track outcomes; and advocating for long-term solutions that national health systems can adopt.
Given this wide-ranging scope, “project management is fundamental,” says Phone Si Hein, MD, project manager, Save the Children, Yangon, Myanmar.
“It’s through effective project management—
managing our resources and people effectively—that we’re
able to improve the quality of care.”
BUILDING TRUST
From the beginning, the Save the Children team
encountered significant challenges. First, to proceed
with the project, approvals and contributions were
required from all stakeholders. That meant not
just USAID and URC but also national, provincial
and local government bodies had to sign off on the
plan—along with nonstate armed ethnic groups at
odds with Myanmar’s government that are active in
the border region.
“Previously, nonstate actors did not trust government or government-affiliated organizations, so we
needed to coordinate with those two sides and build
trust among those partners,” says Dr. Hein.
The challenge of developing those relationships
in the communities vulnerable to malaria was
exacerbated by armed conflict, rainy-season flooding and obstruction by village leaders. Along with
difficulty securing government approvals, those factors delayed the project’s start by six months. But
the team eventually cultivated consensus among all
stakeholders.
“The team met with Myanmar’s national ministry
of health first. Then, with approval and guidance
from them, we went to the state health director to
discuss our program. After that, we had a meeting
with the nonstate actors in the area,” says Kyi Kyi
Ohn, MD, head of health programs, Save the Children, Yangon, Myanmar.
In some cases, two or three “anti-resistance”
meetings were required. In all cases, local health-
care workers were critical. “Because our project is a
community-based project, we have to recruit local
volunteers for case management,” Dr. Hein says.
“Without them, we cannot gain trust.”
While most public health projects suffer from a
lack of resources, Save the Children has contended
with an abundance: There are so many
organizations executing anti-malaria
projects in the southeast region of Myan-
mar that avoiding duplication can be a
challenge. The organization has had to
pull out of several villages mid-project
to make room for other initiatives newly
endorsed by local communities.
In such an environment, adaptability
is a big part of achieving project objec-
tives. “Part of ensuring health outcomes
is constantly re-evaluating, reassessing
and readjusting our activities to see the
changes we want,” Dr. Ohn says. For
example, after the team noticed that
the government and some armed eth-
nic groups were still not on the same
page regarding the project, it conducted
coordination meetings with ethnic
health organizations to discuss problems
accessing villages to conduct prevention
activities.
As with many public health projects, it
may take years to determine whether it
achieved its objectives of long-term and
sustainable positive health outcomes.
But it’s already yielding results in the
form of best practices.
“Throughout, we’ve seen the importance of
what might be considered soft skills, like com-
munication and relationship building. But they’re
not soft at all—they’re fundamental, and all project
managers working in public health need them,”
says Alyssa Davis, thematic adviser-health, Save
the Children, Yangon, Myanmar. “If we want to
achieve public health goals, we need to apply les-
sons learned at scale through partnerships that go
beyond borders.” PM
We’ve seen the
importance of
what might
be considered
soft skills, like
communication
and relationship
building. But
they’re not soft
at all—they’re
fundamental,
and all project
managers
working in
public health
need them.”
—Alyssa Davis, Save the
Children, Yangon, Myanmar
From left, Alyssa Davis, Phone Si Hein, MD, and Kyi Kyi Ohn, MD, all of Save the Children, Yangon, Myanmar