No one left behind: Building capacity of all in healthcare facilities in Myanmar

In five townships in the Ayeyarwaddy Region of Myanmar, WaterAid is promoting adequate water, sanitation and hygiene (WASH) and infection prevention and control (IPC) as essential parts of providing basic health services, including for maternal, new-born and child health.

Safely managed WASH is critical in Health Care Facilities (HCFs) and communities, as well as in response to COVID-19.

Supported by the Australian Government, through Water for Women, WaterAid's project Supporting Safer Births (SSB) in Myanmar aims to strengthen health systems and improve the quality of maternal and new-born healthcare. Through the program, WaterAid has provided a training program called “Training in Environmental Hygiene and Cleaning in Healthcare” (TEACH-CLEAN) to frontline healthcare workers. It is delivered through a “training of trainers” (ToT) approach, where staff such as nurses receive training who can then deliver the training to multiple hospital staff, such as cleaners.

Workers from the hospital who have participated in TEACH-CLEAN reported that they found the training very useful and that they now have better understanding of IPC at hospitals. This program is the first of its kind providing training for general workers who are critical in supporting healthcare staff.

“TEACH-CLEAN is the first training on WASH and IPC for hospital staff particularly the frontline cleaners who are usually ignored for any technical training," said the Deputy Director General of Ayeyarwady Regional Health Department, Dr Than Tun Aung. WaterAid's innovative approach, that takes into the account not just the hospital staff and the people they are helping, but also the systems that supports them, is creating impactful and sustainable WASH interventions.

A nurse is presenting daily life sketch of the cleaner of a hospital at ToT Training (Photo: Swe Zin Tun/WaterAid)

Daw Ei Shwe Sin is a senior nurse who participated in the TEACH-CLEAN training. Daw Ei was familiar with some of the cleaning procedures, but she lacked a complete understanding of the details of several vital cleaning procedures such as “how to use the steamer properly to prevent infections and why PPE should be worn”.

As a master trainer, the TEACH-CLEAN approach helped Daw Ei to improve her knowledge of systematic ways of cleaning hospitals to improve IPC. Daw Ei said one of the most interesting topics for her was the handwashing methods where she learnt that in healthcare settings it is essential to wash the entire forearm up as far as the elbow. This critical understanding will not only improve hospital procedures, but has the potential to flow through to the way Daw Ei manages her hygiene at home and that of her family.

Daw Kyin Than, a lead cleaner at one of the hospitals has worked as a cleaner for 26 years. She is a permanent staff member at the hospital and is responsible for demonstrating to incoming cleaners all the steps of the cleaning process.

After taking part in the TEACH CLEAN training, Daw Kyin learnt new methods on how to engage staff to learn and reflect on how to do systematic step-by-step cleaning and waste management. She felt the training helped expand her knowledge which in turn gave her confidence and empowered her in her role.

“I am so happy that the training was very relevant to me as with my growing age, it is sometimes difficult to memorise all the steps for the cleaning and waste management processes," she said. "The mock exercises during the training helped me to practice participatory methods and familiarised me with the materials. Now I can confidently demonstrate to new cleaners how to make hospital hygienic in a systematic way. I hope when I will involve them practically in the demonstration, they will practice this knowledge more quickly”.

With established footprints, staff and projects across Asia and the Pacific, our partners were able to respond quickly and effectively to the COVID-19 crisis.

A COVID-19 response is a WASH response.

WaterAid have also been disseminating hygiene messages though a number of mediums in response to COVID-19, such as working with one of Myanmar's most well-known broadcasters to produce a series of episodes to promote handwashing practices.

Together with their partner Jhpiego, they are collaborating with the Ministry of Health and Sport to identify potential areas of support and collaboration in COVID-19 activities.

Feature Photo: Cleaners are practising hand-washing steps at multiplier training (Tin Maung Than/Jhpiego)