A participatory action research for improving maternal health through health education program with pictorial handbook in Pao minority group, Myanmar

Approximately 1.3 million women give birth each year in Myanmar and according to the “Nationwide Cause-specific Maternal Mortality Survey”, carried out by Department of Health in 2004-2005, maternal mortality ratio was estimated at 316 per 100,000 live births at the national level. The complications during antenatal and delivery periods were the main causes of maternal mortality and morbidity; and 80% of maternal deaths were mostly at home. More than 70% of the total population lives in rural areas where 89% of all maternal deaths were reported. This study was carried out in three PaO villages which are located in Taunggyi Township, Shan State, Myanmar. The main purpose of this study was to evaluate the effectiveness of maternal health education program using pictorial maternal health education handbook for improving knowledge and attitude and practice/intention to practice regarding maternal health care in antenatal, delivery and postnatal period including breastfeeding and family planning among reproductive age women in PaO ethnic group in Myanmar. Intervention program emphasized on giving health education on antenatal, delivery and postnatal care including breastfeeding and family planning conducted by village health volunteers using pictorial handbook which was developed in their social and cultural context. Participatory approach was used to develop the maternal health education program and both quantitative and qualitative methods were used to evaluate the effectiveness of maternal health education program. The findings revealed that knowledge, attitude and intention to practice of maternal health care and health related behaviors were significantly increased after women’s group education sessions using pictorial maternal health education handbook. Moreover, the maternal health education program empowered the community representatives in identifying and analyzing the women’s health problem, developing action plans to address the priority problems, resource mobilization, having responsibilities in implementing, and evaluation of the health program.