Myanmar is one of the poorest countries in Asia and ranks at 145 out of 188 countries in the Human Development Index. Although the country’s transition from decades of military rule has sparked major transformations, long-term chronic underfunding in the public sector has made out-of-pocket expenditures for health among the highest in the world. Consequently, the private sector is an essential channel for delivering health services.
In this context, PSI/Myanmar, in partnership with Living Goods, launched the Win-Win Network in April 2015 with our first site in Dedaye Township in the Ayeyarwady Region.
The Win-Win network has grown steadily and now includes 250 active CHWs spread across four hubs in four townships, in Seik Phyu (Magway Region), Shwe Pyi Thar (Yangon Region), Thabeikkyin (Mandalay Region), and Pekon (Shan State).
How it works
Win-Win is a network of community-based independent micro-entrepreneurs (88% women) who deliver health education and services and socially-impactful products in rural and peri-urban communities in five townships across Myanmar. Win-Win targets communities with high rates of informal settlements, and low infrastructure and access to health services, which often correlates to a lack of economic opportunities.
Win-Win equips CHWs with the knowledge and capacity to deliver health education and services covering a wide range of relevant topics including nutrition, family planning, maternal and child health, TB and malaria. Treatments for non-communicable diseases such as hypertension will be introduced soon. Monthly training and individual performance coaching visits reinforce and refresh knowledge and skills and enable the introduction of new topics over time. Win-Win CHWs work part-time, based on their own schedules and objectives.
In addition to delivering basic health services, CHWs sell a range of products addressing various health needs (such as nutrition, fever, diarrhea, deworming, water purification, pregnancy tests, supplements, and contraception), as well as hygiene products for the whole family. CHWs are supported with valuable business and marketing skills, and a “business-in-a-bag” approach to encourage door-to-door sales. The basket of goods is dynamic and carefully designed to meet the communities’ needs.
PSI/Myanmar acts as a wholesaler to the entrepreneurs, retaining a small margin to cover the costs of recruiting, marketing, training, and managing the network.
Living Goods provides technical support to PSI/Myanmar for the design and implementation of this network with a manager placed with PSI/Myanmar, and providing strategic direction to their senior leadership to maximize the scale and impact of the initiative.
Active CHWs generate more than $20 per month, most of which comes through sales. This is particularly valuable for women, who often juggle the competing demands of family, work, and household responsibilities. An informal qualitative survey of Win-Win’s CHWs suggests that the typical family revenue increases by 30% after joining, and CHWs report high levels of community recognition and enhanced social status.
active CHWs in Myanmar
Our growth plans
From five hubs and almost 300 active CHWs today, we seek to grow to seven hubs and 700 CHWs by end 2020. As we grow, we are continuously seeking to increase our health impact while improving financial sustainability. We are currently exploring the possibility of investing in mobile technology to support and monitor the CHWs’ activities. We are also working on a concept to integrate Win-Win CHWs within the Universal Health Coverage pilot that PSI is conducting in partnership with the Myanmar Ministry of Health.