease. Of the cases that were screened, 14,600 cases were registered for treatment at Sun Quality Health clinics and more than 4,700 cases were registered at public clinics. Altogether, PSI Myanmar addressed 14.3% of Myanmar’s national TB burden.
A total of 13,691 individuals with suspected TB were also tested for HIV in 2018. Four percent of these cases tested positive.