unicef myanmar short programme strategy notes: 2018-2022...

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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


Proposed Focus for 2018-2022 (Outcome and Outputs Result): ................................................ 67


Results Matrix - Education ................................................................................................................ 72

Programme Component 4) Child Protection .............................................................................. 75

Introduction .......................................................................................................................................... 75

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Partners ................................................................................................................................................ 76




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




Results Matrix- SPCRM ..................................................................................................................... 96

Country Programme Document Myanmar

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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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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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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%.


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%



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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.


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’.


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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


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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


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


20 |






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


Others include:

Child protection subsector; Sector Coordination

11 882 13 758 25 640


21 |






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


22 |






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


23 |






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


24 |






RR OR Total

Total resources 76 705 130 803 207 508

Programme Component 1) Health and Nutrition

25 |


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


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.


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


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


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)


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


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).


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


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.


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.


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.


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


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%)


(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%


(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


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


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),


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-


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


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


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.


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-


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


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


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


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,


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


areas in Yangon


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


and nutrition workers trained

on management of severe

acute malnutrition as per

national standards

0% 50% Administrative data Government

(MOHS, NNC),

UN agencies,

NGOs


facilities reaching more than

0% 60% Administrative data,

programme data

Government

(MOHS, NNC),


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 |


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

https://germanwatch.org/en/cri

https://germanwatch.org/en/download/16411.pdf

http://www.inform-index.org/Portals/0/InfoRM/2016/Country_Profiles/MMR.pdf


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)


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


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)

https://www.adb.org/sites/default/files/institutional-document/33976/files/myanmar-urban-dev-water-sector-assessment.pdf


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)

https://www.adb.org/sites/default/files/publication/42870/myanmar-unlocking-potential.pdf


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:


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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


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.


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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


56 |

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


57 |


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


(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


(Yellow)

GOM reports MALI, MoHS, MOE

and CDC

2.1.5. Existence of water,


planning mechanism


(Yellow)

MALI/MOE and

MOHS annual

reports

DRD/MALI, MoHS,

DBE/MOE and CDC


58 |


verifications

Key partners

2.1.6. Existence of water,


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,


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


59 |


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


(Yellow)

DRD/MALI/MOHS

reports

DRD/MALI, MOHS,

CDC

2.2.7.Guidelines and manuals for

rural and peri-urban water supply

available


(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


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


60 |


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


support

N/A

1,500

MOHS report,

UNICEF Annual

report

MOHS, CDC, CSOs


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


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


(Yellow)

MOHS report,

UNICEF Annual

report

MOHS, CDC, CSOs


CLTS/CATS for rural and peri-

urban sanitation available


(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


implementing National Standards

for WASH in Schools available


(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


61 |


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


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


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


(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


62 |


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


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



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


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


63 |


verifications

Key partners



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 |


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,



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.


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


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.


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.


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.


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).


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.


71 |


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


72 |

Results Matrix - Education


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


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


partners


73 |


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




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


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



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




74 |


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 |


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



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.


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


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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


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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


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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.


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.


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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.


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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


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.


83 |


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


84 |

Results Matrix – Child Protection


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;


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.




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.




Welfare; Myanmar Police

Force Anti Trafficking Task

Force; CP sub-sector


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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.




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).


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.


86 |


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.



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.


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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.


88 |


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


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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


90 |


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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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.



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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).


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.


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


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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


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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


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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.


96 |

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


97 |



Partners


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


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


98 |



Partners


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


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

unicef myanmar short programme strategy notes: 2018-2022...

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