Myanmar's Health Policy
Individual Documents
Description:
"Epilepsy is a major public health problem: it is a chronic noncommunicable disease of the
brain that affects more than 50 million people worldwide. Epilepsy accounts for 0.5% of
the global burden of disease and is associated with stigma, physical and psychiatric
comorbidity, and high economic costs. Nearly 80% of people living with epilepsy reside in
low- and middle-income countries, and 75% do not receive the treatment they need.
Over half of the people living with epilepsy worldwide are estimated to live in Asia. In
comparison with Africa, Asia has more untreated patients, with greater treatment costs
and possibly higher premature mortality. According to the WHO Atlas: country resources
for neurological disorders (second edition), the median number of neurologists is extremely
low in South-East Asia (0.1 per 100 000 population) and the Western Pacific (1.2) – far
fewer than the ratio in Europe (6.6).
In Myanmar, it is estimated that around 500 000 people live with epilepsy, a prevalence of 1.1
per 1000 population. An estimated 95% of people living with epilepsy do not receive the care
required. The main reasons for this include the limited number of health care providers trained
to provide care and support to people living with epilepsy, the limited access to anti-seizure
medications, and a lack of awareness and health education about epilepsy.
For more than 20 years, the WHO has led the global movement against epilepsy. Within
the framework of the Global Campaign Against Epilepsy, WHO aims to bring epilepsy “out
of the shadows”, encouraging countries to prioritize epilepsy in public health planning, as well
as raise awareness of the disease among health care providers and the general public.
The WHO Programme on reducing the epilepsy treatment
gap seeks to achieve these goals in pilot locations in
Myanmar, Ghana, Mozambique and Viet Nam, which can
be used as a model for scale up in other countries. The
Programme offers an innovative community-based model
focused on expanding the skills of nonspecialist health
care providers to diagnose, treat and follow up people
living with epilepsy.
Epilepsy is included as a priority condition in the WHO
mental health Gap Action Programme (mhGAP). It’s
evidence-based guidelines facilitate delivery of interventions by nonspecialist health care providers and is used in
the WHO Programme on reducing the epilepsy treatment
gap to strengthen care provided for people living with
epilepsy and their families. The Programme also includes
strengthening of health systems to increase sustainable
access to anti-seizure medications, reinforcing referral
systems, ensuring better monitoring of epilepsy in health
information systems, and raising awareness to support
people living with epilepsy and their families.
The Myanmar Epilepsy Initiative was launched in 2013
in a phased approach. In 2013, the project was initiated
in the two townships of Hlegu and Hmawbi and then
subsequently scaled up to Lewe, Kawhmu and Thalyinin
2014; Nyaundon, Thaton and Kyaikhto in 2015; Sagaing
and Taunggyi in 2016, and Nyaunglebin and Pantanaw in
2017. The project gradually expanded to 12 townships,
from seven states/regions, covering 2.9 million people.
In 2013 and 2014, situation analyses and baseline
surveys were carried out in the first five project townships
to better understand the existing needs and resources.
The prevalence of epilepsy ranged from 0.83 to 1.9
per 1000 population in the surveyed townships, with
an average prevalence of 1.4 per 1000 population that
was used to estimate the number of people living with
epilepsy in other townships for planning purposes..."
Dr. Thant Thaw Kaung
Source/publisher:
World Health Organisation (WHO)
Date of publication:
2017-01-01
Date of entry/update:
2019-06-13
Grouping:
Individual Documents
Category:
World Health Organisation (WHO), General studies and surveys on health in Burma, Myanmar's Health Policy
Language:
English
Format :
pdf
Size:
2.38 MB
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Description:
"The World Health Organization (WHO) Country Cooperation Strategy (CCS) 2014–2018
for Myanmar provides a coherent medium-term vision of WHO’s technical cooperation,
and defines its strategic framework for working in and with the country. It aligns closely
with the priorities of the National Health Policy, Strategies and Plans and is harmonized
with efforts of the United Nations (UN) system for country development. The present
CCS is built on the experience and achievements of the previous CCS 2008–2011 and
takes into consideration the emerging country situation. It also follows the guidance of
Twelfth General Programme of Work (GPW), which provides a six-year (2014–2019)
vision for the Organization. GPWs set a global health agenda for all stakeholders and
establish a strategic, results-based and accountable framework for WHO. The Twelfth
GPW comprises five, as opposed to a previous 13, programmatic categories and one
administrative category.
Myanmar emerges from decades of isolation with much hope and support from
the global and regional communities. The country has a high potential for rapid growth
and development given its natural resources and youth representing nearly 40% of
the population. Despite this, and consistent efforts for further development, Myanmar
faces multiple constraints and risks that may limit its progress. For example, important
disparities are apparent in access to benefits between rural areas, where about 70% of
the population resides, and urban areas. In the health sector, constraints to improve
the health status of the people include: access to basic health services; inequities and
service availability; disparities in availability and affordability of essential medicines;
adequate infrastructure and public expenditures; and trained health personnel.
Myanmar has made progress towards the Millennium Development Goals (MDGs):
its infant mortality rate (IMR), under five morality rate (U5MR) and maternal mortality
ratio (MMR) declined between 1988 and 2007. The U5MR declined steadily since
then and if this trend continues, the country will achieve the MDG4 (reduce child
mortality) target of 43.3 by 2015. However, the rate in rural areas is almost twice that of
urban areas, and this will also need to be addressed. IMR is also in declining trend, but
challenges remain to meet the MDG target of 28.3 by 2015. Meanwhile, immunization
data are encouraging; Myanmar is free from wild poliovirus transmission and measles
immunization coverage increased from 82% in 2008 to 88.0% in 2011. In November
2012, Myanmar introduced Haemophilus influenza type b (Hib) as a pentavalent vaccine
(DPT+HepB+Hib) in the immunization programme. Based on these trends, the 2015
target of 90% coverage for DTP 3/ Penta3, free from wild poliovirus transmission is
expected to be fulfilled. Reducing maternal morality under MDG5 represents a major
challenge and will require significant efforts to meet the goal. About 88% of deliveries
take place at home with maternal deaths overwhelmingly predominant in rural areas.
On the positive side, the proportion of births attended by skilled health personnel
increased from 51% in 2001 to 70.6% in 2010.
MDG6 – combating HIV/AIDS, malaria and other diseases – has a major potential
to be achieved by 2015. Myanmar already has achieved the goal of a 50% reduction in
malaria morbidity and mortality since 2007, with use of insecticide-treated nets (ITN)
more than doubling between 2004 and 2008. At the same time the tuberculosis (TB)
death rate target has been achieved and the TB incidence target is on track. However,
additional efforts are needed to meet the MDG target of halving the TB prevalence
rate by 2015 as compared to 1990. The main challenges include finding the many
undetected/unreached TB cases, scaling up multidrug-resistant (MDR) TB management
and reducing the dual burden of TB and HIV/AIDS. With regard to HIV/AIDS, the
epidemic is considered to have stabilized nationally since 2000, with hot spots of high
HIV transmission identified at several locations. Continued focus is needed on mostatrisk groups to maintain initial positive achievements. Major challenges also exist to scale
up HIV treatment, which now covers only about 1 in 3 of those in need.
The strong Government commitment to comprehensive development, including the
health sector, is seen in the Framework for Economic and Social Reform (FESR), which
outlines key parameters of the reform process. FESR is an essential tool to realize both
the short- and long-term policy agenda of the Government over the three-year period
starting in 2013, i.e. focusing on both immediate actions as well as on issues that require
in-depth analysis and/or consensus-building. In the health sector, the Government will
focus on a number of innovative measures in health financing. Particular attention will
be paid to allocating more resources to rural primary health care (PHC), infectious
disease control and maternal and child health, in view of the acute need to improve
health indicators in all these areas.
At the ministerial level, ‘Myanmar Health Vision 2030’ was drawn up in 2000 to
meet future health challenges. Supporting this ambitious, long-term health development
plan, the Ministry of Health has formulated the National Health Plan (NHP) 2011–2016,
which is aligned with the latest five-year National Development Plan, the Rural Health
Development Plan, the Project for Upgrading Hospitals, and the National Plan for
Promoting National Education. As such, the NHP is an integral part of the national
economic and development blueprint. It takes account of the prevailing health problems
in the country, the need to realize the health-related goals of the MDG, the significance
of strengthening the health system and the growing importance of social, economic and
environmental determinants of health. WHO has closely collaborated with all health
stakeholders in Myanmar in the successive phases of the NHPs – its strategies and plans,
resource mobilization, implementation and monitoring processes – and in providing
technical advice for the development of the health sector in Myanmar.
Poverty is the principal constraint to improving health status, compounded by factors
affecting vulnerability, difficult-to-reach areas and conflict among ethnic groups. The
Government has undertaken remarkable efforts to build understanding among these
ethnic groups in order to establish a peaceful environment that fosters development.
To address poverty, the United Nations Development Programme (UNDP) introduced the Human Development Index (HDI) in 1994, and provided a significant impact in
building community capacity for self-reliance. In moving forward the socioeconomic
growth of the country, official development assistance (ODA) plays a significant role in
health sector programmes. The total ODA provided to Myanmar was US$ 109.5 million
(US$22.6 million, 20.7% for health) in 2002, increasing in 2009 to US$ 390.7 million
(US$ 61.2 million, 15.7% for health). The aid environment is expanding and reaching
all development sectors. UN Country Team is also engaging in a common framework
– UN Strategic Framework – to assist Myanmar. Now in its second cycle, the present
UN Strategic Framework 2012–2016 addresses four priority issues: encourage inclusive
growth, increase equitable access to quality social services, reduce vulnerability and
promote good governance.
WHO is the lead agency in health sector of the country, in which it actively
collaborates in all development processes and capacity building of the health system.
The CCS follows the guidance of the Twelfth General Programme of Work and regional
orientations and priorities. During its elaboration, the social developments emerging
from the national reform process and key health challenges confronting the country
were carefully synthesized to feed into the strategic agendas and priorities. Close
consideration was given to the contributions by other external partners in identifying
challenges and gaps in health sector cooperation, as well as to lessons learnt from a
review of WHO’s cooperation over the last CCS cycle. Special consideration was also
given to accelerating achievement of the health-related MDG targets by 2015. The
strategic priorities of the CCS 2014–2018 are:
(1) Strengthening the health system.
(2) Enhancing the achievement of communicable disease control targets.
(3) Controlling the growth of the noncommunicable disease burden.
(4) Promoting health throughout the life course.
(5) Strengthening capacity for emergency risk management and surveillance
systems for various health threats.
The priority areas will be addressed through a coordinated programme of work
that will seek to harness the potential strengths of stakeholders The first priority area
is to enhance national capacity to strengthen the health system, including equity in
health, increased access to services, and an adequate and sustainable health-care
financing mechanism. The second priority area is to enhance the achievement of the
communicable disease control targets and MDGs; the third priority area comprises
controlling the growth of noncommunicable disease burden and minimizing the major
risk factors prevalent in the environment. The fourth area aims to strengthen health
system to improve the health conditions of women, children and adolescents and ensure
accountability through reporting on progress towards reproductive and sexual health
as part of achieving the MDGs. The fifth priority area is to prevent disease outbreaks through improved rapid response. For each of the strategic priorities, a set of main
areas of focus and strategic approaches have been formulated.
In addition to the five priority areas, WHO will continue its core functions as directed
by its governing bodies and will actively cooperate with Myanmar on any other public
health challenges. The impact of changes in budgets and staffing with required skills
and competency in the WHO Country Office are expected to be moderate. The CCS
will be implemented in close alignment and in harmonization with the national strategic
agenda and the UN Strategic Framework. WHO will focus its efforts on achieving the
targets identified by the health sector of the country..."
Professor Pe Thet Khin, Dr Poonam Khetrapal Singh
Source/publisher:
World Health Organisation (WHO)
Date of publication:
2018-01-01
Date of entry/update:
2019-06-13
Grouping:
Individual Documents
Category:
World Health Organisation (WHO), General studies and surveys on health in Burma, Myanmar's Health Policy
Language:
English
Format :
pdf
Size:
630.38 KB
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Description:
"Abstract:
The quality of health care available to a population is considered a robust measure of
the effectiveness or otherwise of a nation?s governance. In transitional states with a
legacy of authoritarian governance, the provision of health care may be hostage to
other priorities, leading to sub-optimal outcomes for vulnerable groups. In Myanmar
where the private sector accounts for over seventy per cent of expenditure on health
care, the civil society sector has taken significant responsibility for provision of health
care services in a policy framework which has often been deficient. This article
explores the quality of health care available to Myanmar?s vulnerable populations, the
resources and outcomes fostered by civil society initiatives in a context where the
state is seeking to ?catch up? with others in the region."
Helen James
Date of entry/update:
2015-06-25
Grouping:
Individual Documents
Category:
Myanmar's Health Policy
Language:
English
Format :
pdf
Size:
235.06 KB
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