unicef myanmar short programme strategy notes: 2018-2022...
TRANSCRIPT
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UNICEF Myanmar Short Programme Strategy Notes: 2018-2022
October 2017
©UNICEF Myanmar/2016/ Daniele
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Contents
Country programme document Myanmar ........................................................................... 4
Programme rationale ............................................................................................................................ 5
Programme priorities and partnerships ............................................................................................. 7
Programme and risk management ................................................................................................... 12
Monitoring and evaluation ................................................................................................................. 12
Annex: Results and resources framework ...................................................................................... 14
Programme Component 1) Health and Nutrition ...................................................................... 25
Introduction .......................................................................................................................................... 25
Partners ................................................................................................................................................ 26
Prioritized issues and areas .............................................................................................................. 26
Proposed focus for 2018-2022 (Outcome and Outputs Result): ................................................. 30
Theory of Change Diagram ............................................................................................................... 35
Results Matrix – Health and Nutrition .............................................................................................. 36
Programme Component 2) Water Sanitation and Hygiene (WASH) .................................... 47
Introduction .......................................................................................................................................... 47
Partners ................................................................................................................................................ 48
Prioritized Issues and Areas ............................................................................................................. 49
Proposed focus for 2018-2022 (Outcome and Outputs Result): ................................................. 51
Theory of Change ............................................................................................................................... 55
Results Matrix - WASH ...................................................................................................................... 56
Programme Component 3) Education ......................................................................................... 64
Introduction .......................................................................................................................................... 64
Partners ................................................................................................................................................ 64
Prioritized Issues and Areas ............................................................................................................. 65
Proposed Focus for 2018-2022 (Outcome and Outputs Result): ................................................ 67
Theory of Change Diagram ............................................................................................................... 71
Results Matrix - Education ................................................................................................................ 72
Programme Component 4) Child Protection .............................................................................. 75
Introduction .......................................................................................................................................... 75
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Partners ................................................................................................................................................ 76
Prioritized Issues and Areas ............................................................................................................. 76
Proposed Focus for 2018-2022 (Outcome and Outputs Result): ................................................ 79
Theory of Change Diagram ............................................................................................................... 83
Results Matrix – Child Protection ..................................................................................................... 83
Results Matrix – Child Protection ..................................................................................................... 84
Programme Component 5) Social Policy And Child Rights Monitoring (SPCRM) ........... 91
Introduction .......................................................................................................................................... 91
Partners ................................................................................................................................................ 92
Prioritized Issues and Areas ............................................................................................................. 92
Proposed Focus for 2018-2022 (Outcome and Outputs Result): ................................................ 92
Theory of Change Diagram ............................................................................................................... 95
Results Matrix- SPCRM ..................................................................................................................... 96
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United Nations Children’s Fund Executive Board Second regular session 2017 12-15 September 2017 Item 8 (a) of the provisional agenda*
Country programme document
Myanmar Summary
The country programme document (CPD) for Myanmar is presented to the Executive Board for discussion and approval at the present session, on a no-objection basis. The CPD includes a proposed aggregate indicative budget of $76,705,000 from regular resources, subject to the availability of funds, and $130,803,000 in other resources, subject to the availability of specific-purpose contributions, for the period 2018 to 2022.
In accordance with Executive Board decision 2014/1, the present document reflects comments made by Executive Board members on the draft CPD that was shared 12 weeks before the second regular session of 2017.
* E/ICEF/2017/14.
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Programme rationale 1. The new country programme, 2018-2022, will be implemented during a period of
significant political, economic and social transition, providing unprecedented opportunities and risks for the realization of child rights in country. The first civilian-elected government since 1962 faces the enormous challenges of promoting peace, security and social cohesion and realizing equitable and sustainable development for all communities, within the framework of the new 2030 Agenda for Sustainable Development.
2. The opportunities presented by the Nationwide Ceasefire Agreement (NCA) of October 2015 and the victory of Daw Aung San Suu Kyi’s National League for Democracy in the election of November 2015 are delicately counterbalanced by continued military conflict in northern Shan and Kachin states. In Rakhine State, overall underdevelopment affecting children of all communities is compounded by ongoing communal tensions. Restrictions of movement against certain groups further deprive them of opportunities for growth and development.
3. The new Government set out four goals for the country: national reconciliation; internal peace; transformation to a democratic federal union; and raising the quality of life for the majority of people. It announced a twelve-point economic policy to support these goals in July 2016. The 2016 Union Peace Conference brought together various signatories and non-signatories of the NCA with the hope of initiating political dialogue for lasting peace. In October 2016, the New Vision, New Results for Children conference set out policy priorities in key sectors to support progress for children in the coming years. The country programme is centred on these core national principles and priorities.
4. Myanmar remains a poor country. Despite gross domestic product (GDP) growth of over 8 per cent in the last two years,1 close to one in four households – mainly located in rural and ethnic areas – live below the $1.25 poverty line.2 Half of all households live on or just above the poverty line, with 55 per cent of all children in Myanmar living in income poverty.3
5. Despite positive trends in health and nutrition indicators, the under-five mortality rate of 50 per 1,000 live births4 is high, with half occurring among newborns. Significant disparities exist across geographic regions, peri-urban informal settlements, disaster-prone areas, conflict-affected areas and among disadvantaged ethnic minorities. Seven out of fifteen states/regions contribute to 75 per cent of under-five deaths, with the highest numbers in Chin and Shan. The poorest children are 3.6 times more likely to die as a result of common childhood illnesses, including vaccine-preventable diseases.5 Only 54.8 per cent of children receive all basic vaccinations.6 Out-of-pocket health expenditure can be as high as 75 per cent.7 Undernutrition continues to be a challenge. In 2016 29.2 per cent of under-five children were stunted with wasting at 7 per cent, compared to 35.1 per cent and 8 per cent respectively in 2009.8 Nutrition disparities prevail, with stunting prevalence as high as 41 per cent and wasting as high as 13.9 per cent in some states/regions and townships.9
6. Estimated maternal deaths have dropped from 580 (per 100,000 live births) in 1990 to 200 in 2013, yet Myanmar still has the second highest maternal mortality ratio for
1 Basic Statistics, Asian Development Bank, 2016. 2 Household Income and Expenditure Survey, 2012. 3 Myanmar Census, 2014. 4 Demographic and Health Survey, 2015-2016 (2016). 5 Multiple Indicator Cluster Survey, 2009-2010. 6 Demographic and Health Survey , 2016. 7 Ibid. 8 Ibid. 9 Demographic and Health Survey, 2016.
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countries in the Association of South East Asian Nations (ASEAN).10 About half of all neonatal deaths are related to maternal complications.11 Most newborn deaths occur during delivery and the first day of life. Low institutional delivery (37 per cent) and low skilled birth attendance (60 per cent) contribute to this poor outcome.12 Beyond 28 days of life, pneumonia and diarrhoea cause 20 per cent of deaths among young children.13
7. Five million children lack access to an improved water supply and 1.4 million children lack access to any toilet facility.14 Disparities in access to water, sanitation and hygiene (WASH) are linked to underlying social, political and environmental factors. The 2016 National Strategy and Investment Plan for Rural WASH is an opportunity to improve access to water and sanitation in rural areas, including in emergencies.
8. Despite recent improvements in birth registration coverage to almost 80 per cent in 2014, more than one million children aged 0 to 5 remain unregistered.15 Coverage varies widely across states and regions, from almost 100 per cent in Kayin and Kayah to slightly above 30 per cent in Kachin and Shan, with low levels among children in Rakhine.16
9. There are upward of two million children aged 5 to 17 years out of school, despite Myanmar having reached a high primary net enrolment rate of 95 per cent in 2014.17 For children aged 7 to 11, the school attendance rate is over 80 per cent; however, this rate declines sharply towards the end of primary school.18 In rural areas, 76.3 per cent of children are in school, compared to 92 per cent in urban areas; 28.2 per cent of children from the poorest households are in secondary school, compared to 85.5 per cent from the wealthiest. In Shan State, 23 per cent of children aged 6 to 17 have never been to school, while the national average is 6 per cent.19 Of an estimated 232,000 children with disabilities, two thirds do not attend school,20 owing to social norms reinforcing negative attitudes towards children with disabilities and a lack of inclusive education policies for all children. Poor quality education, evidenced in students’ poor learning outcomes, influences school dropout. In grades two and three, only 23 per cent and 48 per cent of students, respectively, reached curricular expectations and could be considered good readers.21 Enrolment in preschool is only 23 per cent, despite progress, including the launch of the Early Childhood Care and Development (ECCD) Policy and the new kindergarten curriculum. Further, 93 per cent of 2 to 4 year olds with disabilities have no exposure to school readiness programmes.22
10. An estimated 20 per cent of children and adolescents work, with half under the minimum working age and/or working in hazardous environments, the highest prevalence being in Shan State.23
11. A significant number of children and adolescents live away from their parents in some form of institutional care. There are over 200,000 children in the care of a religious institution, 167,000 of whom are adolescents.24 Nearly 700,000 children are under
10 Trends in maternal mortality 1990-2015, World Health Organization, 2015. 11 Demographic and Health Survey, 2016. 12 Ibid. 13 Ibid. 14 Myanmar Census, 2014. 15 Ibid. 16 Ibid. 17 Ibid. 18 Ibid. 19 Ibid. 20 Situation Analysis of Children with Disabilities in Myanmar, UNICEF, 2016. 21 Myanmar Early Grade Reading Assessment, World Bank, 2014. 22 Myanmar Census, 2014. 23 Myanmar Census, 2014. 24 Ibid.
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extended family and non-relative family care.25 There are no formal family-based care options for children in need of protection.
12. Myanmar is currently ranked 10th out of 191 countries on the Index for Risk Management and 2nd on the Global Climate Risk Index of countries most affected by extreme events from 1995-2014. It remains vulnerable to natural hazards, as seen in the 2015 floods, including earthquakes, cyclones, drought and fires. The effects of climate change have elevated the risk of natural and human-induced disasters, threatening economic development and livelihoods.
13. Notwithstanding recent small increases, government funding to health, education and social welfare constitutes barely 10 per cent of overall government spending, which is considerably lower than the regional average.
14. With the opening up of the economy, the private sector plays an increasingly important role in the country development agenda and as duty-bearer in upholding child rights in Myanmar. However, regulatory frameworks and capacity building are necessary to enable businesses to protect children’s rights and adopt child-friendly practices.
15. The 2016 UNICEF situation analysis highlights the complex gender aspects at play in Myanmar, including the unusual phenomenon of higher-than-expected rates of mortality for boys of all ages, as well as how decisions related to education and economic activity impact girls and boys differently. Gender bottlenecks affecting women and girls in particular include limited participation in political processes, governance and decision-making forums; lack of safety and mobility, together with a culture of silence around gender-based violence; limited access to knowledge, information and technology; excessive time burden; and dual responsibilities in domestic life.
16. Lessons from the previous country programme, 2013-2017 – as confirmed by the mid-term review, programme evaluations and consultations with partners – point to the need to holistically address children’s and adolescent’s development following a life-cycle approach, addressing social norms and parental practices, focused on the most disadvantaged children and adolescents. The UNICEF Country Office presence was highlighted as critical in supporting state/region administrations’ evidence-based planning, budgeting, monitoring and coordination and in addressing inequities.
17. In its active involvement in 2030 Agenda discussions, Myanmar showed strong support for the role of data in monitoring progress. Myanmar acknowledged the need for higher investment in the collection, management and use of disaggregated data at the subnational level.
Programme priorities and partnerships 18. Emerging national priorities and development assistance policy inform the country
programme, 2018-2022. The Development Assistance Coordination Unit (DACU), housed within the Foreign Economic Relations Department (FERD) of the Ministry of Planning and Finance, drafted the policy. FERD leads a cross-sectoral consultative group that has overseen preparation of the new country programme and is responsible for coordinating preparation of the United Nations Development Assistance Framework (UNDAF). The programme is rooted in national priorities, harmonized with overall development assistance available to Myanmar, and contributes to UNDAF outcomes.
19. National priorities for development assistance are reflected in the proposed 10 sector coordination groups, which include groups for health, nutrition, social protection and disaster risk reduction, education and technical and vocational education and training. Guidelines for the national peace process have shaped the content and implementation of development assistance.
25 Ibid.
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20. UNDAF outcomes are framed around the five ‘P’s of the Sustainable Development Goals – people, prosperity, planet, peace and partnerships – and reflect national priorities. The structure and content of the country programme are aligned to these outcomes. The programme reflects the resolutions of the New Vision, New Results for Children conference, and is guided by the concluding observations of the Committee on the Rights of the Child and the Universal Periodic Review.
21. To address system-wide bottlenecks that impede realization of children’s rights, the country programme focuses on: (a) generating evidence, analytical work and advocacy; (b) building institutional capacity in social service delivery and information systems; (c) fostering community dialogue to promote behaviours, demand for services and social norms that contribute to realization of child rights; (d) leveraging resources and support for Government-led coordination; (e) promoting access to services, including in humanitarian situations, for the most disadvantaged, through opportunities generated by decentralization and convergence among systems delivered by the Government to ethnic groups; (f) strengthening capacities at union, state/regional and township levels to develop, implement, monitor and guide plans and budgets; (g) providing catalytic support to roll out national plans, policies and strategies; (h) fostering cross-sectoral and multisectoral programming that responds to children as a whole and the environment in which they grow; (i) strengthening partnerships with civil society and private sector; (j) promoting cooperation, sharing lessons and best practices, and fostering innovation between countries, especially across the ASEAN region; and (k) strengthening United Nations coherence for results.
22. UNICEF, in its normative role as knowledge leader and advocate of children’s rights, supports efforts to: (a) reach marginalized groups, especially children and adolescents, in protracted and diverse forms of displacement; and (b) overcome challenges posed by restrictions of movement on populations and active conflict that cuts across programming areas.
23. Programming incorporates actions to enhance social protection, conflict-sensitivity, peacebuilding, resilience and emergency preparedness and response. UNICEF applies a gender lens throughout the programme, focused on gender-based violence and gender equality in regular and emergency settings, in line with the UNICEF Gender Action Plan, 2014-2017. The programme prioritizes support to monitoring systems to ensure systematic collection and use of disaggregated data, focused on the most vulnerable children.
24. The programme’s prioritization of specific geographical locations varies between programme components. It is based on both evidence and analysis that identify disparities in progress against child development indicators, and the need to support children at risk as a result of conflict, displacement and other humanitarian situations, notably in Rakhine, Kachin and Shan states.
25. UNICEF will implement the country programme through six interrelated outcomes that reflect national priorities and align with the UNICEF Global Strategy, 2018-2021. The results for each programme component are set out in the results and resources framework (annex A).
Programme component 1. Health and nutrition
26. The programme contributes to ensuring that more children under five and women of reproductive age, including adolescent girls, have equitable access to and utilize evidence-based health, immunization, HIV and nutrition interventions, including adoption of key behaviours, especially among vulnerable populations in the most deprived states/regions, and conflict-affected and peri-urban areas.
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27. The programme addresses the unfinished agenda of Millennium Development Goals 1, 4, 5 and 6, and corresponding Sustainable Development Goals 2.2, 3.2, 5, 3.3 and 3.8. Health and nutrition are national priorities for development assistance, as reflected in the Government’s commitment to universal health care and its membership in the global Scaling Up Nutrition movement.
28. The programme prioritizes three overarching issues: (a) a health systems based approach; (b) a shift from fragmented programming in silos to integrated services; and (c) bridging the humanitarian-development divide through holistic sector coordination led by the Government. It focuses on: achieving equitable outcomes in health and nutrition; ending preventable maternal death; ending preventable newborn and child death and undernutrition; scaling up nutrition, particularly infant and young child feeding, and treatment of severe acute malnutrition; reaching the unreached for immunization, essential newborn care and integrated management of sick newborn and children; preventing new HIV infections (for example, prevention of mother-to-child transmission); and treating children with HIV.
29. UNICEF will achieve this outcome through health and nutrition outputs that include: evidence-based planning and budgeting; strengthened national systems for procurement, logistics and supply chain management; improved capacity of health-care institutions and front-line health workers; improved capacity for integrated HIV interventions; improved capacity for integrated maternal neonatal and child health (MNCH); community child care practices; and multisectoral political commitments and support.
30. The geographic focus is primarily on four states/regions, based on a composite index of health and nutrition-related deprivations, along with conflict and disaster-affected areas.
31. Key partners include the Ministry of Health and Sports, in particular the Department of Public Health and its divisions; the Department of Medical Services; regional, state and township public health and medical services departments; and ethnic health organizations.
UNICEF will also participate in and promote sectoral collaboration through the Ministry of Health and Sports as well as development partner coordination structures, such as the Myanmar Health Sector Coordinating Committee and the technical and strategic groups.
Programme component 2. Water, sanitation and hygiene
32. In support of the National Strategy and Investment Plan for Rural WASH, this component contributes to ensuring families and institutions in seven states/regions have equitable access to and utilize safe, affordable, adequate WASH services across the lifecycle. As such, it contributes to reducing neonatal, under-five and maternal mortality, communicable diseases, undernutrition and stunting; increasing school attendance; creating a better learning environment; and protecting girls and boys from violence in schools. It supports the achievement of Goal 6, including an increased focus on climate change, conflict and gender inequality.
33. UNICEF will work to achieve this outcome by supporting five output areas that address: government commitment and capacity to scale up WASH; innovative approaches to sustainable water supply services, particularly in challenging locations; elimination of open defecation and promotion of good sanitation and hygiene practices; provision of WASH in health facilities and schools; and ensuring national capacity to deliver WASH services in humanitarian situations.
34. UNICEF continues to provide WASH-sector coordination and leadership both in humanitarian assistance and development work. It advocates for and supports capacity
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development of national and subnational governments to lead sector coordination and support disaster risk reduction.
35. Key partners include: the Ministry of Agriculture, Livestock and Irrigation; the Ministry of Health and Sport; the Ministry of Education; the Ministry of Social Welfare, Relief and Resettlement; the Ministry of Hotels and Tourism; and Myanmar Rural Women’s Network.
Programme component 3. Education
36. The education programme contributes to ensuring that children and adolescents, especially the most disadvantaged, acquire knowledge and skills in an inclusive, safe, quality learning environment to complete pre-primary, primary, transition to secondary and lower secondary education.
37. UNICEF supports the Government’s efforts to achieve Sustainable Development Goal 4 for education and to successfully implement the National Education Strategic Plan (NESP), 2016-2021, to ensure inclusive and equitable quality education and promote lifelong learning for all.
38. UNICEF will work to achieve this outcome by supporting three output areas to strengthen the capacities of: (a) the Ministry of Education and partners to give young children a head start through quality preschools and kindergartens; (b) parents, teachers, communities and ministry staff to support inclusive, gender-responsive education to keep girls and boys, with and without disabilities, in school and able to complete primary and lower secondary education to contribute to social inclusion and cohesion; and (c) institutions at the national and subnational levels to provide out-of-school adolescents with alternative education at primary and lower secondary levels, and provide continuous learning for children and adolescents in conflict-affected areas and during emergencies.
39. UNICEF will assist the Government in strengthening partnerships to increase the participation of different education service providers and partner organizations in the basic education sub-sector. UNICEF will continue as the education development partners’ co-chair for sector coordination and co-lead for education in emergency sector coordination.
40. Key partners include the Ministry of Education; the National Education Policy Commission; the National Curriculum Committee; the Ministry of Social Welfare, Relief and Resettlement; the Ministry of Health and Sports; the Ministry of Planning and Finance; the Ministry of Ethnic Affairs; and non-state ethnic education departments.
Programme component 4. Child protection
41. The programme aims to ensure that all boys and girls, especially the most marginalized, including children with disabilities, are covered by a child protection system that fosters prevention and timely response to violence, exploitation and separation from family.
42. The programme builds on the ongoing establishment of social work case management in the Department of Social Welfare and its connectivity to relevant justice, education and health responses. It works to effectively monitor, report and respond to all boys and girls who are at risk or become victims of violence, abuse, exploitation and neglect. It targets the justice and security sector to increase its specialization in addressing the rising number of child protection cases.
43. Myanmar continues to experience active conflict. There are eight listed parties that use and recruit children in the Secretary General’s Annual Report on Children and Armed Conflict. The monitoring and reporting mechanism for grave child rights violations is
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being strengthened, alongside engagement with all listed entities, to systematically eliminate the practice of using and recruiting children.
44. UNICEF will achieve this outcome through four output areas that: (a) strengthen the capacity of the child protection system to prevent, identify and provide quality gender-sensitive responses to child protection violations, including in emergencies; (b) increase availability of quality specialized protection services for boys and girls; (c) hold all parties to conflict accountable and stop and prevent grave violations against children and the risk of land mines/explosive remnants of war; and (d) strengthen and implement legislation and national child protection policies in accordance with international and regional standards.
45. Key partners include the Ministry of Social Welfare Relief and Resettlement; the Myanmar Police Force; the Office of the Supreme Court of the Union; the Union Attorney General’s Office; the Ministry of Defence; non-state armed groups (which are listed by the United Nations as perpetrators of grave violations against children); the Ministry of Hotels and Tourism; and the hotel and hospitality sector.
Programme component 5. Social policy and child rights monitoring
46. The social policy and child rights monitoring programme seeks to further strengthen government systems and financing in areas that help to reduce child and adolescent poverty and deprivations. It works by improving social and economic inclusion, especially for the most disadvantaged and vulnerable, such as children with disabilities.
47. The programme is fully aligned with the 2030 Agenda, specifically Sustainable Development Goals 1, 10 and 17. This outcome contributes significantly to the localization of the Goals and specifically for indicators for which UNICEF is a custodian.
48. UNICEF will achieve this outcome through three output areas that: (a) strengthen the capacity of the Government to develop, manage and use data, monitoring and evaluation systems to address the situation of girls and boys, especially those aged 0 to 5 and adolescents in Myanmar; (b) enhance the Government’s abilities to systematically provide inclusive, integrated social programmes and social protection, including ensuring the right of every child to birth registration; and (c) improve evidence, capacity and systems for equity sensitive planning, budgeting and implementation.
49. Key partners include the Ministry of Social Welfare, Relief and Resettlement; the Ministry of Planning and Finance; the Central Statistical Organization; and the Parliament.
Programme component 6. Programme effectiveness
50. The programme effectiveness component ensures that the country programme is efficiently designed, monitored, managed, evaluated and supported to meet quality programming standards in achieving results. The component includes cross-sectoral support for communication for development; emergency preparedness and response; disaster risk reduction and climate change adaptation; advocacy, communications and partnerships; planning, monitoring and evaluation; and supply, logistics and other operational support. The component facilitates UNICEF country presence, enhancing the effectiveness of programmes at state and regional levels and promoting engagement with local government and non-state actors.
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Summary budget table
Programme component (In thousands of United States dollars)
Regular resources
Other resources
Total
Health and nutrition 15 932 51 865 67 797
WASH 7 076 25 937 33 013
Education 11 884 20 208 32 092
Child protection 11 882 13 758 25 640
Social policy and child rights monitoring
8 772 5 288 14 060
Programme effectiveness 21 159 13 747 34 906
Total 76 705 130 803 207 508
Programme and risk management 51. The Ministry of Planning and Finance, the main coordinating body providing strategic
direction for government cooperation with the United Nations, is the primary counterpart for the country programme. Programme components and outcomes are managed by the relevant ministries and governmental agencies, in collaboration with civil society organizations and ethnic groups. Coherence with national programmes and other development assistance is through the sector coordination groups.
52. The main threats to country programme implementation include: the complex political situation and pace of reforms; uncertainties of the peace process; access to conflict-affected areas; persistent institutional bottlenecks in policy implementation; and increased intensity and frequency of natural disasters exceeding existing response and resilience capacities. As a mitigation strategy, UNICEF prioritizes institutional capacity building, strengthens communication and evidence-based advocacy, supports the Government in risk-informed programming and regularly assesses and monitors disaster and climate risks. UNICEF will monitor programme implementation risks related to fund transfers and activity implementation through regular updates of risk management tools, performance reviews of office management targets and standards, and implementation of the harmonized approach to cash transfers.
53. Bilateral donors, multi-donor global and country-level partnerships, international foundations, private sector and UNICEF national committees serve as sources of financial resources for the country programme, supplemented by UNICEF core resources.
54. This country programme document outlines UNICEF contributions to national results and serves as the primary unit of accountability to the Executive Board for results alignment and resources assigned to the programme at country level. Accountabilities of managers at state, country, regional and headquarters levels, with respect to country programmes, are prescribed in the organization’s policies and procedures.
Monitoring and evaluation 55. The results and resources framework forms the basis for monitoring programme
components. The plan for research, impact monitoring and evaluation, complemented by a costed evaluation plan, outlines priority research, monitoring and evaluation activities. Significant planned external evaluations that support planning and decision-making and
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provide the basis for informed advocacy include: (a) a formative evaluation of health sector readiness to integrate early childhood care and development (ECCD) interventions; (b) an outcome evaluation of the rural WASH strategy and interventions; (c) an evaluation of pilots in the education sector; (d) an evaluation of communications for development strategies to address violence against children and attitudes towards children with disabilities; and (e) an impact evaluation of the first Government-led maternal and child cash transfer programme in Chin State.
56. UNICEF monitors results through annual management plans, section work plans and internal and peer reviews with implementing partners to assess key strategic, programmatic, operational and financial risks and to define risk control and mitigation measures.
57. Strengthening national and subnational data systems, particularly to monitor progress against Sustainable Development Goal indicators, is a key element under the social policy and child rights monitoring programme component.
58. In coordination with the Government, UNICEF will conduct both mid and end-term country programme reviews. An agile management approach will facilitate real-time strategic shifts that keep pace with the evolving programme environment at state/region and national levels.
59. For humanitarian action, UNICEF uses routine programme monitoring data from the Government and partners, and periodic assessments and localized surveys to complete Country Office humanitarian performance monitoring and the annual Humanitarian Action for Children report.
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Annex: Results and resources framework
Government of Republic of the Union of Myanmar – UNICEF country programme of cooperation, 2018-2022
1: The final version will be presented to the UNICEF Executive Board for approval at its second regular session of 2017.
UNICEF outcomes Key progress indicators, baselines (B) and targets (T)
Means of verification
Indicative country programme outputs
Major partners, partnership frameworks
Indicative resources by country programme outcome: regular resources (RR), other resources (OR) (In thousands of United States dollars)
RR OR Total
1. By 2022, more children under five and women of reproductive
Percentage of births delivered in a health facility.
Surveys Health Management
1. Increased accountability in evidence-based
15 932 51 865 67 797
Convention on the Rights of the Child: (relevant articles of the Convention) Outcome 1: 6,24; Outcome 2: 6, 24; Outcome 3: 28, 29; Outcome 4: 9, 19, 25, 40; Outcome 5: 4, 7, 23, 26. National priorities: (related Sustainable Development Goals; other internationally recognized goals; and/or national goals) National reconciliation and internal peace; priority sectors based on sector coordination groups (health; nutrition; education and technical and vocational education and training; social protection and disaster risk reduction); national plans (National Health Plan, 2017-2021, and other strategic plans in health; National Rural WASH Strategy and Investment Plan; National Education Strategic Plan, 2016-2021; National Social Protection Strategic Plan; National Child Protection Policy and Violence Against Children Action Plan).
UNDAF outcomes involving UNICEF: 1. All people in Myanmar, particularly those affected by poverty, unemployment and vulnerability, benefit from improved sustainable access to social services and enhanced opportunities for human development to reach their full potential. 2. By 2022, Myanmar is enabled to engage in sustainable development processes through enhanced equitable and transparent management of natural resources, environment, climate and disaster risks. 3. By 2022, all people in Myanmar enjoy greater peace, democracy, justice, human rights and equality Outcome indicators measuring change that includes UNICEF contribution: To be provided when available
Related draft UNICEF Strategic Plan 2018-2021 Goal Areas: 1 Outcome 1: Goal Area 1: Every child survives and thrives; Outcome 2: Goal Area 5: Every child lives in a safe and clean environment; Outcome 3: Goal Area 2: Every child learns; Outcome 4: Goal Area 3: Every child is protected from violence and exploitation; Outcome 5: Goal Area 4: Every child has a fair chance in life.
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UNICEF outcomes Key progress indicators, baselines (B) and targets (T)
Means of verification
Indicative country programme outputs
Major partners, partnership frameworks
Indicative resources by country programme outcome: regular resources (RR), other resources (OR) (In thousands of United States dollars)
RR OR Total
age equitably access and utilise evidence-based health, HIV and nutrition interventions, including adoption of key behaviours, especially among vulnerable populations in most deprived states/regions, conflict-affected and peri-urban areas.
Baseline: 37.1% (2016) Target: 50%
Information System (HMIS) Myanmar Demographic Health Survey (DHS) Central Statistics Organization
planning and budgeting for scaling up high-impact interventions and monitoring results with equity.
2. Strengthened national systems for harmonized procurement, logistics and supply chain management
3. National and subnational health-care institutions and front-line health workers have improved capacity to reach more vulnerable populations with quality immunization and MNCH services.
4. Improved capacity to integrate HIV
Key partners as noted in narrative.
Others include the MDG multi-donor trust fund, and Gavi, the Vaccine Alliance.
Sector coordination groups for health and nutrition.
United Nations Network for Nutrition and Food Security.
Percentage of newborns receiving postnatal care within two days (48 hours) of childbirth (home visit or clinic visit) Baseline. 36.4% (2016) Target: 60%
Surveys HMIS Myanmar DHS
Percentage of infants aged 0-5 months who are exclusively breastfed. Baseline: 51.2% (2016) Target: 80%
Surveys HMIS Myanmar DHS Central Statistics Organization
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UNICEF outcomes Key progress indicators, baselines (B) and targets (T)
Means of verification
Indicative country programme outputs
Major partners, partnership frameworks
Indicative resources by country programme outcome: regular resources (RR), other resources (OR) (In thousands of United States dollars)
RR OR Total
Percentage of children < 1 year receiving DTP-containing vaccine at national level. Baseline: Rural – 57.8%; Urban – 75.2%. Target: Rural – 90%; Urban – 90%; Males – 63.5%; Females – 60.7%.
Surveys HMIS Myanmar DHS Central Statistics Organization
interventions for young children and key adolescent populations into essential service delivery.
5. Caregivers, family members, communities and institutions have increased knowledge and skills to practice appropriate child care, hygiene, feeding, dietary, early stimulation, injury and violence prevention and to demand quality health and nutrition services.
6. Increased capacity to legislate, plan and budget effectively the scaling-up of
Percentage of budget requirements for vaccines and related devices covered by the Government. Baseline: 13.6% (2016-2017) Target: 37%
Surveys HMIS Myanmar DHS Central Statistics Organization
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UNICEF outcomes Key progress indicators, baselines (B) and targets (T)
Means of verification
Indicative country programme outputs
Major partners, partnership frameworks
Indicative resources by country programme outcome: regular resources (RR), other resources (OR) (In thousands of United States dollars)
RR OR Total
evidence-based, equitable, nutrition-specific interventions.
7. Increased multisectoral political commitment and approaches for equitable nutrition sensitive interventions.
8. Increased capacity to provide nutrition services.
2. By 2022, families and institutions in seven high-burden states and regions of Myanmar have equitable access to and utilize safe, affordable,
Proportion of the population using basic drinking water service. Baseline: 62.8%26 Target: 75%
Household surveys
1. Strengthened political commitment and capacity for scaling up safely managed WASH services.
Key partners as noted in narrative.
Others include:
WASH cluster partners
7 076 25 937 33 013
Proportion of population having
Household surveys
26 Taken from 2014 Census, which is based on the definition of ‘improved drinking water sources’.
Country Programme Document Myanmar
18 |
UNICEF outcomes Key progress indicators, baselines (B) and targets (T)
Means of verification
Indicative country programme outputs
Major partners, partnership frameworks
Indicative resources by country programme outcome: regular resources (RR), other resources (OR) (In thousands of United States dollars)
RR OR Total
adaptive, adequate and equitable WASH services across lifecycles, especially the most vulnerable children and women.
access to a basic sanitation. Baseline: 67% Target: 73%
2. Enhanced capacity to deliver equitable, safe, gender-sensitive and climate-resilient drinking water supply services to vulnerable populations in targeted areas.
3. Vulnerable communities in targeted areas end open defecation and households have capacity to maintain adequate sanitation facilities and hygiene practices.
4. Increased technical and institutional capacities to build, operate, maintain and monitor WASH services in schools and health facilities.
Proportion of population with hand-washing facility with soap and water available at home. Baseline: 40% Target: 60%
Household surveys
Proportion of schools with basic WASH services Baseline: N/A Target: 50%
Education Management Information System (EMIS); Ministry of Education reports and national survey
Country Programme Document Myanmar
19 |
UNICEF outcomes Key progress indicators, baselines (B) and targets (T)
Means of verification
Indicative country programme outputs
Major partners, partnership frameworks
Indicative resources by country programme outcome: regular resources (RR), other resources (OR) (In thousands of United States dollars)
RR OR Total
5. Increased capacities in emergency preparedness and service delivery to ensure girls, boys and women have access to safe and reliable WASH facilities in humanitarian situations.
3. By 2022, children, especially the most disadvantaged, will acquire knowledge and skills in an inclusive, safe, quality learning environment to complete pre-primary, primary, transit to secondary and lower secondary education.
Percentage of children in kindergarten who have preschool experience Baseline: Total: 39.8%; boys: 38.5%; girls: 41.1% (2009) Target: Total: 66%; boys:65%; girls: 67%
EMIS;
UNICEF field reports; implementing partners reports
1. Increased capacity to give a head start to children aged 3-5 years old through quality preschool and kindergarten education.
2. Increased capacity to actively support inclusive quality education to keep children in school, helping them transit
Key partners as noted in narrative.
Others include:
Sector coordination groups for education and technical and vocational education and training.
11 884 20 208 32 092
Primary completion rate (by disaggregated data)
EMIS
Country Programme Document Myanmar
20 |
UNICEF outcomes Key progress indicators, baselines (B) and targets (T)
Means of verification
Indicative country programme outputs
Major partners, partnership frameworks
Indicative resources by country programme outcome: regular resources (RR), other resources (OR) (In thousands of United States dollars)
RR OR Total
Baseline: Total: 66.84%; boys: 64.2%; girls: 69.63% (2015) Target: Total: 75%; boys: 70%; girls: 80%
and complete quality and inclusive primary and lower secondary education.
3. Increased capacity to provide out-of-school children aged 10 to 18 with alternative education at primary and lower secondary levels, and continuous learning to children in emergencies.
Lower secondary completion rate (by disaggregated data) Baseline: Total: 70.92%; boys: 65.13%; girls:76.61% (2016) Target: Total:77%; boys: 71%; girls: 82%
EMIS
4. By 2022, all boys and girls in Myanmar are covered by a child protection system that fosters prevention and timely response to and recovery from violence, exploitation and separation from family.
Proportion of boys and girls covered by child protection systems as per agreed criteria Baseline: Total: 16%; boys: 17%; girls: 16% (2016) Target: Total: 50%; boys:50%; girls: 50%
Department of Social Welfare (DSW) child protection database; Census data.
1. Increased capacity of national and subnational social services, justice and security sector to prevent, identify and provide quality and adaptive responses to child protection
Key partners as noted in narrative.
Others include:
Child protection subsector; Sector Coordination
11 882 13 758 25 640
Country Programme Document Myanmar
21 |
UNICEF outcomes Key progress indicators, baselines (B) and targets (T)
Means of verification
Indicative country programme outputs
Major partners, partnership frameworks
Indicative resources by country programme outcome: regular resources (RR), other resources (OR) (In thousands of United States dollars)
RR OR Total
Proportion of boys and girls accessing child protection services Baseline: Total: 0.04%; boys: 0.04%; girls: 0.04% (2016) Target: Total: 2%; boys: 2%; girls: 2%
DSW case management information management system and alternative care database; child protection database; children and armed conflict database; trafficking survivor’s database
violations, including before, during and after emergencies.
2. Increased capacity to boost the coverage and quality of specialized child protection services.
3. Improved capacity to monitor grave violations against children and risks related to land mines/explosive remnants of war and advocate for prevention and accountability of parties to conflict.
4. Improved evidence and capacity to strengthen the legal and policy framework to protect and further child rights, in accordance
Group for Social Protection and Disaster Risk Reduction
Country Programme Document Myanmar
22 |
UNICEF outcomes Key progress indicators, baselines (B) and targets (T)
Means of verification
Indicative country programme outputs
Major partners, partnership frameworks
Indicative resources by country programme outcome: regular resources (RR), other resources (OR) (In thousands of United States dollars)
RR OR Total
with international and regional standards.
5. Improved policy environment, budgets and systems for all children, especially the most excluded, guided by improved knowledge and disaggregated data.
Number of children covered by social protection systems Baseline: 0 (2016) Target: 500,000
Administrative records of relevant implementing departments
1. Strengthened capacities to develop, manage and use data, monitoring and evaluation systems addressing the situation of children in Myanmar.
2. Enhanced capacity and improved systems to implement inclusive and integrated social programmes and social protection.
3. Improved evidence, capacity and systems for equity sensitive planning, budgeting and implementation.
Key partners as noted in narrative
8 772 5 288 14 060
Public social sector expenditure (% of GDP) Baseline: 3% (2016) Target: at least 5%
Public budget laws International Monetary Fund article 4 consultation reports
Existence of disaggregated national household survey data on child-focused targets of Sustainable Development Goals collected within the preceding five years Baseline: 8 (2017)
Publicly available survey reports
Country Programme Document Myanmar
23 |
UNICEF outcomes Key progress indicators, baselines (B) and targets (T)
Means of verification
Indicative country programme outputs
Major partners, partnership frameworks
Indicative resources by country programme outcome: regular resources (RR), other resources (OR) (In thousands of United States dollars)
RR OR Total
Target: at least 8
6. The country programme is efficiently designed, monitored, managed, evaluated and supported to meet quality programming standards in achieving results.
Annual management plan produced by end of February each year Baseline: 0 (01/01/2018) Target: 5 (one per year 2018-2022)
Management reports
21 159 13 747 34 906
Effective and efficient utilization of funds maintained on annual basis Baseline: End of year utilization is 98% (2016) Target: End of year utilization is >98%
Management reports
Satisfactory audit ratings during country programme period Baseline: n/a. Target: All audits are satisfactory during 2018-2022
Audit reports
Country Programme Document Myanmar
24 |
UNICEF outcomes Key progress indicators, baselines (B) and targets (T)
Means of verification
Indicative country programme outputs
Major partners, partnership frameworks
Indicative resources by country programme outcome: regular resources (RR), other resources (OR) (In thousands of United States dollars)
RR OR Total
Total resources 76 705 130 803 207 508
Programme Component 1) Health and Nutrition
25 |
Programme Component 1) Health and Nutrition
Introduction
With Myanmar entering a critical juncture with its first civilian-elected government, the UNICEF
Myanmar Country Programme for 2018-2022 marks an important milestone to supporting the
country with making strides towards the attainment of its corresponding Sustainable
Development Goals (SDGs): To end all forms of malnutrition; 3.2: To end preventable deaths
of newborns and children under 5; 3.3: To end epidemics of AIDS, TB, malaria, neglected
tropical diseases and combat hepatitis, water-borne diseases and other communicable
diseases; and 3.8: To achieve universal health coverage, including financial risk protection,
access to safe, effective, quality and affordable essential medicines and vaccines for all. The
Government’s National Health Plan (2017 – 2021) provides an overarching guiding framework
to UNICEF’s support.. This programme component has greater attention to cross-cutting
concerns such as gender equality, integrated humanitarian work, communication for
development (C4D), early childhood development, the use of innovations and partnerships.
This is because the immediate causes of maternal, newborn and young child mortality and
malnutrition in Myanmar include disease, inadequate food, and poor feeding and care
practices, with underlying causes linked to limited access to basic health and social services,
resources, sanitation and hygiene, and women’s empowerment. The causal analysis and
evidence highlight the need for synergistic linkages between health and other sectors (i.e.
social protection, education, WASH) and cross-cutting approaches (i.e. C4D and gender
sensitive empowerment). Yet, given that 50 per cent of all under 5 child deaths are newborns,
©UNICEF Myanmar/2010/Myo Thame
Programme Component 1) Health and Nutrition
26 |
health system strengthening to improve timely and appropriate quality care for mothers and
newborns remain essential.
Partners
The main government partners under the Ministry of Health and Sports (MoHS) are the
Department of Public Health and its Divisions (National Nutrition Centre (NNC), Maternal and
Reproductive Health (MRH), Child Health Development (CHD), Central EPI (cEPI) and
National AIDS Programme (NAP) of Diseases Control) as well as the Department of Medical
Services who are jointly responsible to deliver the essential package of health, nutrition and
HIV services through health facilities. UNICEF works with health partners (e.g. 3MDG multi-
donor trust fund, WHO, UNFPA), and other relevant sectors and Ministries (directly or
indirectly), such as the Ministries of Education, Social Welfare and Labour, and the Ministry of
Agriculture, Livestock and Irrigation, Department of Rural Development to advocate for and
support nutrition-sensitive interventions (i.e. WASH, social protection and agriculture). Using
the SUN platform, UNICEF also works closely with UN agencies, donors, civil society, and
private sector to increase investments for nutrition. Further, UNICEF, through its strong
partnerships and convening role (with GAVI, Global Fund, various international and national
NGOs, civil society, ethnic health and faith-based organizations) consistently supports an
integrated approach to addressing health systems bottlenecks at national and state/regional
levels.
Prioritized issues and areas
The new country programme (2018-2022) will explicitly focus on strengthening health systems in partnerships with government and other actors within and outside of UNICEF, with an increased emphasis on measuring impact of its interventions and building robust evidence on reaching the hardest to reach communities. Responding to such lessons learned, the programme will:
1. Prioritise a health systems based approach: make an incremental shift from service delivery to support evidence-informed system strengthening – using equity-based models and operational research in targeted areas to influence policy, planning, budgeting and strategy development that will inform the Government’s drive to equitably reduce young child mortality in Myanmar.
2. Move from silo fragmented programmes to supporting integrated services: The Health and Nutrition programme needs to build national and subnational capacity to deliver integrated services and approaches. This will allow it to address inextricably linked determinants influencing maternal, new-born, child health and nutrition outcomes.
3. Transcending the humanitarian-development divide: Given the protracted nature of the conflict situation in Myanmar, UNICEF will continue to advocate for and support the greater integration of humanitarian to development programmes by working with government and other stakeholders to strengthen holistic sector coordination mechanisms at national and state/regional levels, including transitioning from cluster approach to a government led national coordination mechanism. Disaster risk reduction and climate change adaptation consideration will be mainstream throughout.
Programme Component 1) Health and Nutrition
27 |
To guide the geographical focus for the proposed health and nutrition programme, a composite index was drawn using a causality analysis and related indicators at the immediate level (e.g. proportion of children without immunisation, proportion not delivered in a health facility), intermediate level (e.g. areas with low hospital bed ratio), structural level (e.g. proportion of girls not in school), and by manifestation (e.g. proportion of children wasted, under 5 child mortality rate). Subsequently, focus states/regions will be: Ayeyawaddy, Rakhine, Chin, Shan and Kayin, Kachin and peri-urban Yangon. Given the above context, prioritized issues and their rationale are summarized below:
Equitable outcomes in health and nutrition - The positive trend in health and nutrition
indicators must be accelerated to meet the SDGs. Myanmar still has a high U5MR (50 per
1,000 live births, which means as many as 100-150 child deaths per day)27. Significant
disparity exists across geographic regions, peri-urban slum, disaster-prone and conflict-
affected areas as well as with disadvantaged ethnic minorities, and while these disparities
may be small in percentage they often equate to large numbers. Stunting is 29.2%2 (almost
one-third of all under 5 children in Myanmar) compared to 35.1% in 20094 and wasting is 7%2
compared to 8% in 20094, with stunting prevalence as high as 41.0 % and wasting as high as
13.9%, in some states/regions and townships. Thirty-eight per cent of the poorest children are
stunted compared to only 16% in the wealthiest. Mothers with no education are more than
twice as likely to have a child who is stunted compared to mothers with secondary education
or higher2. Gender disparities in nutrition for young children do not seem prominent overall,
although stunting among under 5 boys appears to be slightly higher than among girls at 31%
and 27.2% respectively; this merits more formative research in order to better understand. For
the 37% of the population living below the poverty line and the similarly significant proportion
just above, families face hardships accessing food and health care, while being highly
vulnerable to catastrophic health care expenditure. Only 16.8% of women in the poorest
quintile accessed facility-based deliveries compared to 82.5% among the wealthiest quintile2;
70% of the population of Myanmar live in rural areas, where access to quality health care is
more difficult. Children in conflict-affected and hard-to-reach areas are especially vulnerable.
Another area of concern requiring deeper analysis is that, according to 2014 census data,
significantly fewer boys than girls appear to survive their fifth birthday3.
Ending preventable maternal, newborn and child mortality and undernutrition -
Estimated maternal deaths have reduced from 580 (per 100,000 live births) in 1990 to 200 in
2013, yet Myanmar still has the second highest maternal mortality ratio in ASEAN. It is closely
associated with the newborn survival rate since about half of all neonatal deaths are related
to maternal complications. Newborn deaths (first month of life) contribute to 50% of all under
5 child deaths with most occurring during delivery and their first day of life. Low institutional
delivery (37%) and skilled birth attendance (60%)2 contribute to this poor outcome. Beyond 28
days of life, pneumonia and diarrhoea are the top causes of deaths among young children,
representing 20%. Meanwhile, undernutrition contributes to 45% of child deaths. Over 70% of
children 6-23 months old and 38% of women of reproductive age are anaemic2, with no
27 DHS 2015-16
Programme Component 1) Health and Nutrition
28 |
differences between boys and girls for anaemia. Micronutrient deficiencies are generally
widespread28. Thiamine (Vitamin B1) deficiency leads to incidences of infantile beri beri,
contributing to 5% of all under 5 child mortality and substantially in several states/regions29.
Maternal undernutrition poses serious risks for both mother and child, including low birth
weight and susceptibility to disease. Low birth weight is highly correlated with perinatal,
neonatal, and postnatal morbidity and mortality as well as chronic diseases in adulthood that
makes up the largest burden of disease overall in Myanmar. Yet, according to the MICS
2009/10, 8.6% of children were low birth weight (less than 2.5 kg), down from 15% in 2000.
According to a recent health facility assessment30, 85% of all hospitals provided basic
emergency obstetric and neonatal care, compared to only 7% of rural and sub-rural health
centres that are more readily accessible by the rural majority. Lessons learned indicate that
improved competency in MNCH-related emergency referral and care are needed to reduce
MNCH-related deaths.
Scaling Up Nutrition - The main determinants of undernutrition in Myanmar include
inadequate infant and young child feeding (IYCF) and care practices for children and women
of reproductive age (aged 15-49), inadequate maternal nutrition, limited access to health
services, food insecurity, and inadequate hygiene and sanitation. Although exclusive
breastfeeding increased from 23.6% in 2009 to 51% in 2015-16, it is still low. Only 16% of
children 6-23 months consume a minimum acceptable diet, which means that more than 80%
of all young children in Myanmar are not receiving adequate food in quality/diversity or
quantity. Stunting is more common among children in rural areas (32%) than in urban areas
(20%). The situation analysis of nutrition demonstrates the need to prioritise the scale-up of
both nutrition specific and sensitive interventions through multi-sectoral, integrated
approaches, especially in high burden areas and among vulnerable groups. Analysis of
nutrition bottlenecks reveal low caregiver and family perceptions and knowledge gaps about
adequate child feeding, care and early stimulation; weak enforcement of legislation to protect
breastfeeding and ensure access to fortified foods; insufficient allocated resources, policy and
multi-sector coordination; and limited capacity of Government frontline workers to deliver
quality nutrition services. Limited availability of updated and disaggregated nutrition data at
national level, makes it difficult for policy and decision-makers to determine priorities and
effective strategies. Lessons learned from the National Plan of Action for Food and Nutrition
(NPAFN, 2011-2015) demonstrate the need for high level governance and multi-sectoral
coordination for nutrition, rather than under one designated Ministry, if costed plans are to be
implemented effectively.
Immunization – Despite increased coverage of routine immunization (and significant
progress towards polio eradication), there have been outbreaks of vaccine preventable,
communicable diseases like measles, polio and diphtheria reported in the last few years.
According to administrative health data, Penta3 (3 doses of pentavalent vaccine) coverage
28 Multiple Micronutrient Survey 2005, MOH
29 Mortality study, UNICEF 2014 30 Health Facility Assessment: Quality of Maternal Newborn and Child Health Care December 2014
Programme Component 1) Health and Nutrition
29 |
increased from 77% in 2013 to 92% in 2015; 85% of townships have attained over 80% Penta3
coverage compared to only 45% in 2013. The situation is even worse in some townships (e.g.
in Sittwe Township an estimated two in three children did not receive the recommended three
doses of pentavalent while only 21% received two doses of measles vaccines). Meanwhile,
according to DHS data (2015-2016), h 86.9% children aged 12-23 months receiving Penta 1
in comparison to only 62.3% receiving Penta 3 (revealing a 24.6% drop-out rate). The
proportion of children receiving all basic vaccinations was only 54.8%, with coverage differing
slightly by the sex of the child. Male children appear slightly more likely to receive all of the
basic vaccines than female children, with rates of 57.9% and 50.9% respectively. This finding
merits further research and corroboration. Overall, however, the low immunization coverage
and high drop-out rates in some areas are likely due to a limited number of immunization
sessions provided per month, unavailability of cold chain systems in most service delivery
points, low knowledge of caregivers on importance of immunization and where to get them,
and fear of side effects. Recent outbreaks call for more concerted efforts to attain and sustain
high immunization coverage (of over 95%). The Country has attempted to introduce new
vaccines including pentavalent and measles second dose (2012), rubella and IPV (2015) and
PCV (2016). However, other important vaccines such as Japanese Encephalitis (JE) and rota
virus are yet to be introduced.
Prevention of new HIV infections among children and at-scale treatment of HIV
infections among children - HIV prevalence in the general population in Myanmar has
declined to about 0.6%; however the prevalence is relatively high among key populations
including among younger cohorts: people who inject drugs (PWID), men who have sex with
men (MSM), and female sex workers (FSW) and their clients. HIV prevalence among these
adolescents aged 15-19 from key populations is 4.8%, 13.8% and 2.9% in FSW, PWID, and
MSM respectively31. Age of consent for HIV testing is a persistent barrier for adolescent
access to testing and counselling services. Although treatment coverage of children (under
14) living with HIV in 2015 is high (86%), quality remains a concern. Low risk women remain
at risk (24% of new HIV infections), and as a result, there were 757 new mother to child
transmitted HIV infections in 2015. Myanmar has committed to eliminate mother to child
transmission (eMTCT) of HIV by 2025; however, PPTCT services are not available in very
hard-to-reach areas including conflict affected areas. Subsequently, in 2015, 84% of HIV
positive pregnant women received ARV medicine to reduce the risk of mother to child
transmission of HIV but only 46.6% of HIV exposed children received Nevirapine syrup. For
early infant diagnosis (EID), only 17.2% of HIV exposed infants received a virological test for
HIV within two months of age.
Strengthening health systems – Challenges in the enabling environment include many
national policies and guidelines are not well integrated nor uniformly implemented across the
country, and need to be supported by state/regional priorities, evidence-based programing
and monitoring. Increased government investment in health is encouraging, but also risks
widening disparities if not allocated equitably. Other barriers include a limited health
31 General AIDS Progress Report, National AIDS Program (2015)
Programme Component 1) Health and Nutrition
30 |
information management system, inadequate coordination between departments, human
resource retention and development, and emergency preparedness and response. For supply
and demand, out-of-pocket-expense (OOPE) is high (60% of the cost of health care is borne
by private households, well above the 30% limit recommended by WHO). But other reasons
for the lack of service utilisation are more complex. For example, health staff are deterred from
remote outreach visits by high transportation cost (often requiring their own money, up to 30%
of their salaries). Further, a recent WASH assessment in hospitals cited lack of proper water
access (washing and drinking) for patients, inadequate regular cleaning, lack of staff training
on infection prevention and control, and limited budget for facility maintenance and operations.
Migration and natural hazards also affect child and caretaker utilization of health services.
Proposed focus for 2018-2022 (Outcome and Outputs Result):
Outcome Statement:– By 2022, more children under five and women of reproductive
age equitably access and utilize evidence-based health, HIV & nutrition interventions,
including adoption of key behaviours, especially among vulnerable populations in most
deprived states/regions, conflict-affected and peri-urban areas
UNICEF will deliver on eight key outputs specified below, which are the necessary conditions
and changes required during the country program cycle in order to achieve the outcome.
1. By 2022, MoHS and other partners at national and sub-national level, including non-
state actor areas, have increased capacity and accountability in evidence-based
planning & budgeting for scaling up high-impact interventions as well as in
monitoring results with equity
Political commitment has been critical to recent progress in health and nutrition, driving
increases in both government and international development assistance investment.
However, public health expenditure is still inadequate (1% of GDP) and overseas development
assistance for health is slowing. Challenges remain in translating political commitment at
national level into concrete plans and budgets at state/regional and township levels; in finding
synergies among the various initiatives (both within the health sector, and between health and
other sectors); in ensuring that evidence-based planning and real-time monitoring take place
at all levels, with adequate attention to equity and age/sex disaggregated analysis. Thus, to
achieve this output, UNICEF will support health personnel at different levels of the health
system to adequately plan and budget for high impact interventions, routine analysis and use
of HMIS data at national and sub-national levels to inform sustainable approaches and
interventions at scale, generation of evidence of good practices. In addition, Government will
be supported to lead intra- and inter-departmental collaboration and coordination with
partners, at national and sub-national levels, including in emergency preparedness and
response, and considering gender equity.
2. By 2022, national systems for harmonized procurement, logistics and supply chain
management are strengthened for equitable and quality MNCH, immunization,
nutrition and HIV service delivery
Programme Component 1) Health and Nutrition
31 |
In Myanmar, procurement, logistics and supply chain management constraints are major
challenges to making progress in health outcomes and nutritional status. Thus, to achieve this
output, UNICEF will support Government-led coordination and information sharing for logistics
and supply chain management, provide technical support to build national and sub-national
capacity to forecast, procure, store and distribute essential commodities, including the
development of SOPs and guidelines. The introduction of new and under-utilized vaccines will
be accelerated, along with strengthening of cold chain systems at township and community
health facilities to improve effective vaccine management. The establishment/scale-up of real
time stock management of vaccines and other essential commodities (e.g. oral rehydration
salts, zinc tablets, essential antibiotics and nutrition supplies) will also be supported.
Additionally, UNICEF support will accelerate the implementation of the effective vaccine
management (EVM) improvement plan, and conduct a vaccine management assessment in
2018. Efforts will be made to establish and strengthening electronic logistics information
management system for real-time, disaggregated stock management data, supply chain data
analysis, and decision making.
3. By 2022, national and sub national health care institutions and front-line health
workers have improved capacity to reach more vulnerable populations with quality
immunization and MNCH services (including PPTCT) in at least four most deprived
S/R and in conflict, disaster affected32 and peri-urban areas in Yangon
In Myanmar, the limited capacity of health personnel, shortage of life-saving commodities,
inadequately equipped facilities and paucity of timely data, together with vertically oriented
programmes are major challenges to delivery of quality integrated health services to the most
vulnerable. UNICEF will support government-led mechanisms develop and review key SOPs,
implementation guidelines and tools at facility and community level, and the equipment of
national and selected state/region teams with knowledge, skills and resources to provide
training to improve quality facility and community based care, including in emergencies.
State/region health personnel will be assisted to identify and address bottlenecks to deliver
interventions in hard-to-reach townships of the most deprived states/regions, along with
supportive supervision and monitoring systems, and emergency referral systems. This output
will be attained through local partnerships, including with Ethnic Health Organizations (EHOs),
that will seek to address gaps in delivering services and essential commodities to populations
in hard to reach, conflict affected and peri-urban areas. UNICEF field offices will support
community mobilization and dialogue with local authorities, community leaders, and CSOs, to
address and minimize barriers to access these services.
4. By 2022, MoHS and other partners at national and sub-national level, including non-
state actors, have improved capacity to integrate HIV interventions for young
32 The most deprived states/regions proposed are Chin, Shan, Rakhine, and Ayeyarwaddy based on analysis of composite
indicators. Kayin and Kachin states and peri-urban areas in Yangon are also proposed because of specific vulnerabilities identified (conflict, migration and urbanization).
Programme Component 1) Health and Nutrition
32 |
children and key adolescent populations into essential service delivery approaches
sustainably at scale
HIV prevalence in the general population in Myanmar has declined in recent years, but it is
still high among key populations33, including younger cohorts, and appears to be rising among
young MSM. In response, the Government has recommended increased accessibility of HIV
testing and treatment for children and adolescents, especially those at risk for HIV infection,
as well as vulnerable key populations. To facilitate sustained support to scale up point-of-care
testing and to track and follow up care and support for quality, long-life treatment of HIV
infected pregnant women, spouses and their children, UNICEF will support the strengthening
of data systems and analyses at national and sub-national level to identify and track gaps in
response and address social determinants of HIV across both young children and key
adolescent populations. In addition, evidence will be generated on how to attain better HIV-
related outcomes for children as well as strengthen national and sub national capacity to
integrate HIV interventions into health, nutrition and other key social services. Further, CSOs
and EHOs will be engaged to determine the best ways to improve access, coverage and
retention in services, including outreach services to marginalized groups and communities.
UNICEF will promote the utilization of technological and programmatic innovations to
overcome obstacles to accessing HIV testing, treatment and care and to better track women,
children, and adolescents along the HIV continuum of care. UNICEF will work at the national
and subnational levels to impact service integration and improve referral linkages across the
Maternal, Neonatal, and Child Health (MNCH) platforms and other service delivery points,
such as nutrition, family planning and youth (mainly with UNFPA), HIV, and drug
dependency programmes (mainly with UNAIDS).
5. By 2022, caregivers, family members, communities and institutions, particularly in
the four most deprived states/regions34, have increased knowledge and skills to
practice appropriate child care, hygiene, feeding, dietary, early stimulation, and
injury and violence prevention during critical periods of growth and development
and to demand quality health and nutrition services
With attention to gender, addressing knowledge, behaviour, and sociocultural practices is
essential to ensure individual and communal buy-in and demand for health and nutrition
services such as immunization (campaigns and routine), maternal and neonatal health
services, treatment for pneumonia and diarrhoea, and counselling on infant and young child
feeding and care, hygiene and sanitation, early stimulation, and healthy maternal diets.
Addressing demand side barriers, UNICEF will provide technical support to MoHS on C4D
strategies, coordination and interventions on immunization, MNCH, nutrition, and HIV for key
marginalized communities. This will be pursued, while fostering community participation and
engagement to address barriers to access/utilize services and empowering
caretakers/mothers to adopt appropriate preventative and care-seeking practices. Evidence-
based C4D interventions will be supported that use multi-layer communication channels that
33 Targeted young key populations include men who have sex with men; people who use drugs, including injecting drugs; an female sex workers 34 Most deprived states/regions based on composite of 12 indicators: Ayeyarwaddy, Rakhine, Chin and Shan
Programme Component 1) Health and Nutrition
33 |
address social norms, along with the capacity development of frontline workers and local
partners to deliver appropriate messages, while modeling scalable community engagement
and early childhood stimulation approaches for young children (aged 0-3). Cross-sectoral
linkages (e.g. Nutrition-ECCD) will be ensured to support coherent and consistent messages
on nutrition and care to caregivers, families and communities. In hard to reach and vulnerable
areas, where nutrition services have low coverage and there are gaps in outreach and
community mobilization, UNICEF will work with local partners and explore innovative
communication tools to reach target audiences and monitor changes in knowledge and beliefs.
6. By 2022, MOHS and other partners at national and sub-national level, including non-
state actors, have increased capacity to legislate, plan and budget effectively for the
scaling-up of evidence-based nutrition-specific interventions with equity
Although national actions plans and policies for nutrition previously existed, they have not yet
been updated to cover the next five year period, within a costed, common results framework,
which is critical for the effective scale-up of nutrition interventions (outcome level). There are
opportunities to strengthen the nutrition policy environment, especially within the Health
sector. Legislation for nutrition exists, such as the national order on the Marketing of
formulated food for infant and young children, mandatory salt iodization and increased
maternity leave, however, they are not currently monitored and enforced. Thus, UNICEF will
support the integration of high impact nutrition specific interventions in the essential package
of health services; the development of a national nutrition costed plan and operational strategy
with a clear results and M&E framework to scale-up prioritized nutrition interventions; and the
review and strengthening of nutrition legislation. Key strategies include working with relevant
MOHS departments and stakeholders to support a health systems approach and generating
evidence to inform policy and scale-up.
7. By 2022, multi-sectoral political commitments and approaches are in place to
support prioritized, integrated, nutrition sensitive interventions with an equity focus
in 4 most deprived S/R, conflict & disaster affected and peri-urban areas in Yangon
Multi-sectoral governance and coordination for nutrition across relevant sectors, such as
Health, Agriculture, Education and Social Welfare, is required if the effective coverage of both
nutrition sensitive interventions is to be increased equitably to reach all children under 5 and
women of reproductive age. UNICEF will therefore support costed multi-sectoral plans and
governance mechanisms for nutrition, and the mainstreaming of nutrition sensitive strategies
and interventions into relevant sub-national plans, and facilitate the functioning of multi-sector
coordination mechanisms at national and sub-national level to support nutrition. In this regard,
UNICEF will foster good practices for multi-sectoral programming for nutrition, based on local
evidence. Key strategies to be implemented to achieve this output include: partnerships and
cross-sectoral linkages to leverage resources for scaling up nutrition sensitive interventions in
relevant sectors and capacity building of sub-national actors in multi-sectoral coordination
through its field offices. UNICEF will also contribute to knowledge management and
documentation of best practices, based on experience accrued during the country program
cycle.
Programme Component 1) Health and Nutrition
34 |
8. By 2022, Government workers in nutrition related sectors have increased capacity
to deliver nutrition services according to standards at all times in 4 most deprived
S/R and in conflict & disaster affected and peri-urban areas in Yangon
Although nutrition specific services are part of the essential health services package, many
health managers and frontline workers are not able to provide quality nutrition services due to
lack of knowledge and skills in public health nutrition, supply gaps, lack of effective job aids,
poor counselling skills, lack of routine supportive supervision and inadequate data
management for planning and monitoring. Nutrition sensitive interventions provided through
non-health sectors of government are very limited due to lack of human resources trained or
oriented in nutrition in these other sectors, and lack of job aids, tools and messages that are
nutrition sensitive. Against this backdrop, UNICEF will support nutrition capacity building and
training at national and sub-national levels, the updating and adaptation of nutrition job aids
for frontline workers in nutrition-related sectors (i.e. health, social welfare, rural development
(WASH), etc); strengthening of local partnerships to address gaps in service delivery to
populations in hard to reach and peri-urban areas. In addition, UNICEF will strengthen
supportive supervision and monitoring for nutrition, along with local capacity for risk reduction
and mitigation, emergency preparedness and response. In hard-to-reach areas and in times
of emergency, UNICEF will support Government in addressing gaps in service delivery
through local partnerships.
Programme Component 1) Health and Nutrition
35 |
Theory of Change Diagram
Government political and financial
commitments for UHC and Scaling up
Nutrition progresses
Outcome
By 2022, more children under 5 and women of reproductive
age equitably access and utilize evidence-based health, HIV
& nutrition interventions, including adoption of key behaviours especially among vulnerable populations in the
most deprived states/regions as well as conflict-affected and
peri-urban areas
Volatile funding
& bureaucratic
processes
Strengthened Health
evidence-based planning &
monitoring for results
Improved capacities to provide
quality Immunization and MNCH
(including PPTCT) services with
equity
Caregivers and family have
increased KAP and demand
quality health and nutrition
services
Strengthened procurement
and supply chain capacity
Improved capacity in
delivering nutrition services
with equity
Multi-sectoral approaches
are in place to support
nutrition-sensitive
interventions Increased MOHS capacity
to legislate, plan and budget
for nutrition-specific
interventions
Front line health workers
and other duty-bearers
apply knowledge & skills
and use tools available to
them
Relevant Ministries and
sub-national
stakeholders are willing
and able to collaborate in
support of strengthening
the health system
Parents and other
caregivers are able to hold
BHS accountable,
especially in HTR areas.
People apply knowledge
and make informed
decisions.
Support health personnel at all
levels to adequately plan and budget
for high impact interventions
Support routine analysis and use
of HMIS data to inform approaches
and interventions at scale
Support analysis and scenario
planning for sustainable RMNCAH
investments
Generate evidence and
documentation of good practices
Support government-led
intradepartmental and
interdepartmental collaboration and
coordination with partners,
including emergency preparedness
& response included
Conduct joint advocacy,
utilizing the SUN multi-
stakeholder platform, to
support costed multi-sectoral
plans, governance mechanisms,
coordination mechanisms at
national and sub-national
Support mainstreaming of
nutrition specific and sensitive
strategies into relevant sub-
national plans
Define specific, integrated
interventions for Nutrition-
WASH (including Nutrition-
MNCH and Nutrition-ECD) in
work plans
Document good practices
Support the
implementation of high
impact nutrition specific
interventions
Support MOHS in
development of national
nutrition costed plan and
operational strategy
Review and strengthen
nutrition legislation, and
establish monitoring and
enforcement mechanisms
Support MOHS at all
levels to generate, analyse
and utilise evidence, data
and information for
decision-making
Strengthen data systems and
analyses at all levels to identify
gaps in response and address
social determinants of HIV across
both young children and
adolescents
Generate evidence to leverage
Govt. and partners to support
MOHS to effectively achieve
better HIV-related outcomes for
children.
Integrate HIV interventions
into health, nutrition and other
key social services (e.g. child
protection, social protection)
Engage CBOs, CSOs and
EHOs to improve access,
coverage and retention in services,
including outreach services,
utilization & innovations
Support development of
nutrition capacity building
and training plans at all levels
Update and adapt nutrition
job aids to frontline workers
in nutrition-related sectors
(i.e. health, social welfare,
WASH, etc.)
Strengthen and expand
local partnerships in service
delivery to populations in
hard to reach and peri-urban
areas
Strengthen supportive
supervision and monitoring
for nutrition
Strengthen local capacity
for risk reduction and
mitigation, emergency
preparedness & response
Support government-led mechanisms to
develop/review SOPs, implementation
guidelines and tools at facility and
community level
Equip national and selected state/region
teams to improve quality facility and
community based care, including in
emergencies.
Build capacity of state/region health
managers to identify and address bottlenecks
to deliver interventions in hard-to-reach
townships of the most deprived S/R
Strengthen accountability through
sustaining supportive supervision and
monitoring systems for quality facility and
community-based care
Support establishment of referral systems
for emergency complications and for
vulnerable children affected by HIV,
violence, developmental delays and
disability
Technical support to MoHS in C4D
strategies, coordination and scaling up
interventions
Foster community participation and
engagement for demand creation & to
address barriers
Support evidence-based innovative
C4D interventions to empower
caretakers/mothers
Develop evidence-based C4D
interventions using multi-layer
communication channels
Build capacity of frontline workers
and local partners
Relevant Ministries and sub-national
stakeholders are willing and able to
collaborate in support of strengthening
the nutritional services for the most
vulnerable families.
Under-
lying
social
norms
Natural
disasters
&
conflicts
may
Outputs Assumptions
Conflict of interest with
some stakeholders
RISK
Enabling working
conditions in MoHS,
particularly at local level,
keep primary health care
service delivery
functioning.
Integrated HIV interventions
for young children and key
adolescent populations in
essential services Support government-led
coordination and information
sharing for logistics and
supply chain management
Technical support to
assess and build national and
sub-national capacity to
forecast, procure, clear, store
and distribute essential
commodities, including
development of SOPs and
guidelines
Advocate for increased
government financing
Strengthen cold chain
systems and real time stock
management, and e-logistics
information management
system.
Programme Component 1) Health and Nutrition
36 |
Results Matrix – Health and Nutrition
Key results Progress indicators Baseline Target Means of verifications Key partners
Sustainable Development Goal 2: End hunger, achieve food security and improved nutrition, and promote sustainable agriculture
1.2 To end all forms of malnutrition, including achieving by 2025 the internationally agreed targets on stunting and wasting in children under five years of age, and address the nutritional needs of adolescent girls, pregnant and lactating women, and older persons
Sustainable Development Goal 3: Ensure healthy lives and promote well-being for all at all ages
3.1:To end all forms of malnutrition; 3.2: To end preventable deaths of newborns and children under 5;
3.3: To end epidemics of AIDS, TB, malaria, neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases,
and:
3.8: To achieve universal health coverage, including financial risk protection, access to safe, effective, quality and affordable essential medicines and
vaccines for all
Myanmar National Health Plan – (2017-2021): to extend access to the Basic Essential Package of Health Services (EPHS) to the entire population while
increasing financial protection
United Nations Strategic Development Framework 2018 - 2022: TBC
Outcome 1 Statement
1. By 2022, more children under 5 and women of reproductive age equitably access and utilize evidence-based health, HIV & nutrition interventions, including adoption of key behaviours, especially among vulnerable populations in most deprived
1.1 % of live births attended
by a skilled health personnel
(doctor, nurse, midwife)
60.2% (2016) 80% Myanmar DHS/HMIS Government
(MOHS, MRH,
CHD, DoMS),
UN agencies,
NGOs
1.2 % of births delivered in a
health facility
37.1% (2016) 50% Myanmar DHS/HMIS Government
(MOHS, MRH,
CHD, DoMS),
UN agencies,
NGOs
1.3 % of newborns receiving postnatal care within two days (48 hours) of childbirth (home visit or clinic visit)
36.4% (2016) 60% Myanmar
DHS/MICS/Surveys
HMIS
Government
(MOHS, CHD,
DoMS), UN
agencies, NGOs
Programme Component 1) Health and Nutrition
37 |
states/regions, conflict-affected and peri-urban areas (Goal Area 1 UNICEF Strategic Framework 2018-2021)
1.4 % of infants aged 0-5
months who are exclusively
breastfed
51.2% (2016) 80%
Myanmar DHS/Surveys Government
(MOHS, NNC,
Agriculture), UN
agencies, NGOs
1.5 % Children < 1 year
receiving DTP-containing
vaccine at national level
Rural – 57.8%; Urban
- 75.2%
Rural – 90%; Urban –
90% (Males - 63.5%;
Females - 60.7%.
Target: 90%)
Myanmar DHS/Surveys Government
(MOHS, cEPI),
WHO, Gavi, UN
agencies, NGOs
1.6 % of budget
requirements for vaccines
and related devices covered
by the government
13.6% 37% MOPF Government
(MOPF, MOHS,
cEPI), UN
agencies, the
World Bank,
Gavi, NGOs
1.7 % of HIV exposed infants
receiving a virological test for
HIV within 2 months of birth
17.2% (2015) 50% HMIS Government
(MOHS, MRH,
CHD, NAP,
DoMS), UN
agencies, NGOs
1.8 % of children aged 0-59
months with diarrhoea
receiving ORS
Girls - 54.9%; Boys -
68.1%
Girls – 80%; Boys –
80%
Myanmar DHS/Surveys Government
(MOHS, CHD,
DoMS, cEPI),
WHO, Gavi, UN
agencies, NGOs
UNICEF Health &
Nutrition Programme
Outputs
1.1. By 2022, MoHS
and other partners at
national and sub-
national level, including
1.1.1. National Health
strategies and plans with
mainstreamed risk
reduction/resilience,
No Yes Review of national
health and MNCH
strategies and plans
MoHS and
MoPF, UN
agencies
Programme Component 1) Health and Nutrition
38 |
non-state actor areas,
have increased capacity
and accountability in
evidence-based
planning & budgeting
for scaling up high-
impact interventions as
well as in monitoring
results with equity
inclusive of climate change
available
1.1.2. Costed
implementation plans for
maternal, newborn and child
health care is available
2 = partial 1= yes [meets all
criteria]
MNCH Plan and
National Health Plan
Review
Government
(MOHS, DoPH-
DoMS, HMIS),
UN H6, NGOs
1.1.3. Existence of a costed
Multi-Year Plan (cMYP) for
immunisation
Scale: 0 (no existence), 1
(plan drafted), 2 (plan
finalised), 3 (plan is
endorsed by Government), 4
(plan is implemented), 5
(plan is monitored annually)
3 5 Review reports Government
(MOHS, DoPH-
DoMS, HMIS),
UN H6, NGOs
1.1.4. Health Management
Information System
generates periodic reports
with data disaggregated by
age and sex (for relevant
indicators) at national and
sub-national level
Partial Yes Review of annual HMIS
reports
Government
(MOHS, HMIS),
UN agencies,
NGOs
1.1.5. % of targeted DHSS
S/R in which barriers and
bottlenecks related to child
survival are monitored
25% (Rakhine) 100% (Rakhine, Chin,
Ayeyarwaddy, Shan)
Field reports,
SMQ/RAM from
UNICEF programme
data
Government
(MOHS, HMIS),
UN agencies,
NGOs
1.2. By 2022, national
systems for harmonized
procurement, logistics
and supply chain
1.2.1. Effective Vaccine
Management Assessment
overall performance rate
74% ≥80% EVMA report Government
(MoHS, cEPI,
MoPF) Gavi The
Alliance – WHO
Programme Component 1) Health and Nutrition
39 |
management are
strengthened for
equitable and quality
MNCH, immunization,
nutrition and HIV
service delivery
1.2.2. % of Rural Health
Centres with functioning cold
chain equipment
30% 50% Cold chain equipment
inventory
Government
(MoHS, cEPI,
MoPF) Gavi The
Alliance – WHO
1.2.3. % of cold chain
equipment having electronic
continuous temperature
monitoring system
20% 90% EVM assessment
report; administrative
data, MoHS
Government
(MoHS, cEPI,
MoPF) Gavi The
Alliance – WHO
1.2.4. Months of stockouts at
national level of DTP vaccine
0 month (2016) 0 month eLMIS Government
(MoHS, cEPI,
MoPF) Gavi The
Alliance – WHO
1.2.5. Percentage of health
facilities with zero stock out
of severe acute malnutrition
supplies as defined by
national standards
20% (4 out of 20
target hospitals)
(2016)
0% Administrative data,
MOHS
Government
(MOHS, P&S,
NNC)
1.3. By 2022, national
and sub national health
care institutions and
front-line health workers
have improved capacity
to reach more
vulnerable populations
with quality
immunization and
MNCH (including
PMTCT) services in at
least four most deprived
States/Regions and in
conflict, disaster
1.3.1. % UNICEF Supported
health facilities offering
delivery services with
functional newborn
resuscitation equipment
(functional bag and mask in
neonatal size)
66% (2014) 100% in focus S/R Health Facility
Assessment
Government
(MOHS, MRH,
CHD), UN
agencies, NGOs
1.3.2 % UNICEF Supported
health facilities offering
delivery services that have
guidelines for essential
childbirth care
30% (2014) 80% in focus S/R Programme Reports;
MoHS
Government
(MOHS, CHD),
UN agencies,
NGOs
1.3.3 % Community Health
Workers trained to
implement integrated
0.03% (140) 100% (5,000) Training reports,
Programme Reports;
MoHS
Government
(MOHS, CHD),
Programme Component 1) Health and Nutrition
40 |
affected and peri-urban
areas in Yangon
community case
management (% of actually
trained against the planned)
UN agencies,
NGOs
1.3.4. % health care facilities
with functioning basic water,
sanitation and hygiene
facilities
53% (2014) 80% Health Facility
Assessment (targeted
S/R)
Government
(MOHS, CHD,
DoMS), UN
agencies, NGOs
1.3.5. % health facilities
providing PMTCT services
67% (2016) 90% HMIS Government
(MOHS, MRH,
CHD, NAP,
DoMS), UN
agencies, NGOs
1.3.6. % of UNICEF-targeted
children 6-24 months in
humanitarian situations who
are vaccinated against
measles
39% (2016) 80% Humanitarian
Performance Report
Government:
MoHS, Disaster
and cEPI, UN
agencies and
NGOs
1.4. By 2022, MoHS
and other partners at
national and sub-
national level, including
non-state actors, have
improved capacity to
integrate HIV testing
and treatment
interventions for young
children and key
adolescent populations
into essential health
service delivery
approaches sustainably
at scale
1.4.1. National HIV Strategy
and Plans for care and
treatment that are aligned to
the most recent WHO child
and adolescent
recommendations for care
and treatment and included
includes targets for children
and adolescents
2 (National strategy
and plans for care and
treatment are under
review to be aligned to
the most recent WHO
recommendations)
3 (National strategy and
plans have been aligned
to the most recent WHO
recommendations)
NSP HIV Government
(MOHS, MRH,
CHD, NAP,
DoMS), UN
agencies, NGOs
1.4.2. Adoption of the 2015
WHO HIV Treatment
guidelines
2: Country has started
the process of
adopting the 2015
WHO HIV treatment
guidelines and
3: The country has
adopted the 2015 WHO
HIV treatment
guidelines, and its
national guidelines have
been adapted to follow
National Guidelines
Review
Government
(MOHS, MRH,
CHD, NAP,
DoMS), UN
agencies, NGOs
Programme Component 1) Health and Nutrition
41 |
reviewing its current
guidelines
the recommendation
that ART is initiated in
everyone living with HIV
including children
1.4.3. Existence of age-and
sex-disaggregated data on
HIV testing and counselling
among adolescents 15-19
years
No Yes HMIS Government
(MOHS, DMS,
NAP, CHD), UN
agencies, NGOs
1.5. By 2022,
caregivers, family
members, communities
and institutions,
particularly in the four
most deprived
states/regions, have
increased knowledge
and skills to practice
appropriate child care,
hygiene, feeding,
dietary, early
stimulation, injury and
violence prevention
during critical periods of
growth and
development and to
demand quality health
and nutrition services
1.5.1. Existence of a
budgeted integrated multi-
sectoral communication
strategy/plan to support the
promotion of the priority life-
saving and protective
behaviours within affected
communities.
3=No – no plan exists 1=Yes – plan meets all
of above
Country office
programme documents
or national health
communication
programme reports
Government
(MOHS, CHD,
MRH, NNC,
HLPU, MOA,
MOE, MSW), UN
agencies, NGOs
1.5.2. Mothers and
caregivers with knowledge of
at least 5 of the UNICEF
essential family practices
TBD TBD DHS, MICS, KAP
Survey, Programme
reports
Government
(MOHS,MRH,
CHD, NNC,
HLPU, cEPI),
WHO, NGOs
1.5.3. Dropout rate between
DPT1 and DPT3 coverage
24.6% 5% Programme
reports/Evaluation
Government
(MOHSHLPU,
cEPI), WHO,
NGOs
1.5.4.
UNICEF DHSS targeted districts include early child development in their barrier and bottlenecks monitoring
4 = Inadequate/No
(2016)
2=Mostly, if analysis includes 3 elements of above
Programme reports Government
(MOHS,MRH,
CHD, NNC,
HLPU), WHO,
NGOs
Programme Component 1) Health and Nutrition
42 |
If DHSS barrier and
bottleneck analysis includes:
i) existence of a holistic ECD
policy conducive to inter-
sectoral coordination
(enabling environment), ii)
capacity of health workers to
delivery holistic ECD
services including nutrition,
early stimulation and
nurturing care for children
under 3 (supply) iii)
parents/caregivers
awareness on
developmental needs of
children under 3 (demand),
iv) existence of
comprehensive quality
standard for ECD services
including nutrition, early
stimulation and nurturing
care (quality), answer
1=Yes, if includes all 4 of
above, 2=Mostly, if analysis
includes 3 elements of
above, 3=Partial, if analysis
includes 2 elements above,
or 4= Inadequate/No, if
analysis includes 1 or 0
elements of above.
Programme Component 1) Health and Nutrition
43 |
35 In which BHS have been trained in interpersonal communication to improve community dialogue in child health and nutrition
1.5.5. Percentage of districts
facilitating regular community
dialogue with caregivers of
children under 5 to improve
knowledge, attitudes and
practices and address
related social/cultural norms
on maternal newborn and
child health and
development.
16% (54 out of 330
townships) 35
50% (with a focus on
the 199 GAVI HSS
focus townships)
Country office
programme documents
or national health
communication
programme reports
Government
(MOHS, CHD,
HLPU), WHO,
NGOs
1.6. By 2022, MoHS and
other partners at
national and sub-
national level, including
non-state actors, have
increased capacity to
legislate, plan and
budget effectively for the
scaling-up of evidence-
based nutrition specific
interventions with equity
1.6.1. Existence of a national
nutrition policy that includes
prevention or reduction of
stunting (1=no strategy,
2=draft strategy, 3=finalised
strategy, 4=approved by
Government, 5=includes
Government budget line)
2 5 National legislative
document(s)
Government
Ministries
(MOHS, NNC,
MOA, MOE,
MSW), UN,
Donors, NGOs
and other SUN
multi-
stakeholders
1.6.2. Existence of a national
management information
system that includes
disaggregated data on
nutrition available
(as per HQ RAM guide
points scoring)
<4 points
(sub-optimal nutrition
management
information system)
At least 7 points (strong
nutrition management
information system)
HMIS reports of
Government, partner
reports
Government
Ministries
(MOHS, NNC,
MOA, MOE,
MSW), UN,
Donors, NGOs
and other SUN
multi-
stakeholders
Programme Component 1) Health and Nutrition
44 |
1.6.3. Adoption of the
International Code of
Marketing of Breast Milk
Substitutes and subsequent
relevant World Health
Assembly resolutions (score
1-5 as per HQ RAM guide)
4
(code with all
provisions adopted)
5
(code is monitored and
enforced with
designated body)
Reports of the BMS
code national
committee
Government
(MOHS - NNC,
FDA), UN
agencies, NGOs
1.6.4. Existence of a
functional national iodine
deficiencies disorder
coordination body (score 1-5
as per HQ RAM guide)
2
(body exists without
clear defined roles)
5
(body exists with clear
ToR and annual
workplan)
Annual reports and
work plans of
coordination body
Government
(MOHS, NNC,
FDA, MOM), UN
agencies, private
sector
1.7. By 2022, multi-
sectoral political
commitments and
approaches are in place
to support prioritized,
integrated, nutrition
sensitive interventions
with an equity focus in 4
most deprived S/R,
conflict & disaster
affected and peri-urban
areas in Yangon
1.7.1 Existence of a
functional national multi-
sectoral committee for
Nutrition (score 1-5 as per
HQ RAM guide)
1=no committee exists 4=committee exists with
annual workplan
ToR, workplan and
meeting minutes
Government
(MOHS, NNC,
MOA, MOE,
MSW), UN
agencies, Donors
1.7.2 A national costed plan
for nutrition is in place with
multi-sectoral approaches
(1=plan does not exist,
2=drafted, 3=finalised,
4=approved,
5=implemented)
1 5 National nutrition plan Government
Ministries
(MOHS, NNC,
MOA, MOE,
MSW), UN
agencies, Donors
and SUN multi-
stakeholders
1.7.3 Number of sub-national
plans in place with multi-
sectoral approaches for
nutrition
2 (Rakhine, Kayin) 4 (Rakhine, Kayin,
Ayerwaddy, Chin)
Relevant state/region
plans and reports
Government
Ministries
(MOHS, NNC,
MOA, MOE,
MSW), UN
agencies,
Programme Component 1) Health and Nutrition
45 |
Donors, SUN
multi-
stakeholders
1.7.4 Existence of an
emergency preparedness
plan for nutrition (score 1-5
as per HQ guide)
2 (plan is not
standalone or includes
minor elements)
5 (plan is
comprehensive and
implemented)
Emergency
preparedness plan
document(s)
Govt, UN
agencies, NGOS,
DPs
1.7.5. Percentage of CCC
standards met by the country
cluster or sector coordination
mechanism for nutrition
50% 100% Cluster strategy, TORs,
meeting minutes, MIRA,
HNO, Situation
Analysis, Cluster
Coordination
Performance Monitoring
(CCPM) reports
Government, UN
agencies, NGOs,
donors
1.8. By 2022,
Government workers in
nutrition related sectors
have increased capacity
to deliver nutrition
services according to
standards at all times in
four most deprived
States/Regions and in
conflict & disaster
affected and peri-urban
areas in Yangon
1.8.1. Percentage of health
and nutrition workers trained
to provide IYCF counselling
services as per national
standards
5% 80% Administrative data Government
(MOHS, NNC),
UN agencies,
NGOs
1.8.2. Number of service
delivery points (health facility
or community) with adequate
materials for IYCF
counselling, support and
communication
0 5,000 Administrative data,
health facility
assessments
Government
(MOHS, NNC),
UN agencies,
NGOs
1.8.3. Percentage of health
and nutrition workers trained
on management of severe
acute malnutrition as per
national standards
0% 50% Administrative data Government
(MOHS, NNC),
UN agencies,
NGOs
1.8.4. Percentage of health
facilities reaching more than
0% 60% Administrative data,
programme data
Government
(MOHS, NNC),
Programme Component 1) Health and Nutrition
46 |
36 HQ RAM guide says number but we propose to use percentage
75 percent of cure rate for
the management of severe
acute malnutrition
UN agencies,
NGOs
1.8.5. Percentage 36of
pregnant women who
received iron and folic acid
supplements or multiple
micronutrient supplements
64.4% 90% Health facility and
antenatal care clinic
records; population-
based household
surveys
Government
(MOHS, NNC),
UN agencies,
NGOs
Programme Component 2) Water Sanitation and Hygiene (WASH)
47 |
Programme Component 2) Water Sanitation and Hygiene (WASH)
Introduction
As a result of major political, economic and social reforms Myanmar continues to undergo
unprecedented transformations that impact the WASH sector. Policies, strategies and budget
allocations are expected to change significantly within the coming years as both government
and new development partners are likely to bring increasing investment for infrastructure,
public health, education and social services. The UNICEF Myanmar Country Programme for
2018-2022 marks an important opportunity to bring new policies, strategies and management
systems into alignment with Sustainable Development Goals.
The 2014 Myanmar census found that 29% of children (about 5 million) live in households that
do not drink from improved water sources and 25% of children (more than 4 million) live in
households that do not use improved toilet facilities of which almost one million children are
practicing open defecation. In 2016, Myanmar was rated as 2nd out of 189 countries on the
global Climate Risk index37 and 12th on the global disaster risk index38 underlining the large
extent to which the country is affected by the impacts of weather-related stresses and shocks.
This is in addition to multiple ongoing conflicts within the country. The WASH Cluster remains
active to support more than 350,000 conflict affected people across Rakhine, Kachin and
Northern Shan where lifesaving WASH services remain essential. It is estimated that 50% of
rural health facilities do not have access to safe water and adequate sanitation and hygiene
facilities.
37 Global Climate Risk Index 2017 38 Index for Risk Management 2016 (INFORM)
©UNICEF Myanmar/2016/ Khine Zar Mon
Programme Component 2) Water Sanitation and Hygiene (WASH)
48 |
UNICEF plans to work closely with departments of four government counterpart ministries
(Health & Sport, Agriculture, Irrigation & Livestock, Education and Social Welfare)39 to
promote greater internal coordination. Together DRD, DPH & DBE, with support from UNICEF
has launched the Myanmar National WASH Strategy (2016-2030) on February 16th 2017. Its
goal being “to contribute to improved socio-economic life of all the rural populace by 2030
through provision of equitable, effective, efficient and affordable services for water supply and
sanitation and safe hygienic behaviour”. This document and associated investment plan is
expected to form a basis on which to build UNICEF support over the next country programme.
In early 2017 increased budget requests are being made as a result of this and departments
are scaling up resources to begin implementation.
There are more than 60 national and international NGOs and UN agencies (UNICEF, WHO,
UNDP, UNHCR and UN-HABITAT) active in WASH sector. Many of the NGOs provide
emergency support (under WASH Cluster) but their role in non-emergency WASH is
increasing. WASH Thematic Working Group is mainly responsible for coordination on WASH
development programme and the WASH Cluster is responsible for humanitarian response and
coordination. Increased coordination and leadership by the Government of Myanmar is
required to ensure alignment with national and sub-national priorities.
Partners
UNICEF plans to work closely with departments of four government counterpart ministries
(Health & Sport, Agriculture, Irrigation & Livestock, Education and Social Welfare)40 to promote
greater internal coordination. Together DRD, DPH & DBE, with support from UNICEF have
launched the Myanmar National WASH Strategy (2016-2030) on February 16th 2017. Its goal
being “to contribute to improved socio-economic life of all the rural populace by 2030 through
provision of equitable, effective, efficient and affordable services for water supply and
sanitation and safe hygienic behaviour”. This document and associated investment plan is
expected to form a basis on which to build UNICEF support over the next country programme.
In early 2017 increased budget requests are being made as a result of this and departments
are scaling up resources to begin implementation.
There are more than 60 national and international NGOs and UN agencies (UNICEF, WHO,
UNDP, UNHCR and UN-HABITAT) active in WASH sector. Many of the NGOs provide
emergency support (under WASH Cluster) but their role in non-emergency WASH is
increasing. The WASH Thematic Working Group is mainly responsible for coordination of the
WASH development programme and the WASH Cluster is responsible for humanitarian
response and coordination. Increased coordination and leadership by the Government of
Myanmar is required to ensure alignment with national and sub-national priorities.
39 DRD –Department for Rural Development (Ministry of Livestock, Agriculture and Irrigation) DPH – Department for Public Health (Ministry of Health) DBE – Department for Basic Education (Ministry of Education) RRD- Relief & Resettlement Department (Ministry of Social Welfare) 40 DRD –Department for Rural Development (Ministry of Livestock, Agriculture and Irrigation) DPH – Department for Public Health (Ministry of Health) DBE – Department for Basic Education (Ministry of Education) RRD- Relief & Resettlement Department (Ministry of Social Welfare)
Programme Component 2) Water Sanitation and Hygiene (WASH)
49 |
Prioritized Issues and Areas
Vulnerable children without safe water and sanitation services
An estimated 5 million children do not have access to improved water sources and 1.4 million
children are practicing open defecationi . These children are not spread equally and typically
those with the lowest access to improved water and sanitation are those situated in areas that
are exposed to the highest conflict and natural disaster risks. More than 3.5 million children
are migrants who have recently moved to towns and cities. Rapid development of informal
settlements with unplanned water and sanitation services create new urban challenges that
are growing rapidly.
Weak WASH sector arrangements Government institutions are undergoing rapid change
as increasing proportions of the national budget is allocated to social services and
infrastructure provision after decades of neglect. Reforms to public financial management has
the potential to open doors to major institutional financing and private sector participation
within the WASH sector. Currently definitions of roles and responsibilities between ministries
and departments remains weak. Planning and budgeting for effective WASH services across
ministries is a bottleneck to the absorption of increased investment.
Limited focus on long term sustainability of WASH services
There is recognized need for investment in better planning to ensure sustainable water supply
in communities, schools and health facilities are delivered as long term services where
accountabilities for operation and maintenance costs are properly defined, budgeted for and
supported technically. For sanitation the GoM appreciates the household subsidy based
approaches are not affordable at scale and there is need to do more to support sanitation
supply chain development in parallel with targeted and well researched behavioral change
campaigns. To make the transition to a more sustainable service delivery model significant
legislation and policy work is required to put in place regulatory frameworks that can
harmonize approaches, reduce risks for larger external donors and encourage greater
participation of private sector investment. Significant policy work is required to put in place
regulatory frameworks that can properly define roles of duty bearers. The current point in time
seems crucial to support the government of Myanmar in this policy work and UNICEF sees its
role in assuring these policies are equitable.
Schools and health centres with poor WASH facilities
Robust national level data on coverage of WASH services in health facilities and schools is
weak. Limited studies to date suggest that 50% of schools41 and more than 50% of health
facilities have severe deficits in WASH services. Gender segregated facilities are often not
available in schools which is especially important for girls who have reached menarche.
Globally a lack of menstrual hygiene management (MHM) facilities in schools has been shown
to affect attendance and achievement rates and may be a contributing factor to increased
dropout rates for girls before the age of 15. Infections related to poor hygiene in health facilities
are a leading cause of mortality and morbidity of mothers and children. Knowledge that local
health facilities have poor water and sanitation is likely to be a contributing reason that many
41 According to the Myanmar WASH Sector Situation Analysis Final Draft, 8/7/14, only 23 % of schools meet the international benchmark of 1 toilet per 25 students, while 51% achieve 1:50, with the designs being not generally child-or-disability friendly
Programme Component 2) Water Sanitation and Hygiene (WASH)
50 |
women chose to risk giving birth at home over going to health facilities (where sanitary
conditions may be similar or worse). A recent WASH assessment in hospitals cited lack of
proper water access (washing and drinking) for patients, lack of vector control system,
inadequate regular cleaning, lack of staff training on infection prevention and control, and
limited budget for facility maintenance and operation (including for dedicated
cleaning/maintenance personnel)42. Work is needed to ensure that there are budgets, human
capacity and monitoring systems embedded within relevant ministries.
Weak sector coordination and leadership
The Myanmar WASH sector is fragmented across multiple ministries with many overlaps in
roles and responsibilities for provision of water, sanitation and hygiene services. Major barriers
to implementing decentralised management is the lack of information systems to effectively
control risks associated with increased funding to local governments. Without investment in
local human resources it will become increasingly difficult for the GoM to regulate an
expanding sector and ensure the equitable delivery of sustainable services to those in most
need. Moving forward there is a need for the GoM takes a greater responsibility for emergency
preparedness and response across the country in a country that is highly likely to experience
significant disasters within the coming years.
With the opening up of the country, new CSOs and private sector organisations are getting
involved in delivery of water and sanitation services which will require increasing coordination
efforts. Without sufficient policies, standards, human resource and management information
systems it is likely to become increasingly difficult for the GoM to regulate the sector and
ensure the equitable delivery of sustainable services to those in most need.
Lack of WASH service standards and weak information management systems Myanmar met the Millennium Development Goal (MDG) WASH targets nevertheless stunting
and child mortality rates remain much higher than neighbouring countries in the region. There
is evidence that these reported coverage rates do not reflect underlying realities as overall
monitoring of water and sanitation data in Myanmar has been identified as very weak by
multiple reports. There is almost no guidance on standards of service for community water
supply, sanitation, WASH in schools and WASH in health facilities. This lack of definition
makes it difficult to determine coverage and manage information required to track service
delivery performance and progress.
With the opening up of the country, new CSOs and private sector organisations are getting
involved in delivery of water and sanitation services which will require increasing coordination
efforts. Without sufficient policies, standards, human resource and management information
systems it is likely to become increasingly difficult for the GoM to regulate the sector and
ensure the equitable delivery of sustainable services to those in most need.
Chronic underinvestment in the WASH sector UNICEF has supported the GoM to develop a costed investment plan for rural WASH between
2015-2030, which highlights chronic underinvestment in the rural WASH sector and need for
massive long term investment if SDG targets are to be reached. A 2013 report by ADB43 has
42 UNICEF WinHF Study Rakhine 2015 43 ADB -Myanmar Urban Development and Water Sector Assessment, Strategy and Road Map (2013)
Programme Component 2) Water Sanitation and Hygiene (WASH)
51 |
identified perhaps even greater underinvestment in urban WASH sector. Myanmar is one of a
few countries in ASEAN where the percentage of the urban population without access to
improved water sources has actually increased over the past two decades44. Extensive efforts
are required to generate evidence around WASH needs in Myanmar and to advocate for
greater investments.
Proposed focus for 2018-2022 (Outcome and Outputs Result):
Outcome result: By 2022 vulnerable children and families, and institutions in 7 high
burden states and regions have equitable access to and utilize safe, affordable,
adequate and equitable WASH services across the lifecycle, especially the most
vulnerable children and women.
Ensuring the equitable access to and utilization of sustainable, universal, safe, adequate and
affordable WASH services across the lifecycle has a profound impact on a child’s ability to
survive, grow, learn and rise out of poverty while contributing to increased overall productivity
and economic development of a country. UNICEF's theory of change for WASH will contribute
towards the realization of the human rights to water and sanitation which is a core of UNICEF’s
mandate for children.
This outcome embodies the priority issues, bottlenecks and barriers identified in the context
of Myanmar, which if achieved, will significantly contribute to reduce neonatal, under 5 (U5)
and maternal morbidity and mortality. This WASH outcome will also contribute to increase
school attendance, create a better learning environment and protect girls and boys from
violence in schools.
In order to achieve the outcome, UNICEF will deliver on five key outputs specified below.
These outputs will specifically address bottlenecks related to the enabling environment, supply
and demand.
Output result 1: By 2022, GoM has strengthened political commitment and
accountability, and technical and institutional capacity for scaling up safely managed
WASH services that are adaptive to cyclical stress and shocks
Lack of adequate law, regulations, policies, guidelines and plans are the major bottlenecks in
the WASH sector. Sector coordination between ministries and development partners is weak
and the sector is fragmented between different ministries. Information management system
at national and sub national level are outdated and poorly connected.
To address the key issues and challenges, priority actions will include; reviewing and
strengthening sector policies and strategies and importantly ensuring that they are
practically operational. UNICEF will support the GoM for strengthening sector coordination
and institutional arrangement that allow for participation of a broad range of stakeholders,
including participation from vulnerable community, women and marginalized groups. UNICEF
will provide technical assistance to GoM for leading WASH sector and sub sector coordination
44 ADB - Myanmar unlocking potential (2016)
Programme Component 2) Water Sanitation and Hygiene (WASH)
52 |
systems. Similarly at the international level government participation in high level WASH
events and commitment to global agendas will be encouraged. Studies on the economic
benefits of WASH will drive advocacy for improved sector financing that is equitably targeted.
Technical assistance will target long-term human resource capacity building to ensure roles
and responsibilities for effective WASH service delivery can be achieved at scale through both
government and private sector actors. Building upon this UNICEF will work to strengthen
national sector monitoring and planning systems that are integrated with broader
management information systems already established or being established within key
ministries.
Output result 2: Targeted vulnerable families and children have access to adequate,
safe, affordable drinking water
Lack of consideration of operation and maintenance and equitable tariff models in community
managed supply systems is a bottleneck for all members of society to gain access to water.
Lack of human resources in key government departments impacts the ability of the duty bearer
to deliver sustainable WASH services. This is especially true at the local and regional level
which leads to challenges in budgeting, planning, implementation and monitoring of water
services. Some conflict areas are inaccessible to government. In other areas challenges such
as salinity, arsenic, depleting water tables exist. Consideration of the risk of natural disasters
and climate change in the design of water supply system is another essential, but often
overlooked component, to ensuring long term functionality.
To address the key issues and challenges, priority actions will be as follows:
Capacity development of service providers and communities for effective and
sustainable service delivery while mainstreaming gender into every aspect: This
includes designing climate resilience water supply system, water safety plan
development, establishing water quality monitoring system at the community
level, strengthening mechanism for better operation and maintenance (O&M),
strengthening development of equitable tariff systems, private sector engagement
in water supply services.
Advocacy for scaling up of successful and context-appropriate approaches:
Developing advocacy paper and tools for scaling up community managed water supply systems including water safety planning and water quality monitoring. UNICEF will work closely with the government to introduce model village approach that can be replicated at scale.
Partnership with private sector and civil society organisations to trial and develop
new technological solutions: This includes development of innovative solutions
together with government and private sector for delivering climate and disaster
resilient water supply systems mainly for disaster prone areas.
Knowledge management through documentation and research:
Programme Component 2) Water Sanitation and Hygiene (WASH)
53 |
Documentation and research to develop national resources for supporting effective water
supply solutions for vulnerable and poor communities in locations where delivery of water
supply is particularly challenging. UNICEF will support the government counterparts for
conducting sustainability checks. UNICEF will emphasize sharing of knowledge on rural and
peri-urban water supply through national, regional and global knowledge.
Output result 3: Targeted vulnerable children and families have access to adequate and
equitable sanitation facilities, and good hygiene practices, and end open defecation
The absence of affordable and durable climate resilient technology options for sanitation and
hygiene for the most vulnerable communities, coupled with lack of knowledge and prevailing
social norms are some of the key reasons for low quality toilets and open defecation. Private
sector participation has to be strengthened to bring robust local sanitation markets that can
both create demand and meet supply needs of disadvantaged communities.
To address the key issues and challenges, priority actions will include; Promotion of CLTS
based approaches linked to quality formative research to build demand for sanitation
facilities. Working with small scale private sector to strengthen sanitation markets in
targeted areas. UNICEF will support the government to develop Rural Health Center (RHC)
as "sanitation and hygiene promotion hubs”. National and local level sanitation advocacy
initiatives will be pushed out through multiple media channels and where appropriate cross
linkages will be sought with other sectors. Especially relevant will be reaching children through
education sector, infants and young children through the nutrition sector and mothers and new
borns through the health sector. These will be linked through C4D initiatives focussed on
changing harmful social norms.
Output result 4: Institutions (Health and Schools) in up to 5 high burden states/regions
have WASH faculties meeting national standards
Operation and maintenance of institutional WASH facilities is not prioritized as investments
have historically focussed on capital costs only. Currently education and health management
information systems cannot give information on WASH facilities which is a major barrier to
effective planning and budgeting for long term capital and operational costs within these
institutions.
To address the key issues and challenges, priority actions will include; technical assistance to
review and refine WASH in health care facilities, WASH in schools guidelines and manuals,
and advocate for their operationalization at all levels. Innovative models for WASH service
delivery of software and hardware interventions will also be developed and tested. Advocacy
for allocation of dedicated operation and maintenance budget for WASH facilities in schools
and health care centers will also be a priority. UNICEF will work with the government and
WASH partners for establishing model WASH facilities that are meeting the national
standards. At the national level, UNICEF will work with MoE and MOHS, and key partners for
scaling up Thant Shin Star school approach and documenting good practices for effective
planning, monitoring and capacity development. Ongoing support will be provided to MOE and
MOHS to conduct research and knowledge generation related to WASH in Schools and Health
Care Facilities
Programme Component 2) Water Sanitation and Hygiene (WASH)
54 |
Output 5: GoM and CSOs have increased capacities in emergency preparedness and
service delivery to ensure girls, boys and women have access to safe and reliable
WASH facilities in humanitarian situation
Myanmar remains one of the most disaster prone countries in the world with multiple ongoing
conflicts and natural hazards in different parts of the country. Government emergency
coordination mechanisms remain weak with many ministries functioning and responding to
disasters independently without significant coordination with other ministries or civil society.
Early warning systems need strengthening to better anticipate slow onset disasters such as
drought and flood. Capacity of district and township level government staff and civil society
actors needs to be strengthened to ensure that they can provide effective response in first
stages of an emergency. Protracted emergencies has resulted in large numbers of internally
displaced populations who require longer term humanitarian support to maintain basic
services.
To address the key issues and challenges, priority actions will include; Training of government
partners and ensuring they plan for sufficient resources and capacity to deliver rapid and
effective humanitarian WASH responses in the event of a disaster and over longer term
protracted crises. Functional and accountable coordination mechanisms need to be
strengthened at national and sub national levels. Depending upon the humanitarian situation
and need, UNICEF can provide cluster leadership at the request of government. An advocacy
strategy based on Core Commitment for Children (CCC) and humanitarian needs of the
affected populations will be developed. Focus will be given to effective transitioning from
protracted humanitarian to development approaches wherever feasible. UNICEF will work
through partnership with government and CSO partners for establishing operational
emergency supply systems including prepositioning, SOPs and delivery of rapid and effective
humanitarian response in the event of an emergency. The Core Commitments for Children
(CCCs) in Humanitarian Action remain the fundamental guiding principal to UNICEF
humanitarian work and UNICEF will advocate for resource mobilization to address
humanitarian needs and ensure that core commitments for children in humanitarian situations
are fully met.
Programme Component 2) Water Sanitation and Hygiene (WASH)
55 |
Theory of Change
• Escalation of conflicts and need
expansion of humanitarian assistances
• Natural disasters such as cyclone,
flood and landslide, and damages
infrastructure
Government partners remain supportive and committed to strengthen human resource and instructional capacity
Outcome By 2022, families and institutions in seven high burden states and regions have equitable access to and utilize safe, affordable, adequate and equitable WASH services across the
lifecycle, especially the most vulnerable children and women
GoM has strengthened political commitment and accountability, and technical and institutional capacity for scaling up safely managed WASH services that are adaptive to cyclical stress and shocks
GoM especially MOHS and MoE have increased technical and institutional capacities to build, operate, maintain and monitor WASH services in schools and health facilities in accordance with national standards
Affordable and good quality toilets available
(meeting national standards)
Fecal waste is safely managed and disposed of Sanitation marketing established and private sector
engaged in WASH sector
Increased awareness and knowledge and good practices on sanitation and hygiene at HH level
Handwashing facilities are in place National handwashing BCC programme in place
Capacity of township and RHC level MoH staff
strengthened
Climate resilient water supply and sanitation facilities are established
O&M system established (HR,
fund and spare parts) Increased capacity of health staff
for sanitation and hygiene
promotion and education
Outputs
Implementation Strategies
Delay in approval of policies, standards and plans may delay in planning and implementation as well as scaling up some interventions
• Depletion of water source due to climate change
and unitability of adequate quantity of safe water
sources • Inadequate human resource and institutional
capacity
The policies, standards, plans and guidelines that will be developed with support of UNICEF and other stakeholders will be endorsed by the government in a timely
• No major conflict related emergencies.
• Peace agreement signed between armed
groups and the national government • Disaster risk reduction approaches are
integrated
Assumptions
Adequate preparedness activities are planned well in advance
Climate resilient water supply
systems are established Climate resilient WSP systems
are in place at community level
O&M system established (HR, fund and spare parts)
Capacity of township level
DRD staff strengthened
GoM and partners have enhanced technical and institutional capacity to deliver equitable, safe, gender sensitive and climate resilient drinking water supply services to vulnerable populations in seven States and Regions at scale
GoM and CSOs have increased capacities in emergency preparedness and service delivery to ensure girls, boys and women have access to safe and reliable WASH facilities in humanitarian situations
Set up warning/early action system Establish functional coordination
mechanism with government
leadership in emergencies at national and sub national level
Establish operational emergency
supply systems incl. prepositioning, SOPs
Ensure access to water and
sanitation, and adoption of hygiene in humanitarian situation
Capacity of township level RRD
and DRD staff strengthened
Risks
Policies, Guidelines, Rules and
Regulations established (WinHF,
Sanitation, WQ, HWWS, Urban WASH, pvt sector engagement)
Rural WASH strategy operationalized
Effective WASH sector coordination at national and subnational levels
established
WASH sector information management system developed and used
State/regional costed investment plan
developed and approved Increased dedicated budget for WASH in
MALI, MoE and MoHS
Vulnerable communities in targeted areas end open defecation and households have capacity to maintain adequate sanitation facilities and hygiene practices with support from government and local service providers
Programme Component 2) Water Sanitation and Hygiene (WASH)
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Results Matrix - WASH
Key results Progress indicators Baseline Target Means of
verifications
Key partners
Sustainable Development GOAL 6. Ensure availability and sustainable management of water and sanitation and water for all
6.1: By 2030, achieve universal and equitable access to safe and affordable drinking water for all
6.2: By 2030, achieve access to adequate and equitable sanitation and hygiene for all and end open defecation, paying special attention to the needs of
women and girls and those in vulnerable situations
6.3: By 2030, improve water quality by reducing pollution, eliminating dumping and minimizing release of hazardous chemicals and materials, halving the
proportion of untreated wastewater and substantially increasing recycling and safe reuse globally
6.4: By 2030, substantially increase water-use efficiency across all sectors and ensure sustainable withdrawals and supply of freshwater to address water
scarcity and substantially reduce the number of people suffering from water scarcity
Myanmar National WASH Strategy and Investment Plan (2016-2030): To contribute to improved socio-economic life of all the rural populace by 2030
through provision of equitable, effective, efficient and affordable services for water supply and sanitation and safe hygienic behaviour
United Nations Strategic Development Framework 2018 - 2022: TBC
Outcome Statement
Outcome 2: By 2022,
families and institutions in
seven high burden states
and regions have equitable
access to and utilize safe,
affordable, adequate and
equitable WASH services
across the lifecycle,
especially the most
vulnerable children and
women
2.1: Proportion of the population
using a safely managed drinking
water service at community level
6.2%
20% Household surveys DRD/MALI,
DBE/MOE, MOHS,
CDC, WHO, UN
agencies, CSOs
2.2: Proportion of the population
using basic drinking water service
62.8% 75%
Household surveys DRD/MALI,
DBE/MOE, MOHS,
CDC, WHO, UN
agencies, CSOs
2.3: Proportion of the people
practicing open defecation
19% 12% Household surveys MOHS, CDC, WHO,
UN agencies, CSOs
2:4: Proportion of population
having access to a basic
sanitation
67% 73% Household surveys MOHS, CDC, WHO,
UN agencies, CSOs
Programme Component 2) Water Sanitation and Hygiene (WASH)
57 |
Key results Progress indicators Baseline Target Means of
verifications
Key partners
2.5: Proportion of population with
handwashing facility with soap
and water available at home
40% 60% Household surveys DRD/MALI, MOHS,
CDC, WHO, UN
agencies, CSOs
2.6: Proportion of schools with
basic WASH services
N/A 50% EMIS/MOE reports
and national
surveys
DRD/MALI,
DBE/MOE, MOHS,
CDC, WHO, UN
agencies, CSOs
2.7: roportion of rural health
centers that have WASH facilities
meeting national standards
N/A 60% MOHS reports and
national surveys
MOHS, WHO, UN
agencies, CSOs
UNICEF Water, Sanitation
and Hygiene (WASH)
Programme Outputs
2.1. Enabling
Environment
By 2022, GoM has
strengthened political
commitment and
accountability, and
technical and institutional
capacity for scaling up
safely managed WASH
services that are adaptive
to cyclical stress and
shocks.
2.1.1.Existence of national water,
sanitation and/or hygiene sector
policy and strategy
Weak (Red) Established
(Yellow)
Policy
document/GOM
reports and records
DRD/MALI, MoHS,
DBE/MOE, CDC and
UN agencies
2.1.2.National strategy to
eliminate open defecation
available
Weak (Red) Established
(Yellow)
Plan/policy
document/ MOHS
annual report
MOHS/CDC
2.1.3.Existence of functioning
sector coordination mechanism
for water, sanitation and hygiene
Initiating (grey) Established
(Yellow)
MALI/MOE and
MOHS annual
reports
DRD/MALI, MoHS,
DBE/MOE, CDC, UN
agencies and CSOs
2.1.4.Existence of water,
sanitation and hygiene sector
financing mechanism
Weak (Red) Established
(Yellow)
GOM reports MALI, MoHS, MOE
and CDC
2.1.5. Existence of water,
sanitation and hygiene sector
planning mechanism
Weak (Red) Established
(Yellow)
MALI/MOE and
MOHS annual
reports
DRD/MALI, MoHS,
DBE/MOE and CDC
Programme Component 2) Water Sanitation and Hygiene (WASH)
58 |
Key results Progress indicators Baseline Target Means of
verifications
Key partners
2.1.6. Existence of water,
sanitation and hygiene sector
monitoring, evaluation and
learning mechanism
Weak (Red) Initiating (Grey) MALI/MOE and
MOHS annual
reports
DRD/MALI, MoHS,
DBE/MOE and CDC
2.1.7.Number of UNICEF-
supported districts (or equivalent
lowest level where planning and
budgeting conducted) with active
WASH equity based monitoring
systems with disaggregated
information
0 3
States/Regions
MALI/MOE and
MOHS annual
reports
DRD/MALI, MoHS,
DBE/MOE and CDC
2.1.8. Number of sustainability
checks conducted with
independent third parties with
related management response
1 3 MALI/MOE and
MOHS annual
reports
DRD/MALI, MoHS,
DBE/MOE and CDC
2.1.9.Existence of water,
sanitation and hygiene sector
capacity development mechanism
Weak (Red) Initiating (grey) MALI/MOE and
MOHS annual
reports
DRD/MALI, MoHS,
DBE/MOE and CDC
2.2. Water Supply
By 2022, GoM and partners
have enhanced technical
and institutional capacity to
deliver equitable, safe,
gender sensitive and
climate resilient drinking
water supply services to
vulnerable populations in
2.2.1.Proportion of people
accessing basic drinking water
during the reporting year only, as
a result of UNICEF direct support.
62.8% 70%
GOM report,
UNICEF Annual
report
DRD/MALI, CDC
2.2.2. Proportion of people with
access to a safe drinking water
source in the reporting year only,
as a result of UNICEF direct
support
6.2%
12% GOM report,
UNICEF Annual
report
DRD/MALI, CDC
Programme Component 2) Water Sanitation and Hygiene (WASH)
59 |
Key results Progress indicators Baseline Target Means of
verifications
Key partners
seven States and Regions
at scale.
2.2.3. Number of people living in
water safe communities in the
reporting year only, as a result of
UNICEF direct support (water
safety action plan)
N/A
500,000
GOM report,
UNICEF Annual
report
DRD/MALI, CDC
2.2.4. Number of people living in
water climate resilient
communities in the reporting year
only, as a result of UNICEF direct
support
N/A
250,000
GOM report,
UNICEF Annual
report
DRD/MALI, CDC
2.2.5. Number of people
accessing a sustainable drinking
water service in the reporting year
only.
N/A
500,000
GOM report,
UNICEF Annual
report
DRD/MALI, CDC
2.2.6.National and sub national
water safety framework in place
Weak (Red) Established
(Yellow)
DRD/MALI/MOHS
reports
DRD/MALI, MOHS,
CDC
2.2.7.Guidelines and manuals for
rural and peri-urban water supply
available
Weak (Red) Established
(Yellow)
CDC/MALI/MOHS
reports
DRD/MALI/CDC
2.3. Sanitation and
Hygiene
By 2022, vulnerable
communities in targeted
areas end open defecation
and households have
capacity to maintain
adequate sanitation
facilities and hygiene
2.3.1.Number of people who
gained access to basic sanitation
services in the reporting year
only, as a result of UNICEF direct
support
N/A
750,000
Field monitoring,
partners’ report
MOHS, CDC, CSOs
2.3.2.Number of people living in
newly triggered communities in
the reporting year, as a result of
UNICEF direct support
N/A
1,500,000
Field monitoring,
partners’ report
MOHS, CDC, CSOs
Programme Component 2) Water Sanitation and Hygiene (WASH)
60 |
Key results Progress indicators Baseline Target Means of
verifications
Key partners
practices with support from
government and local
service providers
2.3.3.Number of people living in
communities certified free of open
defecation in the reporting year
only as a result of UNICEF direct
support
N/A
500,000
MOHS report,
UNICEF Annual
report
MOHS, CDC, CSOs
2.3.4.Number of communities
"triggered" in the reporting year
only, as a result of UNICEF direct
support
N/A
1,500
MOHS report,
UNICEF Annual
report
MOHS, CDC, CSOs
2.3.5.Number of communities
certified free of open defecation in
the reporting year only as a result
of UNICEF direct support
465
1,000
MOHS report,
UNICEF Annual
report
MOHS, CDC, CSOs
2.3.6.Number of communities
certified free of open defecation
as a result of UNICEF and
partner support
(leveraged/indirect)
N/A
10,000
MOHS report,
UNICEF Annual
report
MOHS, CDC, CSOs
2.3.7.Handwashing behaviour-
change programming exists at
community level
Weak (Red) Established
(Yellow)
MOHS report,
UNICEF Annual
report
MOHS, CDC, CSOs
2.3.8.Guidelines and manuals for
CLTS/CATS for rural and peri-
urban sanitation available
Weak (Red) Established
(Yellow)
CDC/YCDC/MOHS
reports
MOHS, CDC, CSOs
2.4. WASH in Institutions
By 2022, GoM especially
MOHS and MoE have
increased technical and
institutional capacities to
2.4.1.Guidelines and manuals for
implementing National Standards
for WASH in Schools available
Weak (Red) Established
(Yellow)
MOE reports DBE/MOE
2.4.2.Number of schools with
water and sanitation facilities that 500
1,500
MOE report/EMIS DBE/MOE, MOHS
Programme Component 2) Water Sanitation and Hygiene (WASH)
61 |
Key results Progress indicators Baseline Target Means of
verifications
Key partners
build, operate, maintain and
monitor WASH services in
schools and health facilities
in accordance with national
standards
meet national standards have
been installed in the reporting
year only, with UNICEF direct
support
2.4.3.Number of schools that
practice daily group handwashing
in the reporting year only, as a
result of UNICEF direct support
and/or leveraged through national
programmes
500
1,500
MOE report/EMIS DBE/MOE, MOHS
2.4.4.Number of schools with
Menstrual Hygiene Management
implemented in schools
programmes as a result of
UNICEF direct support and/or
leveraged through national
programmes
N/A 250
MOE report/EMIS DBE/MOE, MOHS
2.4.5.Number of health centres
(clinics, hospitals, etc.) that have
basic WASH facilities in the
reporting year only, as a result of
UNICEF direct support
N/A 200
MOHS report/HMIS MOHS, CDC
2.4.6.uidelines and manuals for
implementing National standards
for WASH in HF available
Weak (Red) Established
(Yellow)
MOHS report/HMIS MOHS, CDC
2.5. WASH in
Emergencies
By 2022, GoM and CSOs
have increased capacities
2.5.1.Number of people in
humanitarian situations who
access safe drinking water as per
327,742
150,000
Humanitarian
reports, cluster
reports, program
records and reports
RRD/MSWRR,
DRD/MALI, MOHS
and Cluster members
Programme Component 2) Water Sanitation and Hygiene (WASH)
62 |
Key results Progress indicators Baseline Target Means of
verifications
Key partners
in emergency
preparedness and service
delivery to ensure girls,
boys and women have
access to safe and
reliable WASH facilities in
humanitarian situations
agreed sector/cluster coordination
standards and norms
2.5.2.UNICEF-targeted
population in humanitarian
situations accessing sufficient
quantity of water of appropriate
quality for drinking, cooking and
personal hygiene
71,794
35,000
Humanitarian
reports, cluster
reports, program
records and reports
RRD/MSWRR,
DRD/MALI, MOHS
and Cluster members
2.5.3.Number of people in
humanitarian situations accessing
appropriate sanitation facilities
and living in environments free of
open defecation as per agreed
sector/cluster coordination
standards and norms
355,465
150,000
Humanitarian
reports, cluster
reports, program
records and reports
RRD/MSWRR,
DRD/MALI, MOHS
and Cluster members
2.5.4.UNICEF-targeted
population in humanitarian
situations accessing appropriate
sanitation facilities and living in
environments free of open
defecation
60,046
30,000
Humanitarian
reports, cluster
reports, program
records and reports
RRD/MSWRR,
DRD/MALI, MOHS
and Cluster members
2.5.5.Number of people in
humanitarian situations who have
access hand-washing facilities by
sector/cluster
241,336
120,000
Humanitarian
reports, cluster
reports, program
records and reports
RRD/MSWRR,
DRD/MALI, MOHS
and Cluster members
2.5.6.UNICEF targeted population
in humanitarian situations who
have access hand-washing
facilities
57,372
25,000
Humanitarian
reports, cluster
reports, program
records and reports
RRD/MSWRR,
DRD/MALI, MOHS
and Cluster members
Programme Component 2) Water Sanitation and Hygiene (WASH)
63 |
Key results Progress indicators Baseline Target Means of
verifications
Key partners
2.5.7.UNICEF-targeted
population in humanitarian
situations accessing appropriate
WASH facilities and hygiene
education in schools, temporary
learning spaces and other child
friendly spaces
N/A
100,000
Humanitarian
reports, cluster
reports, program
records and reports
RRD/MSWRR,
DRD/MALI, MOHS
and Cluster members
Programme Component 3) Education
64 |
Programme Component 3) Education
Introduction
Since launching reforms in 2011, Myanmar has made great strides in education, and the new
government has accelerated momentum. The education facet of the new Country Programme
aims to contribute to the Government’s efforts to achieve Sustainable Development Goal 4 for
Education and successfully implement the National Education Strategic Plan (NESP) 2016-
2021. The programme will align with the NESP, focusing on the realization of equity and
inclusion in basic education and the improvement of students’ learning. This will be achieved
through evidence-based policy advocacy, system strengthening, communications for
development and inclusive partnerships at national and sub-national levels and maximizing
synergies with child protection, social policy and child rights monitoring, health and nutrition,
water, sanitation and hygiene, and communications teams within MCO.
Partners
The main partners with whom UNICEF will work for the proposed education programme are
MoE, including State, Region and Township Education Offices, National Education Policy
Commission, National Curriculum Committee, Ministry of Social Welfare, Relief and
Resettlement (MoSWRR), Ministry of Health and Sports, Ministry of Planning and Finance,
Ministry of Ethnic Affairs. UNICEF will continue to support the MOE to strengthen the
coordination forum, Education Sector Coordination Committee, and it’s Sub-Sector Working
Groups. UNICEF will work in coordination with the Asian Development Bank, Australia,
©UNICEF Myanmar/2016/ Khine Zar Mon
Programme Component 3) Education
65 |
Denmark, DFID, EU, JICA, and UNESCO, World Bank, as well as other bilateral and UN
agencies, and international and national NGOs. UNICEF will leverage its convening role to
build strategic coalitions with and amongst non-state ethnic education departments, as well
as local NGOs, community-based, civil society organizations, international and national
academia.
Prioritized Issues and Areas
UNICEF’s education programme will focus on strengthening the capacity of the MoE and other
stakeholders to move towards equity in education and improve learning. Priority issues have
been defined jointly by the MoE and UNICEF through a series of consultations with partners,
taking into account UNICEF’s in-country experience-to-date, strengths at the country, regional
and global levels, as well as comparative advantage in relation to other partners’ work in
education. Three areas of focus that have been agreed upon are:
Early Learning
Equity, Inclusion and Quality in Basic Education
Alternative Education for out-of-school children
Early learning
Progresses have been made in the area of early learning, including the launch of new KG
curriculum and the ECCD Policy. However, preschool and KG teachers’ competency and
motivation, curriculum relevance, the availability of safe, stimulating teaching-learning
environments and appropriate assessments persist as challenges. The new KG curriculum,
though planned for delivery in mother tongue, is mostly delivered in Myanmar language,
creating a challenge for young children’s learning. 92% of school-based preschool teachers
of MoE are recruited and paid by communities, creating a challenge of sustainability. There is
no pre-service training institution for preschool teachers and parents have limited
understanding of children’s developmental milestones. Given the importance of multi-sectoral
approach to education for young children, there is a need to improve sectoral coordination.
Equity, Inclusion and Quality in Basic Education
Myanmar reached a high primary net enrolment rate of 95% in 201445. For children aged 7-
11, the school attendance rate is over 80%; but, declines sharply towards the end of primary
school46. Shan State has the biggest proportion of children aged 6-17 who have never been
to school (23%), with the national average at 6%. Of an estimated 232,000 (1.35%) children
with disabilities, 2 in 3 do not attend school47. Rakhine State has some of the lowest education
45 UNESCO 2016. Global Education Monitoring Report. 46 According to UNICEF Situation Analysis based on the data from Dr. Muta (presentation), JICA consultant, this means that: for 100 students who begin grade 1, only 70 complete primary, 60 enrol in lower secondary, 45 complete lower secondary, 38 join upper secondary school and only 30 take the matriculation exam. 47 Department of Social Welfare, MoSWRR & UNICEF, (2016). Situation Analysis of Children with Disabilities in Myanmar
Programme Component 3) Education
66 |
indicators nationally and one of its townships, Maungdaw, has the lowest GPI in the country:
0.73 at primary and 0.25 at lower/upper secondary level.
Lack of inclusive education policies for all children and social norms reinforcing negative
attitudes towards children of some characteristics, especially children with disabilities, are
critical bottlenecks to achieve equity and inclusion in education. In order to achieve equity and
inclusion, there is a need for the education system to analyse reasons for out-of-school
children, school dropout, and poor learning outcomes, and to provide interventions that are
relevant and effective to different groups of children, depending on the analysis.
One of the most influencing factors on school dropout is the poor quality of education,
evidenced in students’ poor learning outcomes. Only 23% and 48% of the Grade 2 and 3
students, respectively, reached curricular expectations and could be considered good
readers48. Students’ poor learning outcomes may be partially explained by the fact that around
half of primary teachers are ex-/daily-wage teachers with insufficient preparation, as a result
of the MoE’s recent policy to allocate five teachers to every school49. It is found that head
teachers spend most of their time on school administrative work, not as instructional leader
and mentor.50 Quality of teaching and learning is also critically affected by the quality of the
assessment and examinations system, as evident that Chapter End Tests focus on fact
memorisation and place little focus on critical thinking.51
Responding to humanitarian crises is a key challenge for the education system. An estimated
141,000 children (51% girls) aged 3-17 in conflict-affected states of Rakhine, Kachin and
northern Shan, are most at risk of not accessing formal education52. The education system is
not sufficiently prepared to respond to vulnerabilities and disaster preparedness needs to be
strengthened in coordination with other stakeholders. Complex migration within and across
Myanmar’s borders is a significant feature of Myanmar society and children’s lives: evidence
from a 2016 study shows that independent child migrants were least likely to have improved
access to education after migrating, with 10% of working girls and 30% of working boys
reporting decreased access.
Capacity gaps exist amongst education officers at national and sub-national levels in planning,
implementing, monitoring and evaluating education activities and mobilising community to
support to education.53
48 Work Bank Group (2015). Myanmar Early Grade Reading Assessment for the Yangon Region. Washington DC: Work Bank Group. 49 In 2013-14 and 2014-15 academic years, more than 72,800 daily-wage teachers were hired49 and in 2016-17 AY, nearly 24,700 daily-wage teachers were hired49, meaning that around 97,500 of 195,286 primary teachers are ex-/daily wage teachers. 50 Lall, M., San, T.S.; San, N.N., Myat, T.T, &Khaing, L.T.T. (2013). Teachers’ voice: What education reforms does Myanmar need? Yangon: Myanmar Egress 51 Thein, M. (2016). The research report on Basic Education assessment. 52 Humanitarian Needs Overview 2016 by OCHA 53 According to the findings of the 2016 Capacity Gap Assessment supported by Quality Basic Education Programme (QBEP), the average score earned by participants in Capacity Gap Assessment is below par in the nine capacity domains except 2.5/5.0 in general admin and 3.0/5.0 in financial management and budgeting.
Programme Component 3) Education
67 |
Alternative Education for out-of-school children
However, there are still upwards of 2 million children aged 5-17 years old out of school54. Key
reasons for not attending school cited by the 10-15 age cohort of those never enrolled, 43.5%
are “school costs are not affordable,” and 32.4% cite “lack of interest”55. Similarly, lack of
engagement in the classroom and employment attraction are more specific reasons for drop
out among adolescent boys and girls aged 10-1756. Amongst working children surveyed,
45.5% had started working before the age of 13. A recent study57 of gender dynamics affecting
participation of girls and boys in secondary education revealed that all adolescent respondents
cited corporal punishment as a reason for their dropout. Adolescent girls are frequently absent
from schools due to lack of menstruation management facilities and lack of toilet privacy.58
These issues point to the need for access to alternative, relevant, flexible education, bolstered
by appropriate frameworks which enable accreditation and, where possible, transition to a
quality, inclusive formal system, enhancing life chances for employment and self-fulfillment,
building agency, and strengthening young people’s sense of belonging.
Proposed Focus for 2018-2022 (Outcome and Outputs Result):
VISION: All children in Myanmar acquire skills and knowledge and thereby will be better
equipped to manage their own lives and contribute to the well-being of their families,
communities and a peaceful, and economically prosperous society.
Outcome Statement: By 2022, children, especially the most disadvantaged, will acquire
knowledge and skills in an inclusive, safe, quality learning environment to complete pre-
primary, primary, transition to secondary and complete lower secondary education.
Output 1: MoE and other partners at national and sub-national levels have increased capacity
to give a head start to children aged 3-5 years though quality preschool and Kindergarten (KG)
education.59
UNICEF will support evidence-based advocacy and policy dialogue with key partners to;
operationalise the ECCD policy, including the National ECCD committee and its subsidiary
bodies, increase investment in early childhood education, advocate for establishment of
ECCD as a profession and support the MoE and MOSWRR on C4D strategies for parental
education for early learning. Support will be provided to MoE in system strengthening to
provide quality and relevant pre-school and Kindergarten learning opportunities to young
children through development of tools such as ECI services and guidelines to assess and
54 UNICEF Myanmar Situation Analysis based on the 2014 Census. School aged population: 11.2 million = 4.8 million (5-10 year olds) +6.4 million (11-17 year olds) 55 Ibid. 56 Ministry of National Planning & Economic Development, Ministry of Health and UNICEF Myanmar: A Qualitative Study on Myanmar Adolescents- with a Focus on out-of-school and working adolescents, 2014. 57 UNICEF (2016). Bottleneck analysis of gender dynamics affecting participation of girls and boys in secondary education and implications
for social cohesion, draft
58 Myanmar: Unlocking the potential, ADB, 2014. 59 NESP Strategies 4: 1: Strengthening governance and coordination in pre-school services; 4.2: Expand access to pre-school
services in rural and remote areas; 4.3 Improve pre-school quality to better prepare children for primary school.
Programme Component 3) Education
68 |
improve the quality of early learning, as well as a baseline mapping of existing pre-school
services. With MoE, UNICEF will maximize its role as a convener, reinforcing and forging
networks and partnerships with State, Non-State Actors, ethnic groups, academia,
international institutions and public sector for collaborated support for ECE and expanded
coverage in areas not yet reached by GoM, and for the development of mother-tongue-based
teaching and learning materials for preschools and KG.
Output 2: Parents, teachers, communities, MoE and other partners have increased capacity
to actively support inclusive quality education to keep girls and boys (especially the most
marginalised) in school, helping them transition and complete quality and inclusive primary
and lower secondary education and thereby contribute to social inclusion and cohesion.60
UNICEF will support the development and operationalisation of national guidelines and
standards outlined in the NESP, such as Language policy, and School Quality Standards
Assurance Framework and national guidelines on WASH in Schools and school construction.
UNICEF will support further evidence generation on issues such as the transition from primary
to secondary, violence in school, and education for children with disabilities, to feed into
advocacy for policies that are equity-focussed, child-rights based and promote inclusion and
retention. Child rights monitoring in education, in collaboration with other Ministries and
partners, will further inform policy formulation as well as education planning, budgeting and
monitoring. The programme will assist the MoE to strengthen its capacity to effectively
implement the NESP, for achieving equity and gender equality in education through the
capacity development of head teachers and other education officers (TEOs, DEOs, SEOs and
central levels) to plan, manage, monitor and evaluate education activities and engage
community in support of teachers to maximize the outcome of teaching and learning. UNICEF
will support the MoE to devise in-service teacher education policy framework and guidelines.
Social protection measures through a cross-sectoral model will be explored to make schools
more inclusive, resilient and relevant and thereby keep children and adolescents at risk in
school61. UNICEF will continue to prioritise co-leadership and active participation in education
sector coordination, using its convening role to promote inclusive participation of civil society
and other actors in policy dialogue, and leverage resources for education for the most
disadvantaged, including through GPE engagement. UNICEF will support the MoE to
operationalise the Basic Education Partnership Programme, (NESP Chapter 5 outlines
Strategy 2: Strengthening partnerships). “The focus of this strategy will be on partnerships
with non-state/nongovernment actors, public-private partnerships (PPPs), partnerships with
regional and local governments, and partnership with parents and communities.”62 UNICEF
will support sub-national systemic changes for improved inclusive education planning and
budgeting. At State level, support will be provided to bring government and non-government
60 NESP Chapter 5: Basic education reforms: Strategy 5.1: Strengthening policy, legislation and systems; 5.2 Strengthening partnerships; 5.3: Advocacy and communication; Chapter 6: Basic education Access Quality and inclusion, strategies 6.2: Support compulsory and inclusive education; 6.3: Improve school quality through a national school-based quality assurance system; Chapter 8: Student Assessment and Exams Strategy 1: Improve assessment and examinations; Ch. 8 Teacher Education and management. 61 Including DFAT/World Bank supported student stipend program 62 NESP Chapter 5, Strategy 5.2.2: Component 1 Development of a partnership mechanism to support the participation of different education service providers in the basic education reforms. An important factor in the successful implementation of the basic education reforms is the extent to which they are mainstreamed in other organisations involved in basic education provision, such as monastic schools, private sector schools, community-based schools, schools funded by non-governmental organisations and schools managed under ethnic education systems.
Programme Component 3) Education
69 |
education service providers together to facilitate the provision of inclusive education and
pathways between systems, in Rakhine, Kachin, Shan, Chin, Kayah, Mon and Kayin. UNICEF
will assist the MoE on local curriculum for primary education. UNICEF will support student
assessment and examination improvement for primary education.
Output 3: MoE at national and sub-national levels have increased capacity to provide out-of-
school children aged 10-18 with quality-assured, certified and nationally accredited alternative
education at primary and lower secondary levels, and continuous learning for children in
emergencies, in collaboration with key partners63.
Based on the reality of the large number of out of school children, UNICEF will assist MoE to
strengthen coordination and management of alternative education. UNICEF will provide
technical support to further develop and operationalise the Alternative Education policy,
including an implementation plan and monitoring mechanism. UNICEF will assist MoE to
establish a National Alternative Education (AE) Coordination Committee and to inform these
reform processes, a mapping of supply and demand64 will be supported through a quantitative
baseline survey of existing AE providers, and a qualitative exploration of learners’ needs.
UNICEF will strengthen pathways between the formal and alternative systems by building on
work already undertaken on existing equivalency programmes to support MoE to develop a
multiple AE pathways programme enabling children to transition between non-formal and
formal systems, or progress into training/employment. This will be actioned through technical
support to MoE to develop and pilot the National Youth Education Certificate, development of
a national certification system to enable accreditation of NGO-supported courses and via
technical advisory, capacity development of a teacher competency framework and a teacher-
training programme tailored for AE, linked to the general Teacher Competency Framework.
Finally, UNICEF will continue to provide support to education in emergencies, in coordination
with other partners and sectors at the national and sub-national levels, through its mandate
as Education Cluster Co-lead. UNICEF will focus on government capacity building and system
strengthening in EiE preparedness and response, and compliance with the Inter-Agency
Network for Education in Emergencies (INEE) standards.
By an iterative process of prioritization, and through consultation with partners within the
education and related sectors, UNICEF Myanmar has concluded it can best contribute to the
development of quality, inclusive, equitable education in Myanmar by building directly on its
work in basic education and by simultaneously providing technical expertise to advancement
of other partner’s work in upper secondary and TVET education. All work will be carried out
in alignment with the NESP, in support of the GoM vision for Education, and in collaboration
with relevant partners of the sector and those related to its goals. Key areas which present
opportunities for UNICEF to complement the work of other partners include: alternative
education and forging multiple pathways between complementary systems; sub-national
planning and coordination; convening government, development partners and civil society;
primary education assessment; and cross-sectoral issues relating to inclusion and rights, such
63 Aligned with NESP Chapters on Basic Education, Access, Quality, and Inclusion, Student Assessment and National Examinations, Teacher Education and Management 64 As recommended by the NFPE Study (QBEP, 2016).
Programme Component 3) Education
70 |
as gender, disability, out of school children, DRR, social cohesion, child health, child
protection, and WASH. These issues in particular will be strategized and actioned with the
teams of UNICEF Myanmar in order to mobilize cross-sectoral analysis, planning and action.
Programme Component 3) Education
71 |
Theory of Change Diagram
Assumptions Risks Output Implementation
strategies
Volatile funding environment
(domestic and external and
bureaucratic processes may adversely
affect implementation
Head start/early learning: MoE and other partners at national and sub-
national levels have increased capacity to give a head start to children aged
3-5 years old through quality preschool and kindergarten education
Disconnect
between national
and sub-national
impedes NESP
implementation
Disaster and conflicts may
negatively affect provision of
quality, inclusive education
services
Teacher competency framework is in place
Alternative Ed: MoE at national and sub-national levels have increased capacity
to provide out-of-school children aged 10-18 with quality-assured, certified and
nationally credentialed alternative education at primary and lower secondary levels, and continuous learning for children in emergencies, in collaboration with
key partners.
Teachers at all levels of basic education apply new knowledge and skills
1. Strategic support to MoE and partners for Communications for
Development for parental education on early learning and developmental milestones.
2. Advocacy and policy dialogue with key partners and MoE for increasing
investment in early childhood education, establishment of ECCD as a profession, and operationalization of ECCD policy and management
bodies.
3. Strengthened systems to provide quality and relevant pre-school and Kindergarten learning to young children through development of tools and
guidelines to assess and improve quality of ECE services. (ECI system,
ECD scales) and through development of national standards for pre-school teacher training and development of national pre-school standards (linked
to SQSAF at primary level).
4. Coordination and partnerships with State, Non-State Actors, ethnic groups, academia, international institutions and public sector for
collaborated support for ECE and expanded coverage in areas not yet
reached.
1. Promote participation of parents and community members to take part in school management through the School Quality Standards
Assurance Framework and strengthen linkages with cross-sectoral
services & supports to help children stay in school. 2. Evidence-based advocacy for policy reforms to ensure that they are
inclusive, relevant, conflict sensitive and promote social cohesion,
including Inclusive Education policy and Language policy and Communication for Development to combat negative attitude towards
children with disabilities and promote gender sensitivity.
3. Technical support to MoE to develop and operationalize in-service teacher education policy framework and guidelines, and student
assessment reform to improve education quality and inclusiveness.
4. Technical support to sector coordination and overall education system at the national and sub-national levels to develop, plan, budget
for, implement and monitor equity-focused, inclusive, gender-
responsive and conflict-sensitive education plans, and promote coordination.
MoE may
deprioritize AE
system due to limited
budget
1. Support MoE-led coordination and management of alternative education,
technical support to develop and operationalize the Alternative Education policy,
with formulation of implementation plan, monitoring mechanism, and Quality Assurance standards.
2. Advocacy for expanded access to alternative education (built on baseline
mapping) and to strengthen linkage from non-formal to formal education systems, and provide MoE-recognised, accredited completion certificates to
equip out of school children (especially adolescents) with knowledge and skills
needed to enter training, employment or further study. 3. Education response in emergencies and humanitarian crises with other partners
and Education Cluster co-lead at national and sub-national levels for
coordination.
Curricula reforms are further promoted as planned (will not be discontinued)
Inclusive Ed: Parents, teachers, communities, MoE and other partners have increased capacity to actively support inclusive, quality
education to keep children (especially the most marginalised) in
school, helping them transit and complete quality and inclusive primary and lower secondary education and thereby contribute to
social inclusion and cohesion.
Myanmar National Education Strategic Plan 2016-2021 Goal: Improved teaching and learning, vocational education and training, research and innovation leading to measurable improvements in student achievement in all
schools and educational institutions.
UNICEF Myanmar 2018-2022 Education Vision: All children in Myanmar acquire skills and knowledge and thereby will be better equipped to manage their own lives and contribute to the well-being of their families, communities and peaceful and economically prosperous society.
Policy makers and parliamentarian are held accountable and become more transparent.
Education decentralization further promoted with more authority, decision-making and resources available at sub-national level.
Complementary programme continue to be funded/implemented such as school health, feeding and psychosocial programme.
Children are allowed to use their mother tongue when learning.
Govt. has adequately planned and allocated budget for education sector and emergency programmes
Outcome: By 2022, children, especially the most disadvantaged, will acquire knowledge and skills in an inclusive, safe, quality learning environment to complete pre-primary, primary, transit to
secondary and complete lower secondary education.
Evidence may not be
effectively used for
policy & planning
Programme Component 3) Education
72 |
Results Matrix - Education
Key results Progress indicators Baseline Target Means of verifications Key partners
Sustainable development Goal 4: Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all
Myanmar National Education Strategic Plan 2016-2021 (draft) Goal: Improved teaching and learning, vocational education and training, research and
innovation leading to measurable improvements in student achievement in all schools and educational institutions.
UNDAF Outcome: TBC
Outcome Statement
Outcome 3: By 2022, children, especially the most disadvantaged, will acquire knowledge and skills in an inclusive, safe, quality learning environment to complete pre-primary, primary, transit to secondary and complete lower secondary education.
3.1: Percentage of children
in Kindergarten who have
preschool experience
Total: 39.8%;
boys: 38.5%; girls:
41.1% (2009)
Total: 66%;
boys:65%; girls:
67% (2022)
MoE administrative
data, UNICEF field
reports and PCA
partners' reports; MICS
report
MoE, DSW, INGOs and PCA
partners
3.2: Primary completion
rate (by disaggregated
data)
Total: 66.84%; boys: 64.2%; girls: 69.63% (2015)
Total: 75%; boys:
70%;
girls: 80% (2022)
MoE administrative data MoE, I/NGOs and education
partners
3.3: Lower secondary
completion rate (by
disaggregated data)
Total: 70.92%;
boys: 65.13%;
girls: 76.61%
(2016)
Total:77%;
boys:71%;
girls:82% (2022)
MoE administrative data MoE, I/NGOs and education partners
UNICEF Education
Programme Outputs
3.1. MoE and other
partners at national
and sub-national
levels have increased
capacity to give a
head start to children
aged 3-5 years old
3.1.1. Early Learning Policy and early learning programme including quality early learning curriculum and standards (RAM c2a)
score-2
(2018)
score-4
(2022)
Report from MoE and
DSW
MoE, DSW, INGOs and PCA
partners
3.1.2. Existence of an effective early learning policy with clear budget
score 3
(2018)
score-4
(2022)
Report from MoE and
DSW
MoE, DSW, INGOs and PCA
partners
Programme Component 3) Education
73 |
Key results Progress indicators Baseline Target Means of verifications Key partners
through quality
preschool and
kindergarten
education.
allocation in place (RAM c2d)
3.1.3. % of target
townships with operational
ECCD committee that can
demonstrate measurable
improvements in access to
quality preschool
education in their
townships
Nil (2016)
50 % of targeted townships (2022)
Report from MoE and
DSW
MoE, DSW, MoHA, INGOs
and PCA partners
3.2. Parents,
teachers,
communities, MoE
and other partners
have increased
capacity to actively
support inclusive
quality education to
keep children
(especially the most
marginalised) in
school, helping them
transit and complete
quality and inclusive
primary and lower
secondary education
and thereby
contribute to social
inclusion and
cohesion
3.2.1. Availability of School
Quality Standard
Assurance Framework
score 1
(2018)
score 5
(2022)
Programme reports;
MoE reports
MoE and UN agencies and
other education partners
3.2.2. Existence of a national law or policy that fosters multilingual education to allow children to learn in their mother tongue during the early grades (RAM e6a)
score 2
(2018)
score 4
(2022)
MoE reports
MoE and UN agencies and
other education partners
3.2.3. Existence of a
national/system-level large
scale assessment,
including for early grades
(RAM c1c)
score 1
(2018)
score 4
(2022)
MoE reports MoE and UN agencies and
other education partners
3.2.4. Existence of In-
Service Teacher Education
policy framework and/or
related guidelines
score 1
(2018)
score 3
(2022)
Programme reports;
MoE reports
MoE and UN agencies and
other education partners
3.2.5. Number of township
and State/Region with
Education
Improvement/Development
Plan, partially budget
Townships: 0
States: 0
(2016)
Townships: TBC
States: TBC
(2022)
Programme reports;
MoE reports
MoE and UN agencies and
other education partners
Programme Component 3) Education
74 |
Key results Progress indicators Baseline Target Means of verifications Key partners
allocated and
operationalized
3.3. MoE at national
and sub-national
levels have increased
capacity to provide
out-of-school children
aged 10-18 with
quality-assured,
certified and
nationally
credentialed
alternative education
at primary and lower
secondary levels, and
continuous learning
for children in
emergencies, in
collaboration with key
partners
3.3.1. Availability of
Alternative Education
Policy Framework
score 2- policy
drafted
(2018)
score 4 (policy is
operationalized
(2022)
Policy launched by the
MoE
MoE; relevant Ministries,
MLRC (Myanmar Literacy
Resource Centre), I/NGOs and
private sectors
3.3.2. Availability of
Alternative Education
Quality Standard
Assessment Framework
(AEQSAF)
score 1- no
existence of
AEQSAF
(2018)
score-4: AEQSAF
is operationalized
(2022)
AEQSAF is launched
and funded by the MoE
MoE; relevant Ministries,
MLRC (Myanmar Literacy
Resource Centre), I/NGOs and
private sectors
3.3.3. Percent of (UNICEF
targeted) children in
humanitarian situations
accessing formal or non-
formal basic education
(including pre-primary
schools/early childhood
learning spaces) (RAM d1)
Total: 79%;
Boys:49%;
Girls:51%
(2016)
Total: 80%;
Boys:50%;
Girls:50%
(2022)
HRP quarterly HPM
quarterly report
MoE, other UN organizations,
Save the Children, I/NGOs,
faith-based organizations
Programme Component 4) Child Protection
75 |
Programme Component 4) Child Protection
Introduction
The Government of Myanmar has taken important steps over the years to advance the
protection of children. Efforts by the Ministry of Social Welfare, Relief and Resettlement to
initiate child protection social work case management has produced results, and is expanding.
The police, receiving an increased number of child abuse cases, have committed to enhanced
training for police across the country, and are appointing child protection focal points at
township level police stations in some states and regions. Similarly, the Supreme Court has
embedded key child protection reforms within their strategic plans, including capacity building
of courts for addressing increased child protection cases. The Ministry of Health and Sport is
looking at their social work capacity, and aims to enhance coordination with police and social
welfare. Alternatives to institutional care for children in Myanmar are under development by
the Ministry of Social Welfare and key partners, and awareness raising to prevent sexual
exploitation and discourage orphanage tourism are underway. At the same time, the capacity
of civil society and NGOs has increased in Myanmar, with more groups with expertise and
experience around the protection of children. Data on child protection is also more widely
available. The 2014 census, large-scale studies on child labor, migration, and other studies
and data collection exercises have led to increased understanding about the magnitude of
children that face protection risks. Important legal and policy reforms are either completed or
are under development. The Government of Myanmar has adopted a new factories and shops
act, which defines the minimum age of employment in those settings at 14 years – in line with
international norms. The Government has also drafted a new Child Law, which, once adopted,
will dramatically improve the legal environment for children more broadly. A child protection
policy and action plan are also under development, and will capture some of the important
©UNICEF Myanmar/2016/ Khine Zar Mon
Programme Component 4) Child Protection
76 |
reforms taking place. Conflicts continue to leave many children vulnerable to abuse and
exploitation, particularly in Rakhine, Kachin, and Northern Shan. There will be a continued
need to support specific approaches to reach the most vulnerable and marginalized children
in these areas. Armed conflict in Myanmar over the years has also resulted in 8 listed parties
for use and recruitment of children, including the Myanmar Armed Forces and 7 non state
armed groups. The Myanmar Armed Forces entered into an Action Plan with the UN in 2012,
and has made good progress towards ending the practice. Continued work to consolidate and
sustain these gains will be needed in 2018. Efforts to sign and implement Action Plans with
the 7 listed non-state armed groups will be needed. Decades of conflict has also left the
country deeply affected by land mines, which will continue to need attention and support in
the coming 5 years.
Partners
The main government partners are the Ministry of Social Welfare, Relief and Resettlement
including the Department of Social Welfare and the Relief and Resettlement Department; the
Ministry of Home Affairs, including the Myanmar Police Force; and the Union Supreme Court.
Additional government partners include the General Administration Department under the
Ministry of Home Affairs; the Union Attorney General’s Office; the Ministry of Hotels and
Tourism; the Ministry of Health and Sport; and the Ministry of Education. UNICEF works with
sister UN agencies (UNODC, UNDP, UNFPA, UNHCR, IOM), and relevant NGOs and CSOs
working in the area of child protection in Myanmar. UNICEF also works closely with multilateral
and bi-lateral donors and development partners to ensure child protection activities and
priorities of the Government and the sector are resourced. UNICEF, through its strong
partnerships and convening role consistently supports an integrated approach to addressing
child protection system bottlenecks at national and state/regional levels.
Prioritized Issues and Areas
Poverty is a key driver of household vulnerability and violence against children. One in three
households is living below the poverty line in Myanmar. 88% of the poorest households are
rural and over 50% of all households are exposed to shocks. The greater the number of
children in the household, the more likely that household is to be poor. Households with four
children are four times more likely to be poor than households with one child, and more than
twice as likely to be poor than households with two children. Primary school attendance rates
are high in Myanmar. However, between 12-14 years of age, children begin dropping out
quickly. By the time a child turns 15 there is a 50% chance that they will not be in school at
all, with boys dropping out at a slightly higher pace than girls. Many of these children are
removed from school to help with the family income, with girls more exposed to domestic work
and boys often sent to work in shops and agriculture. According to the census and a recent
ILO report, 20% of children are working, and half of them are under the minimum working age
and/or are working in hazardous environments. The highest prevalence of child labour is in
Shan State. Child labour has been identified as a key area. However, stakeholders recognize
that at least half of economic active children are likely not being exploited. High levels of drop-
out rates in middle and secondary school, inequitable economic growth, and the lack of a
social protection system, are contributing factors for children to be sent to work early. The
work to address middle and secondary transition, including retention, within the education
sector over the next 5 years will help keep children from dropping out early as will investments
in social protection. Child protection will focus on the worst forms of child labour, and efforts
to link systems that can better identify and refer these children to the emerging social work
Programme Component 4) Child Protection
77 |
case management system run by the Department of Social Welfare and civil society and a
child-friendly justice system.
In recent years, Myanmar has seen an increase in reported cases of girls and boys who
experience violence. This is in part due to efforts of the Government and civil society partners
to initiate and strengthen referral mechanisms at community level to social work responses.
In 2015, following the adoption of the National Social Protection Strategy at the highest level
of Government, a formal social work case management system (one of the flagships identified
in the national strategy) was established in the Department of Social Welfare (DSW).
Increasingly, DSW is recruiting, training and deploying social workers who are assigned to
receive and follow up on referrals of violence against children. Despite the limited reach of
DSW given its lack of a presence across the country, 1330 cases have been referred to their
social work case managers, who are cooperating with local NGOs and line ministries and
departments to respond. Increasingly, the social work response of DSW is being linked to a
range of needed actions, moving the government and partners away from an issue driven
approach to a cross-cutting systems approach that addresses a range of vulnerabilities.
Furthermore, ongoing discussions with the Police and Judiciary indicate that increases in child
protection cases are recognized as a critical area to strengthen their capacity to respond in
coordination with other protection actors and to build trust with communities around the
evolving justice responses for children. At this point, the emerging system is mainly reactive –
able to respond to cases of violence and exploitation at later stages. The system does not
have formal links with health and education systems where detection and prevention of early
signs of abuse and exploitation is possible. A key issue identified by stakeholders has been
the absence of specialized child protection and family support services, including family based
alternative care and mental health services. An independent evaluation of this work has found
that while significant efforts are needed to further embed and institutionalize the social work
case management approach within government, it is making a difference in the lives of
children, and ownership of the Government is steadily increasing.
A growing number of children across Myanmar are subjected to some form of institutional
care. There are over 200,000 children in the care of a religious institution, 167,000 of whom
are between the ages of 10-14. While the 2014 census data shows that nearly 700,000
children are being cared for in extended family and non-relative family care, there is no formal
family based care options for children in need of protection (supported kinship care or foster
care). A new pilot by the Government to introduce foster care in Mandalay and Yangon is
underway. However, the limitations of the child care system mean that children will continue
to be placed predominantly in residential care and informally through family-to-family
arrangements in the coming years. Efforts to ensure orphanages do not proliferate further will
be needed. There are no other actors in Myanmar beyond UNICEF working in this area with
the Government.
The number of identified trafficking cases has doubled in recent years (from 300 in 2010 to
600 in 2015). Every year, approximately 15% of identified trafficking cases are children. For
UNICEF, the prioritized entry point based on our strategic value add and the work of IOM, ILO
and other partners in this area will be to further develop synergies and connections between
trafficking interventions and the larger child protection system, including the capacity building
of child protection social workers in DSW, capacity building of the police to address the
Programme Component 4) Child Protection
78 |
growing number of children as victims and witnesses of crime (including trafficking) and
appropriate referral pathways.
Conflict, displacement, and restrictions on the movement of Muslim communities in Rakhine
state result in tens of thousands of children who experience particular child protection threats.
Shan state, which continues to experience ongoing conflict, has the highest rate of child
marriage in the country, particularly for girls. In Shan and Kachin, boys are being recruited in
the context of ongoing conflict. Internally Displaced populations in Rakhine and Kachin lack
access to government protection services and out-migration from Rakhine puts children at risk
of trafficking and other forms of exploitation, especially adolescents. Trafficking is often
masked by the promise of safe migration, with brokers exploiting children and families.
Migration is an important feature of Myanmar’s society, and is in many ways positive. Systems
need to be sensitive and supportive to safely support positive forms of internal and external
migration, but also prevent and respond to exploitation and child rights in the context of
migration. Based on latest data, 1 in 5 persons in Myanmar is a migrant. This includes more
than 3.5 million migrant children, and millions of others whose parents have migrated.
According to global landmine watch groups, Myanmar ranks as the third most contaminated
state in the world. Over the past 12 months, 111 landmine and ERW incidents were
documented (including 48 children), causing 32 deaths and severe injuries to 79 people.
UNICEF will address this issue through its emergency intervention work in areas where the
government is unable or unwilling to provide a protection response; and within its ongoing
collaboration with government, non-government armed groups and partners on responses to
grave violations against children. In Mine Action, UNICEF continues to lead the national Mine
Risk Working Group, creating space for further developments around de-mining, and linkages
for de-mining strategic organizations (UNMASS, HALO, DCA, MAG, etc.).
Although data on children in contact and in conflict with the law is not widely available,
information obtained from the Supreme Court and the Police show that there have been and
continue to be increase in child protection cases in the justice sector. Over the past year there
more cases have been reported to police and the justice system for a response. In Myanmar’s
criminal justice system, it is increasingly acknowledged that underlying causes of child
offending are often related to psychosocial or socio-economic issues that child and family are
facing, necessitating the need for a better partnership with child protection and welfare actors
in order to successfully tackle the problem and ensure prevention. All of these shifts in thinking
and public demand have helped demonstrate the need for better specialization of justice
system professionals to work on most prevalent issues (including child sexual abuse and GBV
cases, prevalent offences committed by children), increase focus on prevention and while
doing so, establish systematic cooperation with social work case managers, health system
practitioners and providers of specialized services to support girls and boys.
The unique situation of Myanmar’s social, economic and political transition is bringing rapid
changes that require innovative thinking and partnerships to address complex problems.
Sexual exploitation of children in the context of travel and tourism and expanding internet
access is a growing area of concern. The increase in tourism in Myanmar, both domestic and
international, is a great benefit for the country in many ways. The upward trends of tourists
also poses risks for children, including in the area of ‘orphanage tourism’ which can contribute
to the growth of orphanage care for children as a business model and increase risks of sexual
exploitation. Learning from across the region, including in Cambodia and Bali, show a direct
Programme Component 4) Child Protection
79 |
linkage between the growth of tourism and child protection concerns. Innovative partnerships
and approaches that bring together the Ministry of Hotels and Tourism with the Police and the
Department of Social Welfare are needed that bridges to the private sector, particularly in the
hospitality and tourism sector. There will be efforts to expand on the good work initiated by the
Government in this area. Similarly, the increase in internet access, from 20% in 2013 to an
anticipated 80% by the end of 2017, presents both opportunities and risks for children.
Ensuring the growing access to the internet is leveraged as an opportunity to reach children
with information to better protect themselves will need to be complemented with efforts to
increase their protection from online exploitation risks.
Based on the criticality and scale of issues identified, UNICEF’s comparative advantage, an
understanding of investments and contributions by development partners within the sector,
expected resource availability, knowledge of effective solutions, and lessons learned from
previous Programme, the Child Protection Programme will prioritize the following key areas.
1) violence against children, including gender based violence; 2) alternative care for children
who cannot be otherwise cared for in their family environment; 3) children in contact with the
law (as victims, witnesses and/or perpetrators); 4) children affected by emergencies,
displacement, or restrictions on freedom of movement; 5) children affected by armed conflict,
including children affected by landmines.
Proposed Focus for 2018-2022 (Outcome and Outputs Result):
Outcome Statement: By 2022, all boys and girls in Myanmar are covered by a child protection
system that fosters prevention and timely response to and recovery from violence, exploitation
and separation from family.
The work of UNICEF will aim to strengthen a holistic child protection system. The core focus
is on prevention and response to violence, with attention focused on sustainability and
supporting the development of national capacities, including capacity of justice actors to
address child victims, witnesses and perpetrators in line with international standards; and
efforts to reach children in situations of sudden onset and protracted emergencies. The work
recognizes the importance of addressing social norms related to violence, and addressing the
issues of gender based violence, especially as it relates to adolescent girls.
Building on the work of the current country programme UNICEF will continue to support the
establishment of social work case management in the Department of Social Welfare and its
connectivity to relevant justice, education and health responses. This effort will enhance the
capacity of Government to effectively monitor, report and respond to all boys and girls who
are at risk or become victims of violence, abuse, exploitation and neglect. The work with the
justice and security sector will aim to increase specialization for addressing the increased
number of child protection cases, and strengthening accountability frameworks. These efforts,
which UNICEF has been working with government to strengthen in the current country
programme, will be further enhanced in the new country programme, bringing greater
coherence and convergence across efforts of the social and justice sectors.
Output 1: By 2022, increased capacity of national and sub-national social service, justice and
security sector to prevent, identify and provide quality and adaptive responses to child
protection violations, including before, during and after emergencies.
Programme Component 4) Child Protection
80 |
Continued efforts to strengthen the capacity of the Department of Social Welfare to recruit,
train, deploy and support social work case managers for child protection will be augmented
with efforts to engage the Ministries of Health and Education. Work within the police and
judiciary has advanced in the current country programme, with police committing to appoint
child protection focal points in township level police stations who can work with the Department
of Social Welfare expanded social work case managers to address cases of violence and
abuse. The next country programme will build on this commitment, with UNICEF supporting
capacity building of police, strengthened supervision and monitoring, and enhancing linkages
with social welfare, health and education. NGOs will continue to play a critical role, however,
as the government continues to develop and expand their efforts, a new role for key child
protection NGOs will need to take shape. The convergence of police, social welfare, health
and education capacity to identify and respond will be bridged to other child protection issues
in an effort to build one effective system that can respond to many vulnerabilities. Ongoing
work with the Ministry of Labor and the Factories and Shops will aim to ensure that identified
cases of child labor are linked to emerging social work systems that can assist with best
interest determination, family assessments, and reintegration support. Ongoing efforts to
support the Anti-Trafficking Task Force to better address prevention, reporting and response
to child victims of trafficking will also be brought further in line with the national child protection
system, maximizing synergies and complementarities. The recent attention to children on the
street will also benefit from capacity building of front line child protection social workers to
address the growing phenomenon ‘street children’. Focusing on social work outreach,
ensuring a child and family-centered approach will help further move away from a system that
institutionalizes children to one that supports their ability to live safely in communities. There
will be efforts to ensure that the capacity building efforts of Government in the area of child
protection social work and child friendly justice responses are continuously bridged to these
difficult to reach areas including IDP camps, and conflict sensitive areas.
A strong focus will be placed on strengthening the internal training institutes of the line
Ministries to produce ‘at-scale’ results, including support to the Department of Social Welfare
to be ‘first responders’ to child protection in sudden onset emergencies and natural disasters.
In addition, partnerships between Government agencies recruiting child protection specialists
and emerging academic programmes in social work and child protection, including with
Yangon University will be expanded. The work will build on innovative partnerships to ensure
gender empowerment at the level of social work service delivery and the justice response,
including through innovative approaches with University based design thinking groups and
youth and adolescent networks. In addition, efforts to strengthen Government’s capacity to
collect and disaggregate key data from the evolving child protection social work and justice
response system will assist with scaling up effective interventions and advocacy for increased
budgets. Ensuring an approach that is sensitive to gender dimensions, including sexual
exploitation of adolescent girls and the over-representation of boys in the justice system will
be embedded into the capacity building efforts with government. A national study on violence
against children will help to further strengthen understanding of the social norms that drive
violence, and strategies to address these in schools, communities and institutions.
Output 2: By 2022, key institutions and service providers have increased capacity to boost
the coverage and quality of specialised child protection services.
Programme Component 4) Child Protection
81 |
The efforts highlighted in Output 1 will result in an increased number of child protection cases
being addressed by Government and civil society. While social work and a child friendly justice
and security sector response is important, there will be an increased need to develop
specialized services that can be used by front line protection actors. In this regard there will
be continued efforts to develop alternatives to institutional care for children, including foster
care and supported extended kinship care. Intensive dialogue with institutional care providers
will be a feature of the work, particularly faith leaders, in an effort to promote a transformation
from a largely institutional based care system to a family support, community-based care
system. In addition, continued efforts to mitigate the impact of tourism growth on child
protection will focus on expanding from initial awareness and pilots to institutionalized
systematic awareness raising, training and defined accountabilities in the response to
instances of sexual exploitation and separation from family. Child protection social workers
and justice professionals in relation to alternative care will be clearly defined and supported.
Standards for foster care and residential care will be developed and implemented with the
Ministry of Social Welfare, Relief and Resettlement. Building partnerships with the travel and
tourism sectors around prevention of orphanage tourism, ensuring that the increased risks
associated with commercial sexual exploitation of children in the travel and tourism sector are
addressed will be complimented with studies and evidence to support implementation.
Specific services in Mine Action, reintegration of children from different forms of child
protection violations: trafficking, recruitment and use in armed groups and armed forces,
institutional care, including frameworks and universal ‘minimum package of support’ services
for children in need of social-economic reintegration, will also be needed. The increased
number of reported cases of sexual violence against girls to the police and the department of
social welfare require specialized services to address victims of sexual violence, and
awareness raising to enhance prevention.
Output 3: By 2022, key civil society groups and Government actors have improved capacity
to monitor grave violations against children and risks related to land mines/ERW and advocate
for prevention and accountability of parties to conflict.
UNICEF will continue to strengthening the Monitoring and Reporting Mechanism (MRM) for
grave violations of children’s rights in the context of armed conflict in line with Security Council
Resolution 1612. Efforts will focus, in particular, on areas where non-state armed groups are
operational, in an effort to expand the reach of the MRM. UNICEF will work in partnership with
civil society and the CTFMR. UNICEF will continue to support and monitor the implementation
of the Joint Action Plan to end the use and recruitment of children in the armed forces. As the
Joint Action Plan is finalized, UNICEF will also support the Government to further
institutionalize complaints mechanisms for under-aged recruitment in national frameworks, to
ensure sustainability. UNICEF will focus its work in the next country programme on developing
signing and implementing plans of action with the listed non-state armed groups, who will be
required to develop and implement action plans with the CTFMR. To assist with this continued
work, there will be a focus on strengthening information management to capture all grave child
rights violations, both for engagement with parties to the conflict, and for effective advocacy.
Accountability will be a core aspect of the work, and UNICEF will continue to strengthen
accountability frameworks and measures within both Government and non-government
actors. Coordination and implementation of mine action, particularly mine risk education,
victim assistance and information management will be continued and strengthened in the new
country programme. In the ongoing implementation of this work UNICEF will ensure that the
Programme Component 4) Child Protection
82 |
voices of adolescents who have been affected by armed conflict are integrated appropriately
in the peace process.
Output 4: By 2022, the Government of Myanmar has improved evidence and capacity to
strengthen the legal and policy framework to protect and further child rights, in accordance
with international and regional standards.
UNICEF will continue to address the legislative environment for children by building on the
new Child Law which, once adopted, will dramatically change the legal landscape for children.
The new country programme will assist the Government to develop Rules and Regulations for
the new Child Law through ensuring a participatory approach with civil society. Other cross-
cutting legal frameworks that UNICEF will support include common age verification
procedures for all concerned ministries, ensuring mainstreaming of key cross-cutting issues
(DRR, emergency, gender etc.) in various legal initiatives, revision of relevant legislation and
bi-laws in relation to trafficking and child labour, and revision of the criminal code. Focus will
also be placed on new legislative initiatives and policies around on-line protection of children.
Myanmar’s increased integration with regional and international frameworks will also be
supported. UNICEF will support the Government of Myanmar to meet its ASEAN commitments
on child protection through, for example, developing a plan of action to eliminate violence
against. UNICEF will also support the Government of Myanmar to develop a national child
protection policy, which will be rooted in emerging good practice. Standard operating
procedures for cross-cutting line ministries and departments to respond effectively and
efficiently to increased child protection referrals will be developed by the Government with
inputs and support from UNICEF> UNICEF will also advocate for Myanmar to ratify OPAC,
and assist with its domestication into national legal frameworks where needed. Building on the
work described in Outputs one, two and three, Awareness raising to the public on new policies
and legislation especially in remote areas where people, including children, are less aware of
their rights, through traditional approaches as well as new approaches via social media, will
be critical to ensure all people in Myanmar are aware of their rights and responsibilities.
Programme Component 4) Child Protection
83 |
Theory of Change Diagram
Results Matrix – Child Protection
Broad ranging partnerships, with national and international institutions to enable legislative and policy formulation and implementation of assistance to families of the most vulnerable, and at risk children. National Human Rights actors effectively contribute to the monitoring and response to child rights violations.
By 2022, the Government of
Myanmar has improved evidence
and capacity to strengthen the
legal and policy framework to
protect and further child rights, in
accordance with international and
regional standards.
Listed parties engage with the UN, and the Government of
Myanmar facilitates access to non-state armed groups and
gives its consent for the signing of Action Plans.
VISION for Change
By 2022, all boys and girls in Myanmar are covered by a child protection system that
fosters prevention and timely response to and recovery from violence, exploitation and
separation from family.
By 2022, increased capacity of
national and sub-national social
service, justice and security
sector to prevent, identify and
provide quality and adaptive
responses to child protection
violations, including before,
during and after emergencies.
By 2022, key institutions and service providers
have increased capacity to boost the coverage
and quality of specialized child protection
services.
By 2022, Government and Non-Governmental actors have improved capacity to monitor grave violations against children and risks related to land mines/ERW and advocate for prevention and accountability of parties to conflict.
Use innovative approaches to model new protection services that are sustainable and can go to scale, and measure the effectiveness of these interventions. Partnerships between Government and private sector actors, particularly the travel and tourism sector, strengthens awareness of child protection concerns.
Strategic engagement with listed parties to effectively and transparently develop, sign and implement Action Plans to end use and recruitment of children will require strong data and evidence. Broad ranging partnerships with civil society, religious groups, government and non-governmental actors will be required to build trust, maintain neutrality and achieve results.
Outputs Implementation Strategies
Capacity building through strategic partnerships in order to build a cadre of professionals across all sectors who are dedicated and specialized in child protection awareness raising, prevention, and response. Create politically strategic linkages to national frameworks and policies, and leverage data collection and analysis for advocacy. Strengthen Government capacity for planning budgeting. Address demand side bottlenecks through strategic engagement with communities applying a C4D lens.
Political and/or religious or ethnic tensions weaken the Government and partner’s ability and
Risk
Natural disasters may overwhelm national capacities to deal with child protection
The Government and non-governmental actors continue to
prioritize human resource capacity building, including allocation of necessary resources; and line ministries and departments
coordinate and contribute to
The Government and key stakeholders continue to invest in necessary specialized services for
protection, utilizing innovative approaches and learning from the
experience within the region.
Assumptions
Government is willing and able to translate international legal
obligations into strong domestic legal and policy frameworks that can be implemented, particularly in its efforts to strengthen rule of
law for children.
Advocacy and dialogue with key partners, including leveraging the voices of adolescents, maintains focus on the child protection agenda and ensures that all partners are doing their part to support a functioning system
Programme Component 4) Child Protection
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Results Matrix – Child Protection
Key results Progress indicators Baseline Target Means of
verifications
Key partners
Sustainable development Goal:
UNDAF Outcome:
Outcome Statement
Outcome 4: By 2022,
all boys and girls in
Myanmar are covered
by a child protection
system that fosters
prevention and timely
response to and
recovery from violence,
exploitation and
separation from family.
4.1: Proportion of boys and
girls covered by child
protection systems as per
agreed criteria
16% (Girls 16%;
Boys 17%)
Total:50%;
Boys:50%;
Girls: 50%
Numerator:
Department of Social
Welfare (Coverage of
Child Protection Social
Workers); CPiE
Database.
Denominator: Census
data (2014).
Ministry of Social Welfare
Relief and Resettlement;
Department of Social
Welfare; CP sub-sector;
SPCRM.
4.2: Proportion of boys and
girls accessing child protection
services
0.04% (both
0.04% for boys
and girls)
Total: 2%;
Boys: 2%; Girls:
2%
Numerator: DSW case
management IMS and
alternative care
database; CPiMS
database; CAAC
database; trafficking
survivor’s database.
Denominator:
Numerator from
indicator on coverage.
Ministry of Social Welfare
Relief and Resettlement;
Department of Social
Welfare; Myanmar Police
Force Anti Trafficking Task
Force; CP sub-sector;
SPCRM.
UNICEF Child Protection Programme Outputs
4.1. By 2022, increased
capacity of national and
sub-national social
service, justice and
security sector to
prevent, identify and
4.1.1. # of child protection
cases, including in
development and humanitarian
situations, followed up through
the national case management
system
2287 (including
750 cases in
humanitarian
context)
56,449* DSW Case
Management IMS;
CPiMS data on case
management.
Ministry of Social Welfare
Relief and Resettlement;
Department of Social
Welfare; Myanmar Police
Force Anti Trafficking Task
Force; CP sub-sector
Programme Component 4) Child Protection
85 |
Key results Progress indicators Baseline Target Means of
verifications
Key partners
provide quality and
adaptive responses to
child protection
violations, including
before, during and after
emergencies.
4.1.2. Number of townships
and displaced communities
covered by case management
services
109 (including 37
townships by
DSW, 72 villages
and camps within
the disaster and
conflict affected
areas)
300 (townships,
villages and
camps)
Sector and sub-sector
reports.
Ministry of Social Welfare
Relief and Resettlement;
Department of Social
Welfare; CP sub-sector.
4.1.3. Number of townships
with police and judiciary
trained on child protection
curricula
3 50 Sector reports; training
records of MPF and
Union Supreme Court.
Myanmar Police Force,
Union Supreme Court, and
DSW
4.1.4. Child protection referral
mechanism for health,
education and justice sectors
developed and operational
(SCALE: 0- referral
mechanism does not exist; 1-
referral mechanism drafted for
DSW and justice sector; 2-
referral mechanism drafted for
health and education sectors;
3- referral mechanisms are
adopted; 4 - referral
mechanisms are
operationalized)
0 4 Consultation reports,
drafts, final endorsed
mechanism(s).
Department of Social
Welfare, Myanmar Police
Force, Union Supreme
Court, Ministry of Health,
Ministry of Education
4.1.5. # of children and
community members
participating in awareness
raising activities in line with a
national level action plan on
482,889 1,000,000 DSW, MPF, MoH,
MoE, CPWG and
MRCS databases.
DSW, Myanmar Police
Force, Ministry of Health,
Ministry of Education, Child
Protection Working Group,
MRCS.
Programme Component 4) Child Protection
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Key results Progress indicators Baseline Target Means of
verifications
Key partners
prevention of and response to
child protection violations
4.1.6. % of disaster affected
children who have access to
case management services.
N/A 80% Department of Social
Welfare and CPWG
databases.
DSW, CPWG, OCHA
4.1.7. Government and other
implementing partner adopt
DRR/Child Protection
framework to better protect
children before, during and
after man-made and natural
disasters. (0 – not available; 1
– draft available; 2 –
consultations on draft
conducted; 3 – final draft
available; 4 – final draft
endorsed and adopted)
0 4 Sector reports CPWG members, DSW
Union & State, ASEAN
DRRWG
4.2. By 2022, key
institutions and service
providers have
increased capacity to
boost the coverage and
quality of specialised
child protection
services.
4.2.1 Proportion of children in
residential care out of the total
number of children in formal
care
100% 80% DSW database on
registered
orphanages; Ministry
of Religious Affairs
databases; Studies
and Sector Reviews.
Ministry of Social Welfare
Relief and Resettlement;
DSW; Ministry of Religious
Affairs; National Alternative
Care Working Group.
4.2.2 Specialized alternative
care, integrated victim support
services and diversion
developed for children
(SCALE: 0-not available; 1-
gaps in availability of
specialized services identified;
2- options for specialized
0 4 Sector reports. Department of Social
Welfare, Myanmar Police
Force, Specialized NGOs,
subject area experts.
Programme Component 4) Child Protection
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Key results Progress indicators Baseline Target Means of
verifications
Key partners
service models developed; 3-
at least one specialized
service model developed; 4 -
at least two specialized service
models developed)
4.2.3 Proportion of children
alleged of or having committed
offences that were diverted or
offered alternatives to
detention.
81.7% 90% Myanmar Police
Force, Union Supreme
Court, DSW
Information
Management System
for case management
system
Myanmar Police Force,
Union Supreme Court and
DSW
4.2.4 Percentage of children
released from armed forces
and armed groups and
survivors of other grave
violations enrolled in socio-
economic reintegration
80% 90% CPIMS, PRIMERO,
IMSMA
DSW, MRCS, RMO, KMSS,
Save the Children
4.2.5 % of contaminated
townships equipped with a
victim assistance service
directories for child survivors
of landmines/ERW and
children living with disabilities
10% 60% MRWG/VATG website,
directories
MRWG partners, DSW, HI,
MRCS
4.3. By 2022, key civil
society groups and
Government actors
have improved capacity
to monitor grave
violations against
4.3.1. Number of listed armed
groups in the annex to the
report of Secretary General on
children and armed conflict
that implement signed action
plans with the UN to stop and
1 5 Annual SG Report on
CAAC, GHN
National Prevention
Committee, Listed NSAGs,
CTFMR partners, Civil
Society Groups in and near
non-Governmental controlled
areas.
Programme Component 4) Child Protection
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Key results Progress indicators Baseline Target Means of
verifications
Key partners
children and risks
related to land
mines/ERW and
advocate for prevention
and accountability of
parties to conflict.
prevent use and recruitment of
children
4.3.2. Percentage of
individuals and communities
living in contaminated areas
that have increased
knowledge on safe behaviours
towards landmines/ERW
20% of affected
people and
communities in 52
townships in nine
states/regions
60 % of affected
people and
communities in
52 townships
Information
Management System
for Mine Action and
KAP survey report
(compared to results of
2013-2014 KAP)
National and Sub-National
MRWG partners
(Government and non-
Governmental), DCA
4.3.3. Percentage of grass-
root level network/faith based
organizations in conflict-
affected areas aware of
reporting procedures of Grave
Violations against children
28% (14
organizations
including NGOs
and CBOs)
100% (50
organizations
including NGOs
and CBOs)
CPIMS, number of
reported grave
violations, Programme
reports.
CTFMR partners
4.3.4. All State and Union level
coordination platforms on Mine
Action and Monitoring and
Reporting on Grave Violations
against children continue
functioning
6 6 Humanitarian reports MRWG
4.4. By 2022, the
Government of
Myanmar has improved
evidence and capacity
to strengthen the legal
and policy framework to
protect and further child
rights, in accordance
with international and
regional standards.
4.4.1. Child Protection Policy
and Action Plan is drafted,
costed and adopted (SCALE =
0 - None, 1 - First draft of
National Child Protection
Policy (CPP) ad Action Plan
prepared , 2 - Final draft of
National Child Protection
Policy (CPP) ad Action Plan
ready ; 3- Action Plan is
0 4 Child protection policy
draft; reports of
consultation
workshops
DSW, Ministry of Health,
Ministry of Education,
Ministry of Home Affairs,
Union Supreme Court, Union
Attorney General's Office
Programme Component 4) Child Protection
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Key results Progress indicators Baseline Target Means of
verifications
Key partners
costed; 4- National CPP and
Action Plan is adopted
4.4.2. Rules and procedures in
place for the enforcement of
the new Child Law (SCALE =
0 - Rules and Procedures
(R&P) have not been
developed; 1 - analysis of
required procedures
completed , 2 - R&P have
been drafted 3 - R&P
endorsed by respective
government agencies, 4 - R&P
adopted)
0 4 Analysis report;
procedures at various
stages of drafting;
adopted Rules and
Procedures.
DSW, Ministry of Health,
Ministry of Education,
Ministry of Home Affairs,
Union Supreme Court, Union
Attorney General's Office
4.4.3. Justice for Children
Strategy/policy available and
implemented (SCALE = 0 -
strategy does not exist; 1 -
draft of the strategy has ben
developed; 2 - final draft of the
strategy developed; 3 -
strategy endorsed by all
stakeholders 4 - strategy
adopted)
0 4 Strategy drafts;
consultation reports;
strategy/policy
adopted and signed by
all stakeholders.
Ministry of Home Affairs
(Myanmar Police Force,
Prisons Department,
Transnational and Organized
Crime Department, Anti-
Trafficking in Persons
Division), Union Supreme
Court, Attorney General's
Office and Department of
Social Welfare; Parliament of
Myanmar; UNDP, UNODC,
UNFPA, UNHCR, other
development partners.
4.4.4. Alternative care
framework in place (SCALE =
0 - None, 1 - AC framework
drafted, 2 - AC framework
0 4 Alternative care
framework drafted;
Final alternative care
framework; reports of
DSW, Alternative Care
Technical Working Group,
NGO partners, FBOs,
monarchists
Programme Component 4) Child Protection
90 |
Key results Progress indicators Baseline Target Means of
verifications
Key partners
final draft developed, 3 - AC
framework endorsed by DSW,
4- AC framework adopted)
technical working
group; reports of
consultations
Programme Component 5) Social Policy And Child Rights Monitoring (SPCRM)
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Programme Component 5) Social Policy And Child Rights Monitoring (SPCRM)
Introduction
This note describes the Social Policy and Child Rights Monitoring (SPCRM) component of
UNICEF Myanmar’s 2018-22 Country Programme. The key issue that this programme area
seeks to address is the high rate of child poverty in Myanmar. Despite rapid GDP growth over
the last five years (7-8%), recent estimates suggest that close to 60% of all children in
Myanmar live in monetary poverty. This is almost twice the average poverty rate in Myanmar.
In addition to monetary child poverty, detailed recent analysis on the situation of children in
Myanmar also highlights the multiple other deprivations and disparities – especially for children
aged 0-5 (e.g: stunting, child mortality) and 11-17 (e.g: child labour, school dropouts). There
are also notable inequities in these outcomes driven by geography, place or residence and
education levels of household head, among other factors. Children with disabilities and lacking
birth registration are particularly vulnerable. And even as there is increasing data on children
that allows for improved understanding of the factors causing these outcomes, there are still
gaps in terms of systems that can support more regular, disaggregated monitoring of the
situation of children. Very low social sector allocations (especially in Social Welfare) are also
a major bottleneck. However, despite all these issues, the government’s capacities to invest
and implement responses to addressing the various causes of child poverty and inequities is
increasing in Myanmar. This provides significant potential to address factors contributing to
the existing situation, and to ensure sustainable child poverty and disparity reduction.
©UNICEF Myanmar/2017/ Khine Zar Mon
Programme Component 5) Social Policy And Child Rights Monitoring (SPCRM)
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Partners
UNICEF will continue its partnership with Ministry of Social Welfare, Relief and Resettlement
(MSWRR-DSW); Ministry of Planning and Finance (MOPF); Central Statistics Office (CSO);
Relevant S/R Governments; Ministry of Health and Sports (MOHS); General Administrative
Department (GAD), Ministry of Labour Immigration and Population (MOLIP).
Prioritized Issues and Areas
This programme component is articulated with a vision to strengthen government systems and
financing in ways areas that help reduce child poverty and deprivations, informed by better
and more systematic data, to lead to improved socio-economic inclusion, especially for the
most disadvantaged and vulnerable children. This is expected to directly contribute to the
progress towards SDGs 1, 10, 16 and 17, and indirectly contribute to a range of other SDGs.
It is anticipated that improved data and knowledge on children will systematically guide, inform
and evaluate these efforts, as well as contribute to the broader ability of the government to
mainstream SDGs. Based on this vision, the main programmatic goals will be: improved data,
knowledge and M&E systems for children, improved coverage of social protection and
inclusive social programmes (birth registration, and for children with disabilities) for children
and equity based planning and public finance.
Proposed Focus for 2018-2022 (Outcome and Outputs Result):
Based on the context described above, the proposed outcome for the SPCRM programme is
as follows: “Improved policy environment, budgets and systems for all children, especially the
most excluded, guided by improved knowledge and data.” This focuses on a set of actions to
support strengthen evidence, advocacy and capacities to enable an improved policy
environment, budgets and integrated government systems to reduce child poverty and
associated vulnerabilities. While the reduction of child poverty requires multi-faceted efforts
from a range of UNICEF programme areas, there are some macro factors that either limit an
understanding of the issues around it or hamper capacities to address these issues (e.g.: data,
planning, public finance) which the SPCRM programme area will focus on. There will also be
an emphasis on responses to child poverty and vulnerabilities that require multi-sectoral
responses (like birth registration, disabilities) and/or a focus on the economic aspects of
inclusion for children (e.g.: social protection). This will be especially important in helping
accelerate strengthening Myanmar’s capacity for the achievement of the SDGs. Based on this
outcome, this programme component is comprised of 3 key pillars of work (Outputs):
Output 1: By 2022, the government has strengthened capacities to develop, manage and use
M&E systems addressing the situation of children in Myanmar.
This output is centered on child-focused data and analysis (esp. child poverty), including
through strengthened M&E systems. Its main objective is to improve the data/analytical
environment on critical child related indicators (SDG related in particular) and issues,
especially through partnership-focused approaches with national counterparts, and in a
coordinated manner with other UN agencies and all development partners. The focus on
strengthening capacities to produce administrative data – at national and sub-national levels
– is an explicit recognition of the importance of robust administrative data systems with the
onset of the SDG era. There are 3 key areas of work under this output: a) First, facilitating
discussions, enhance capacities and, when required, contribute to filling child data gaps and
Programme Component 5) Social Policy And Child Rights Monitoring (SPCRM)
93 |
inequalities in information, especially at subnational level and in areas where access to
information remains particularly challenging; b) Second, supporting relevant partners to
strengthen their abilities to transform data into knowledge about all children in Myanmar; and
c) Third, and as the most substantive pillar under this output, supporting selected government
bodies to strengthen their Monitoring and Evaluation systems and their capacity to manage
them, so that they can generate child-related and equity sensitive information accurately and
regularly, at both national and subnational levels.
Assumptions: Approval of draft Statistics Law, including provisions on survey coordination;
Decentralization of the CSO, with presence of CSO officials at the township level – measure
already approved but it will take some time to have all staff in place; Establishment of high
level commission on quality of statistics; Establishment of M&E units in all ministries –
measure already approved, to be implemented by the beginning of the new CPD;
Establishment of a “programme appraisal” department within the Ministry of Planning and
Finance, expected to include programmatic evaluation functions – measure already approved,
staff and Terms of Reference for the department expected to be in existence by the start of
the next CPD; Establishment of a research unit in the Ministry of Social Welfare, Relief and
Resettlement.
Output 2: By 2022, the government has enhanced abilities to systematically provide inclusive
and integrated social programmes and social protection.
The extent of socio-economic exclusion and vulnerabilities faced by children in Myanmar, and
which contribute to the high rates of child poverty as mentioned earlier, is clear from UNICEF’s
Situation Analysis. As part of the SPCRM programme component, in areas requiring cross-
cutting and integrated efforts, UNICEF can contribute to enhance government systems and
capacities to address some key causes of such exclusion. This includes: a) helping expand
child sensitive social protection coverage to tackle high rates of child poverty and invest in
Myanmar’s ‘cognitive capital’, especially building on current efforts by DSW/MSWRR in the
implementation of the National Social Protection Strategic Plan, starting with the integrated
modality (cash transfers and case management) for implementing the Maternal and Child
Cash Transfer Programme being rolled out in Chin State; b) assisting the effective functioning
of a Civil Registration and Vital Statistics (CRVS) system that helps ensure the right of every
child to birth registration (which builds on ongoing efforts by the CCBDR and IAWG/CSO to
revise the Vital Registration Manual that brings VR practices in line with child rights principles
and hence removes key bottlenecks to Universal Birth Registration and Vital Registration);
and c) supporting improved coordination capacity and systems that enhance social inclusion
of children with disabilities (informed by the first ever Situation Analysis on Children with
Disabilities in Myanmar that DSW/UNICEF produced, which was recently launched). Based
on Myanmar’s context and UNICEF’s comparative advantage (building on existing
experiences), all of these efforts will help an increased proportion of vulnerable and excluded
children to be reached through inclusive social programmes and social protection.
Assumptions: Political commitment is strong to maintain progressive government budget
allocations to social protection; The CRVS law is successfully passed on time (2017) with an
identified Civil Registrar General function; Continued prioritization for CSO’s expansion at the
sub-national level; The necessary by-laws for the law on the right of PWD are passed in the
parliament in a timely manner
Programme Component 5) Social Policy And Child Rights Monitoring (SPCRM)
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Output 3: By 2022, there is improved evidence, capacity and systems for equity sensitive
planning, budgeting and implementation.
This output has the overall objective of strengthening government systems, at relevant
administrative levels (Union and S/R), to enable effective and efficient implementation of
equitable programmes for children. Given how a range of factors related to planning and
budgeting have been identified as key bottlenecks to reduce child poverty and inequities, some
of which UNICEF has expertise and experience to help address, it is logical to have a
dedicated focus on these issues. While it is not possible for UNICEF alone to address wider
planning and budgeting/PFM challenges, it can make a strategic contribution through focused
and strategic efforts, advocacy and partnerships in 3 areas: a) further analysis and
assessment(s) on the decomposition and trends of social sector budgets (health, education,
social welfare); b) Continued strengthening of MSWRR’s planning and budgeting capacities
to increase its ability to effectively, efficiently and equitably implement key programmes that
reduce child poverty and inequities; and c) technical support to States/Regions in helping
strengthen their ability to undertake sub-national planning that is more evidence based (also
linking to efforts on producing quality sub-national data on children as part of Output 1) and
equity sensitive, in collaboration with other UN agencies and development partners also
supporting broader local planning approaches. Assumptions: Disaggregated expenditure data
(e.g. World Bank’s BOOST database) is publicly available to enable child-focused analyses
and advocacy; States/Region governments receive increasing administrative and fiscal
responsibilities; the government’s overall PFM reforms continue – in order to maintain the
interest and direction for line ministries to improve their PFM
Programme Component 5) Social Policy And Child Rights Monitoring (SPCRM)
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Theory of Change Diagram
VISION for Change
Children in Myanmar have equitable access to social protection and social services.
Expanded systems (social protection, registration system for CwD and birth registration)
and adequate social sector financing are in place to help realize this goal. Improved data
and knowledge on children systematically inform these efforts.
By 2022, the government has strengthened capacities to develop, manage and use M&E systems addressing the situation of girls and boys in Myanmar
By 2022, the government has enhanced abilities to systematically provide inclusive and integrated social programmes and social protection.
By 2022, there is improved evidence, capacity and systems for equity sensitive planning, budgeting and implementation.
Enabling environment and coordination frameworks progressively strengthened (e.g: Social Protection Law, CRPD Committee) to facilitate continued or increased political support for improved policy environment to help reduce social exclusion faced by the most vulnerable children.
Improvements in the design, implementation, monitoring and evaluation inclusive and integrated social programmes (social model driven certification/registration for CwD, e-platform for vital registration, social protection flagship programmes) enable authorities to implement effective systems for reduced child poverty.
Relevant government and other stakeholders undertake systematic research and analysis for enhancing programme effectiveness and advocacy to secure buy-in for expansion in coverage
Relevant government agency/departments (e.g: MOPF) are able to undertake more detailed child focused public expenditure assessment(s) to better understand areas requiring further investments to reduce child poverty.
Strengthened MSWRR capacity for planning and budgeting for efficient, effective and equitable implementation of its mandated programmes.
Select States/Regions are able to integrate an equity and child-focused angle in regular planning practices and approaches.
Outputs
Implementation Strategies
A ‘platform’ is created to discuss data gaps related to children, and ways in which they can be addressed (including through UNICEF support in critical areas).
Systematic conversion of data to information and knowledge (including dissemination efforts) for policy use and public consumption, as well as for statutory reporting on children and women’s rights.
Key government departments, at national (MSWRR, CSO, Planning Dept.) and sub-national (Planning Dept., CSO) levels, have systems to support the regular monitoring and evaluation of the situation of girls and boys in Myanmar
Continued weaknesses in
coordination; Shortfalls in
external political prioritization and
financing
Risk
Relevant statistical laws and frameworks are approved, and institutional structures are progressively in place.
Continued willingness by government and public to increasingly demand and use evidence/knowledge
Government is willing and able to formulate and implement commitments (including data related) for equitable social sector financing. Expected increase in sub-national decentralized decision-making, especially in the social sectors, transpires.
Assumptions
The government and related stakeholders continue to understand the urgency of improved birth registration and social protection for children.
Government and other actors have improved awareness of on the importance of social inclusion for CwD. Relevant policy and legal frameworks are enacted in a timely manner.
Programme Component 5) Social Policy And Child Rights Monitoring (SPCRM)
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Results Matrix- SPCRM
UNICEF Myanmar Country Program Result Matrix 2018 - 2022
Key Performance Indicators
Partners
Indicator Baseline Target MOV
Outcome
Outcome 5: Improved policy environment, budgets and systems for all children, especially the most excluded, guided by improved knowledge and disaggregated data
5.1: Number of children covered by social protection systems
1) 0 (2016) 1) 500,000 (2021/2022)
1) Admin records of relevant implementing departments (DSW etc)
MSWRR (Lead)
5.2: Public social sector expenditure (% of GDP)
2) 3% (2016) 2) at least 5% (2021/2022)
2) Public budget laws (numerator) + IMF article 4 (denominator)
MOPF (Lead)
5.3: Existence of disaggregated national household survey data on child-focused targets of SDGs collected within the preceding 5 years
3) 8 (DHS, Census, MLFS, MPCLS, MLCS, MICS, IHLCA2, HIES2012) (2017/2018)
3) at least 8 (2021/2022)
3) Publicly available reports
CSO (Lead)
Output 1
Geographic Coverage: National
5.1. By 2022, the government has strengthened capacities to develop, manage and use M&E systems addressing the situation of children in Myanmar.
5.1.1. Number of child-related SDG indicators with disaggregated data collected
17 (19 UNICEF priority indicators have a baseline in the UNDP report, but the 2 WASH indicator values are deemed incorrect) (2016)
29 (actual number of priority indicators for Myanmar needs to be defined) (2021/2022)
CSO and line department databases
CSO, MSWRR
Programme Component 5) Social Policy And Child Rights Monitoring (SPCRM)
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UNICEF Myanmar Country Program Result Matrix 2018 - 2022
Key Performance Indicators
Partners
Indicator Baseline Target MOV
5.1.2. Number of knowledge products and reports produced by UNICEF on child-related issues in the previous 2 years, including at sub-national level
4 (2017 SitAn; 2016 CWD Sitan; 4 CFTSP)
At least 10 (Child poverty study, disability studies, SitAn, subnational studies, etc.) (2021/2022)
Publications CSO, PD, MSWRR, Relevant S/R Governments
5.1.3. Number of systems strengthened to routinely monitor and evaluate the situation of children, including at sub-national level
0 (2017/18) At least 4 (NECD, DSW, sub-national platforms and fora, etc.) (2021/2022)
Publication of reports; UNICEF trip reports/programme visit reports
CSO, PAPRD, MSWRR, Relevant S/R Governments
Output 2
Geographic Coverage: National
5.2.By 2022, the government has enhanced capacity and improved systems to implement inclusive and integrated social programmes and social protection
5.2.1. Existence of strategies and mechanisms to increase inclusion of excluded children into social protection
1 (2016) at least 5 (2022) Meeting minutes, UNICEF Trip Reports, TORs of committees
MSWRR, MoHS, MOPF, Parliament
5.2.2. Existence of monitoring and evaluation mechanisms to follow up on social protection delivery/system
0 (2016) at least 10 (2022) Availability of reports MSWRR, CSO
5.2.3. Availability of national sex-disaggregated data on child rights realisation, including data on CWD
0 (2016) at least 5 (2022) MSWRR/DSW admin records
MSWRR, MoHS, Parliament
Programme Component 5) Social Policy And Child Rights Monitoring (SPCRM)
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UNICEF Myanmar Country Program Result Matrix 2018 - 2022
Key Performance Indicators
Partners
Indicator Baseline Target MOV
5.2.4. Existence of free and universal birth registration service within the civil registration in accordance with national legal requirements
0% (2016) at least 5 (2022) UNICEF trip/programme visit reports
CSO, MOHS, GAD, MOLIP
Output 3
Geographic Coverage: National
5.3. By 2022, there is improved evidence, capacity and systems for equity sensitive planning, budgeting and implementation.
5.3.1. Public financial management capacity in the MSWRR to support planning and implementation of policies for vulnerable groups
1 (2017) 3 (2022) UNICEF TA project monitoring reports
MSWRR, MOPF
5.3.2. Number of information and reports on child-focused public expenditures (direct, indirect and total) produced by government
2 (2014 study, budget database)
at least 5 (2022) Publications/reports MOPF, Parliament
5.3.3. Local governments with functioning mechanisms for public engagement by men and women in local planning, budgeting and monitoring processes
2 (Chin, Thanintaryi) (2017)
5 (2022) UNICEF trip/programme visit reports
MOPF, Relevant S/R Governments
i Census 2014