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Burma's health system -- comparative and general studies

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Title: Achieving Health Equity in Contested Areas of Southeast Myamar - မန္မာႏုုိင္ငံအေရွ ႔ေတာင္ပိုုင္း ပဋိပကၡနယ္ေျမမ်ားမွက်န္းမာေရး တန္း
Date of publication: July 2016
Description/subject: စကားခ်ီး ျမန္မာႏိုင္ငံ၏ သေဘာထားကြဲလြဲမႈမ်ားျဖစ္ပြားရာေဒသမ်ားတြင္ က်န္းမာေရးေစာင့္ေရွာက္မႈအတြက္ ဝန္ေဆာင္မႈမ်ားအား အုပ္ခ်ဳပ္မႈစနစ္ ပံုစံ ၂မ်ိဳးျဖစ္သည့္ အစိုးရ၏ က်န္းမာေရးဝန္ႀကီးဌာနမွ လည္းေကာင္း၊ တိုင္းရင္းသား လက္နက္ကိုင္အဖြဲ႕အစည္းမ်ားႏွင့္ ဆက္စပ္လွ်က္ရွိေသာ ဝန္ေဆာင္မႈေပးသူမ်ားမွလည္းေကာင္း ေပးလွ်က္ရွိပါသည္။ ၂ဝ၁၁ ႏွင့္ ၂ဝ၁၂ ခုႏွစ္မ်ားတြင္ ပစ္ခတ္ တိုက္ခိုက္မႈ လက္မွတ္ေရးထိုးၿပီးေနာက္ပိုင္းတြင္ ႏွစ္ဖက္အၾကား ယံုၾကည္မႈတည္ေဆာက္ရန္ႀကိဳးပမ္းမႈမ်ားအေပၚအေျခခံၿပီး NLD ဦးေဆာင္ေသာ အစိုးရသစ္သည္ ျမန္မာႏုိင္ငံရွိ ထိခိုက္ခံစားရမႈအမ်ားဆံုးေသာသူမ်ားထံသို႔ က်န္းမာေရးေစာင့္ေရွာက္မႈမ်ား ေရာက္ရွိေစႏုိင္ရန္အတြက္ အဆိုပါ စနစ္ ၂ခုအၾကား ပူးေပါင္းေဆာင္ရြက္မႈမ်ား တိုးတက္လာရန္ ရည္ရြယ္၍ မႀကံဳစဖူးအခြင့္အလမ္း မ်ားအား ေဖာ္ေဆာင္ခဲ့ပါသည္။ အဆိုပါအေျခအေနတြင္ ျမန္မာႏုိင္ငံ၏ သေဘာထားကြဲလြဲမႈမ်ားျဖစ္ပြားရာေဒသမ်ားရွိ က်န္းမာေရး ဝန္ေဆာင္မႈေပးအပ္ျခင္း ႏွင့္ က်န္းမာေရးတန္းတူညီမႈဆိုင္ရာ သုေတသနအစီအရင္ခံစာအား အာရွေဖါင္ေဒးရွင္းမွ ဝမ္းေျမာက္စြာျဖင့္ တင္ျပအပ္ပါသည္။ ယင္းေဒသမ်ားရွိ လက္ရွိ လည္ပတ္ေနေသာ က်န္းမာေရးဝန္ႀကီးဌာန ႏွင့္ တိုင္းရင္းသားလူမ်ိဳးစု ႏွင့္ ရပ္ရြာအေျချပဳက်န္းမာေရး အဖြဲ႕အစည္းႏွစ္ခုစလံုး၏ က်န္းမာေရးဝန္ေဆာင္မႈအစီအစဥ္မ်ားအား ဤအစီအရင္ခံစာတြင္ ၿခံဳငံုေဖာ္ျပထားပါသည္။ အစိုးရ ႏွင့္ အစုိးရမဟုတ္သည့္ အဖြဲ႕ ၂ ဖက္စလံုးအတြက္ မူဝါဒဆိုင္ရာ အႀကံျပဳခ်က္မ်ား ၊ အဓိကအခြင့္အလမ္းမ်ား ၊ ေပါင္းစည္းျခင္းဆိုင္ရာ အယူအဆမ်ားအားလည္း ထည့္သြင္းေဖာ္ျပထားပါသည္။ အဓိကအခ်က္မွာ စနစ္ႏွစ္မ်ိဳး စင္ၿပိဳင္ဝန္ေဆာင္မႈေပးေနသည့္ လက္ရွိအေနအထားသည္ အခ်ိန္ အတုိင္းအတာတစ္ခုအထိ ဆက္လက္တည္ရွိေနနုိင္ပါသည္။ ပါဝင္လုပ္ကိုင္ေနၾကသူမ်ားအားလံုးသည္ တျဖည္းျဖည္း ယံုၾကည္မႈ တည္ေဆာက္လာႏုိုင္ရန္ နွင့္ ေပါင္းစည္းေရးလုပ္ငန္းစဥ္အတြက္ အလားအလာေကာင္းမ်ား ေပၚထြက္လာေစရန္ ၂ ဖက္အၾကားတြင္ ေကာင္းမြန္ေသာ ပူးေပါင္း ညိွႏိႈင္းေဆာင္ရြက္မႈမ်ား ျဖစ္ေပၚလာေစရန္ စိတ္ရွည္လက္ရွည္သတိထား ပံ့ပိုးေပးသင့္ပါသည္။ အထူးသျဖင့္ ၿငိမ္းခ်မ္းေရးလုပ္ငန္းစဥ္ ၏ ႏုိင္ငံေရးဆိုင္ရာ ေတာင္းဆိုမႈမ်ား နွင့္ အျခားဆက္စပ္သည့္ လုပ္ငန္းစဥ္မ်ားေၾကာင့္ က်န္းမာေရး တန္းတူညီမႈ ရည္မွန္းခ်က္အား ထိခိုက္ေႏွာင့္ေႏွးေစမႈ မျဖစ္ေစရေအာင္ အာရံုစိုက္ေဆာင္ရြက္ရမည္ျဖစ္သည္။ ဤသုေတသန အစီရင္ခံစာသည္ ရည္ရွည္တည္တံ့ ေသာ ၿငိမ္းခ်မ္းေရးရရွိရန္အတြက္ ရည္ရြယ္လုပ္ေဆာင္လွ်က္ရွိေသာ ရႈပ္ေထြးလွသည့္ ျပႆနာရပ္မ်ားအား ေဆြးေႏြးရာတြင္ အေထာက္အကူျပဳႏုိင္မည္ဟု ေမွ်ာ္လင့္ပါသည္။ ဤသုေတသနစာတမ္းအား ျမန္မာႏိုင္ငံအေျခစိုက္ အလြတ္တန္းသုေတသီမ်ားျဖစ္သည့္ ေဒါက္တာ ဘီလ္ေဒးဗစ္ ႏွင့္ ကင္မ္ဂ်ိဳလိဖ္ တို႔မွ ေရးသားပါသည္။ ဘီလ္ေဒးဗစ္သည္ ျပည္သူ႔က်န္းမာေရးက႑အား အထူးျပဳေလ့လာၿပီး ကင္မ္ဂ်ိဳလိဖ္သည္ လံုျခံဳေရး ၊ အေထာက္အပံ့ဆိုင္ရာ မူဝါဒ ႏွင့္ တုိင္းရင္းသား ပဋိပကၡဆုိင္ရာ ကိစၥရပ္မ်ားတြင္ ေလ့လာခဲ့ပါသည္။ သုေတသနစာတမ္းအတြက္ ရန္ပံုေငြေထာက္ပံ့ေပးေသာ အဖြဲ႕အစည္းမွာ ၿဗိတိန္အျပည္ျပည္ဆိုင္ရာဖြံ႕ၿဖိဳးေရးဌာန (DFID) ျဖစ္ပါသည္။ ယခုစာတမ္းတြင္ ေဖာ္ျပထား ေသာ အယူအဆမ်ားသည္ စာေရးသူသုေတသီမ်ား၏ အယူအဆမ်ားသာျဖစ္ၿပီး DFID သို႔မဟုတ္ အာရွေဖာင္ေဒးရွင္းတုိ႔၏ အယူအဆမ်ားျဖစ္သည္ဟု မမွတ္ယူႏုိင္ပါ။
Author/creator: ဘီလ္ေဒးဗစ္ ႏွင့္ ကင္မ္ဂ်ိဳလိဖ္
Language: Burmese (ျမန္မာဘာသာ)
Source/publisher: Asia Foundation
Format/size: pdf (4.8MB-reduced version; 7.9MB-original)
Alternate URLs: http://asiafoundation.org/wp-content/uploads/2016/07/AchievingHealthEquityinContestedAreasofSouthea...
http://asiafoundation.org/latest-by-location/?wpvcountries=Myanmar
Date of entry/update: 07 August 2016


Title: Achieving Health Equity in Contested Areas of Southeast Myanmar (English)
Date of publication: June 2016
Description/subject: Preface: "In many of Myanmar’s contested regions, healthcare services are provided through two parallel governance systems – by the government’s Ministry of Health, and by providers linked to ethnic armed organizations. Building upon efforts to build trust between these two actors following ceasefires signed in 2011 and 2012, the new National League for Democracy-led government offers an unprecedented opportunity to increase cooperation between these systems and to ensure health services reach Myanmar’s most vulnerable populations. In view of this, The Asia Foundation is pleased to present this research report on health equity and healthcare provision in Myanmar’s contested regions. The report provides an overview of existing health service arrangements in these areas, from both the Ministry of Health and from ethnic and community-based health organizations. It then unpacks the concept of “convergence”, highlighting key opportunities and policy recommendations for both government and non-government actors. The key message here is that given the reality of parallel service systems, and the likelihood that they will remain in place for quite some time, the focus of all involved should be to carefully and patiently support greater coordination and cooperation between them to build both trust and viability for the challenging convergence process over time. In particular, attention must be paid to ensure that the political demands of the peace process and any related timelines do not undermine the goal of healthcare equity. We hope that this report will contribute to the ongoing discussion of the complex set of issues that must be considered to achieve durable peace."
Author/creator: Bill Davis and Kim Jolliffe
Language: English
Source/publisher: Asia Foundation
Format/size: pdf (2.8MB-reduced version; 3.3MB-original)
Alternate URLs: http://asiafoundation.org/wp-content/uploads/2016/07/Achieving-health-equity-in-contested-corner-of...
http://asiafoundation.org/latest-by-location/?wpvcountries=Myanmar
Date of entry/update: 07 August 2016


Title: Ceasefires and health: challenges and opportunities for health equity in eastern Burma/Myanmar - Burmese (ျမန္မာဘာသာ)
Date of publication: 19 August 2015
Description/subject: Abstract: "From 2011 to 2015, eight separate ceasefires were signed between the Myanmar government and armed groups across eastern Myanmar. Although sporadic fighting continues, this region of the country is receiving both humanitarian and development interventions. In other contexts, the transition from conflict to post conflict has been accompanied by a transition in donor funds from humanitarian to development programs. This funding transition can impact people’s health: analyses of these situations suggest that the nature of aid instruments, donor behavior and politics, and the government’s capacity and legitimacy are all determinants of health in transition periods. The transition in eastern Myanmar is made more complex by the existence of two parallel health systems—one run by the Ministry of Health and one run by a network of ethnic health authorities and community-based providers. Although both sides have indicated their willingnessto coordinate and collaborate on health interventions in a process called "convergence," the changing donor environment and gaps in funding could create additional barriers to equitable and universal health service delivery in Myanmar. This paper describes how the transition from humanitarian aid to development can impact health service delivery in Eastern Myanmar. The paper outlines how the transition creates challenges and opportunities for delivering healthcare, and it makes recommendations on how donors and implementing agencies can best navigate these challenges.".....Paper delivered at the International Conference on Burma/Myanmar Studies: Burma/Myanmar in Transition: Connectivity, Changes and Challenges: University Academic Service Centre (UNISERV), Chiang Mai University, Thailand, 24-­26 July 2015.
Author/creator: Tara Russell
Language: Burmese (ျမန္မာဘာသာ)
Source/publisher: International Conference on Burma/Myanmar Studies: Burma/Myanmar in Transition: Connectivity, Changes and Challenges: University Academic Service Centre (UNISERV), Chiang Mai University, Thailand, 24-­26 July 2015
Format/size: pdf (132K)
Alternate URLs: http://rcsd.soc.cmu.ac.th/web/Burma/home.php#
Date of entry/update: 19 August 2015


Title: HEALTH SYSTEM TRANSFORMATION IN MYANMAR: ARE THE CURRENT CHANGES PROMISING?
Date of publication: 26 May 2015
Description/subject: OUTLINE: Myanmar profile... ● Myanmar’s current health status... ● Myanmar Health System... ● Overview... ● Comparison with South East Asian countries... ● Equity of access to Reproductive Health services... ● Current Changes in Myanmar Health System... ● Conclusions and Recommendations
Author/creator: Phyu Phyu Thin Zaw
Language: English
Source/publisher: Stanford University
Format/size: pdf (7.9MB)
Date of entry/update: 14 August 2016


Title: How can financial risk protection be expanded in Myanmar?
Date of publication: 2015
Description/subject: "1. What is the challenge? Protecting people from financial hardship when they fall ill is one of the two key elements of universal health coverage (UHC). In practice, this means that the majority of health care costs have to be met from government revenues so that services are provided free or with a small affordable co-payment. The alternative is to rely on pre-payment through some form of insurance, where risks are pooled across all contributors. These two approaches are not mutually exclusive; tax funding and insurance can be complementary. The challenge in Myanmar is that at present neither approach is functioning. Government spending is too low to meet people’s health needs and the proportion of the population covered by insurance is negligible. As a result, families face a stark choice in the event of serious illness: either defer treatment and face the consequences, or incur what can amount to catastrophic expenses and a downward spiral of disinvestment and poverty..."
Language: English
Source/publisher: Asia Pacific Observatory on Health Systems and Policies via WHO (Myanmar Health Systems in Transition - Policy Note #4)
Format/size: pdf (473K)
Date of entry/update: 13 August 2016


Title: How can health equity be improved in Myanmar?
Date of publication: 2015
Description/subject: "1. What are the challenges? Myanmar is a country in which people’s access to health services is determined more by where they live than their need for care – a situation that is fundamentally inequitable. The challenge is to reduce levels of inequity between different groups in the population and different geographical areas, and most particularly to ensure that health services reach poor and disadvantaged groups, including minorities and those living in conflict-affected areas. 2. What do we know? There is a growing body of evidence about the extent and dimensions of health inequity in Myanmar..."
Language: English
Source/publisher: Asia Pacific Observatory on Health Systems and Policies via WHO (Myanmar Health Systems in Transition - Policy Note #2)
Format/size: pdf (478K)
Date of entry/update: 13 August 2016


Title: How can the township health system be strengthened in Myanmar?
Date of publication: 2015
Description/subject: "1. What is the challenge? A network of basic health facilities has been established in each of the 330 townships, covering both rural and urban areas. For the vast majority of Myanmar’s people, particularly the 70% who reside in rural areas, the township health system (THS) is the only government-funded source of preventive, promotive and curative services. A typical THS has a catchment population of between 150 000 and 200 000, is managed by the Township Health Department, and led by the Township Medical Officer (TMO). At the centre of the system is the township hospital, and below this a network of station hospitals, rural health centres (RHC) and sub-rural health centres (sRHC), each with a specified complement of staff, supported by volunteer health workers. To achieve the national policy objective of progressing towards universal health coverage (UHC) through a primary health-care approach by 2030, the THS is critical to success. It is responsible for the bulk of health care delivery – particularly in rural areas – and is at the heart of national health development in Myanmar. However, if the THS is to be the backbone of health care provision, it currently suffers from a severe case of osteoporosis..."
Language: English
Source/publisher: Asia Pacific Observatory on Health Systems and Policies via WHO (Myanmar Health Systems in Transition - Policy Note #3)
Format/size: pdf (484K)
Date of entry/update: 13 August 2016


Title: What are the challenges facing Myanmar in progressing towards Universal Health Coverage?
Date of publication: 2015
Description/subject: "The Government of the Republic of the Union of Myanmar is committed to achieving universal health coverage (UHC) by 2030. In practice, this means that over the next 15 years the aim is to progressively ensure that all people in all parts of the country have access to the health-care services they need – both preventive and curative – without suffering financial hardship when paying for them. This ambitious goal is seen as a desirable end in itself, and as a means to achieving people-centred development. This policy note is the first in a set of four. It provides an overview of the challenges to be overcome in making progress toward UHC and sets out recommendations for how they can be tackled. The other notes look in more detail at three specific issues: how UHC can improve equity, and how strengthening the township health system and expanding financial risk protection contribute to UHC..."
Author/creator: Phone Myint, Than Tun Sein, Andrew Cassel
Language: English
Source/publisher: Asia Pacific Observatory on Health Systems and Policies via WHO (Myanmar Health Systems in Transition - Policy Note #1)
Format/size: pdf (503K)
Date of entry/update: 13 August 2016


Title: Health in Myanmar 2011 (Myanmar Health Care System)
Date of publication: 2011
Language: English
Format/size: pdf (200K)
Date of entry/update: 30 September 2012


Title: Health in Myanmar 2010 (Myanmar Health Care System)
Date of publication: 2010
Description/subject: Myanmar health care system evolves with changing political and administrative system and relative roles played by the key providers are also changing although the Ministry of Health remains the major provider of comprehensive health care. It has a pluralistic mix of public and private system both in the financing and provision. Health care is organized and provided by public and private providers.
Language: English
Source/publisher: WHO
Format/size: pdf (989.17 K)
Alternate URLs: http://www.whomyanmar.org/LinkFiles/Health_Information_2.pdf
Date of entry/update: 10 November 2010


Title: GUIDELINES FOR HEALTH SYSTEM ASSESSMENT
Date of publication: 13 June 2009
Description/subject: Section 1:- Introduction and Background: "In 2008, an independent review committee recommended an award of a health system strengthe ning grant through the Global Alliance for Vaccines and Immunization. This grant was subsequently approved by the Board of GAVI in 2008. A central strategy in strengthening health systems was the development of Township Coordinated Health Plans. In order to have a Township Coordinated Health Plan based on identified needs, the strategy proposes a baseline health system assessment in each Township..."
Language: English
Format/size: pdf (300K)
Date of entry/update: 27 June 2015


Title: Contemporary medical pluralism in Burma
Date of publication: January 2008
Description/subject: Conclusion - human rights and the right to health: "As in other developing nations, particularly in Africa, in Burma, a substantial proportion of government medications and preventive-health materials are sold on the black market. The theft of medical equipment, medicines and other products from international and UN organisations means these products can be purchased easily in Yangon’s main markets. The transparency of aid delivery and the provision of materials from international donors are issues that continually confront in-country aid providers. The Australian medical practitioners currently working in Burma (Myanmar/Burma Update 2007) attest to the latent capacity and talent still evident among the Burmese medical fraternity, but the cost of health care, the continuing exodus of qualified medical personnel, the loss of much traditional knowledge since the colonial period and the existence of conflict zones within the country are all factors contributing to limit Burmese people’s access to health care. Taken as a whole, the possibility of affordable, accessible and evidence-based health care is extremely limited for the majority of Burma’s 54 million inhabitants. In this context, it is not surprising that Burmese people turn to folk and magical forms 201 Contemporary medical pluralism in Burma of medical practices, such as exorcists, alchemists and wizardry, when they have exhausted their financial resources and cannot find relief. In the wake of the suppression of the so-called ‘Saffron Revolution’ in September–October 2007, it is perhaps timely to conclude with some thoughts about the long-term consequences of the lack of a right to health. There is indisputable photographic evidence of shootings and beatings administered to protestors during the attempted Saffron Revolution16 and the former UN Special Rapporteur on Human Rights in Myanmar, Sergio Pinheiro, put the death toll at 31 with up to 4000 arrested and 1000 still detained as of 11 December 2007 (UNHRC 2008:4). In earlier work (Skidmore 2005, 2003), I described the long-term consequences of inculcating a state of fear and of perpetual vulnerability in the urban populace. Since September 2007, there has been a demonstrable increase in the efficiency by which terror, as distinct from fear, can be created among the population. In other countries in which violence has been perpetrated and witnessed, there are well-documented harvests of suicide, trauma and mental health problems. It is not possible to gather such health data in Burma, yet psychological health must surely be considered when describing Burma’s humanitarian and health crises. Paranoia, nightmares, confused and impaired thinking and psychological defences such as denial are also prevalent among the Burmese I have interviewed in the wake of the violence in Yangon (Skidmore 1998). Jail terms for monks and civilians who took part in the demonstrations, as well as reports of torture within prisons and harsh sentences to prison and labour camps, have together created a pathological psychological climate. In Yangon, the anger that Burmese Buddhists feel at the continuing barricading and closure of monasteries and the continuing arrests of monks is palpable. To seek health care for trauma and fear, however, is to risk charges of subversion and treason. In making these comments about the mental health of the urban populace, the purpose is not to detract from the serious human rights issues that occur among forcibly displaced civilian populations in Burma’s civil war zone. In addition to the significant volume of core human rights abuses occurring in Burma, however, is a virtually undocumented and untreated epidemic of psychological trauma. This psychological trauma is a crucial aspect of a lack of a right to health and it is in part related to the subversion of medical ethics that is required of Burmese people who train and practice medicine in Burma today. There are precious few provisions for psychological, psychiatric or counselling help for those suffering from the long-term effects of living in a state of fear. At times of crisis such as during the September 2007 street protests against cost-of-living increases and military rule, anxiety, fear and paranoia can become acute, but medical personnel also live in fear of giving aid to people branded as enemies of the State or criminals during these moments of resistance. 202 Dictatorship, disorder and decline in Myanmar The latter part of this chapter documents forms of health care offered by non-state providers, but also the forms of illness and disease that are not permitted to exist and therefore to be treated. It does so to emphasise not just the patent inadequacy of the current regime’s expenditure on health care, but to draw attention to the continuing denial of the fundamental right to health for the majority of the population".
Author/creator: Monique Skidmore
Language: English
Source/publisher: 2007 Myanmar/Burma Update Conference via Australian National University
Format/size: pdf (153K)
Alternate URLs: http://epress.anu.edu.au/myanmar02/pdf_instructions.html
http://epress.anu.edu.au/myanmar02/pdf/whole_book.pdf
Date of entry/update: 30 December 2008


Title: Poor health care system plagues Myanmar
Date of publication: 26 October 2007
Description/subject: MAE SOT, Thailand — They travel for days though checkpoints, across dangerous roads and past Myanmar's bribe-hungry soldiers to make it to the Thai border. They're not refugees fleeing the junta -- they simply want to see a doctor. Myanmar has one of the world's worst health care systems, with tens of thousands dying each year from malaria, tuberculosis, AIDS, dysentery, diarrhea and a litany of other illnesses. While there are hospitals in the impoverished Southeast Asian nation also known as Burma, only a few can afford to pay hospital workers the various "fees" in the tightly controlled nation fueled by corruption. "Even if you use the toilet in the hospital you have to pay money," said a 70-year-old man from Phyu Township, who journeyed two days by bus to see a doctor at the Thai border town of Mae Sot and have a cataract removed. He declined to give his name for fear of reprisals. "They never think of improving health care," he said. "They only pull the trigger. Because they are holding the guns, we have to live like this."
Author/creator: Margie Mason
Language: English
Source/publisher: USA Today
Format/size: html
Date of entry/update: 12 November 2010


Title: Gonioscopy findings and prevalence of occludable angles in a Burmese population: the Meiktila Eye Study
Date of publication: 2007
Description/subject: Aim: To determine the prevalence of preglaucomatous angle-closure disease in central Myanmar. Methods: A population-based survey of inhabitants >40 years in the Meiktila District was carried out; 2481 subjects were identified, 2076 participated and 2060 underwent gonioscopy of at least one eye. Eyes with angles traditionally described as ‘‘occludable’’ were recorded as primary angle-closure suspects (PACS); eyes with PACS and peripheral anterior synechiae (PAS), or an increased intraocular pressure but without primary angle-closure glaucoma, were recorded as primary angle closure (PAC). Results: The prevalence of PACS in at least one eye was 5.7% (95% CI 4.72 to 6.62); prevalence increased with age and was more common in women (p,0.001). The prevalence of PAC in at least one eye was 1.50% (95% CI 1.47 to 1.53). All participants with PAS had at least 90° of closure (range 90–360°). Conclusion: The prevalence of preglaucomatous angle-closure disease (PACS and PAC) in this population was 5.7% and 1.5%, respectively. PACS was more common in women, and its prevalence increased with age.
Author/creator: R J Casson, H S Newland, J Muecke, S McGovern, L M Abraham, W K Shein, D Selva, T Aung
Language: English
Source/publisher: Pub Med Central
Format/size: html, pdf (148.57 K)
Alternate URLs: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1955640/pdf/856.pdf
Date of entry/update: 03 November 2010


Title: Health and Security Control of Diseases – Post-Elimination/Eradication Strategies for Sustaining Disease Control Activities
Date of publication: 2007
Description/subject: Abstract Disease Control and Prevention are an important component of Health Security. Of the many aspects of disease control, those pertaining to the control service activities during the post-elimination or eradication era are extremely important to prevent the re-emergence of the disease. Myanmar has conquered five diseases and the country is endeavouring to sustain control activities so that the conquered diseases always remain under control and thus reduce the disease burden. After the successful eradication of smallpox, no specific anti-smallpox activity was being undertaken. The Myanmar Health System, which is an integrated system is being further strengthened and the authorities are alert to the international situation regarding bio-terrorist attacks and are in contact with the International Epidemiology Network and drug and vaccine stockpile.
Author/creator: U Ko Ko
Language: English
Source/publisher: World Health Organization, SEAR, Regional Health Forum – Volume 11, Number 1, 2007
Format/size: pdf (109.71 K)
Alternate URLs: http://www.searo.who.int/LinkFiles/Regional_Health_Forum_Control_Diseases.pdf
Date of entry/update: 02 November 2010


Title: Prevalence of glaucoma in rural Myanmar: the Meiktila Eye Study
Date of publication: 2007
Description/subject: Aim: To determine the prevalence of glaucoma in the Meiktila district of central, rural Myanmar. Methods: A cross-sectional, population-based survey of inhabitants >40 years of age from villages in Meiktila district, Myanmar, was performed; 2481 eligible participants were identified and 2076 participated in the study. The ophthalmic examination included Snellen visual acuity, slit-lamp examination, tonometry, gonioscopy, dilated stereoscopic fundus examination and full-threshold perimetry. Glaucoma was classified into clinical subtypes and categorised into three levels according to diagnostic evidence. Results: Glaucoma was diagnosed in 1997 (80.5%) participants. The prevalence of glaucoma of any category in at least one eye was 4.9% (95% CI 4.1 to 5.7; n = 101). The overall prevalence of primary angleclosure glaucoma (PACG) was 2.5% (95% CI 1.5 to 3.5) and of primary open-angle glaucoma (POAG) was 2.0% (95% CI 0.9 to 3.1). PACG accounted for 84% of all blindness due to glaucoma, with the majority due to acute angle-closure glaucoma (AACG). Conclusion: The prevalence of glaucoma in the population aged >40 years in rural, central Myanmar was 4.9%. The ratio of PACG to POAG was approximately 1.25:1. PACG has a high visual morbidity and AACG is visually devastating in this community. Screening programmes should be directed at PACG, and further study of the underlying mechanisms of PACG is needed in this population.
Author/creator: R J Casson, H S Newland, J Muecke, S McGovern, L Abraham, W K Shein, D Selva, T Aung
Language: English
Source/publisher: Pub Med Central
Format/size: html, pdf (185.38 K)
Alternate URLs: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1955608/
Date of entry/update: 03 November 2010


Title: Armut im Land der Goldenen Pagoden. Soziale Sicherheit, Gesundheit und Bildung in Burma; Focus Asien Nr. 26
Date of publication: 29 December 2005
Description/subject: In den letzten Jahren häufen sich die Meldungen über die kritische humanitäre Situation in Burma. Die sozialen Indikatoren Sterblichkeitsraten, Bildungsindikatoren, Verbreitung von typischen Armutskrankheiten wie Malaria und Tuberkulose, die alarmierende Verbreitung von HIV/AIDS - zeichnen ein düsteres Bild über den Zustand des Landes, wobei es große regionale und gesellschaftliche Unterschiede gibt. Die Broschüre gibt Einblicke in die Bereiche Gesundheits- und Bildungswesen in Burma, wobei Erfahrungen aus der praktischen Arbeit von Hilfsorganisationen dargestellt werden. Neben Vorstellungen vom Wohlfahrtsstaat werden darüber hinaus die Situation burmesischer Migrant/innen in Thailand beleuchtet, die Auswirkungen des Opiumbanns auf die Bevölkerung der Wa-Sonderregion untersucht und Chancen und Risiken humanitärer Hilfe diskutiert. Inhalt: Ulrike Bey: Armut im „Land der Goldenen Pagoden“; Marco Bünte: Dimensionen sozialer Probleme in Myanmar – Ein Überblick; Hans-Bernd Zöllner: Der Traum vom budhistischen Wohlfahrtsstaat; Tankred Stöbe: Das Gesundheitssystem in Burma/Myanmar unter Ausschluss der ethnischen Minderheiten?; Brenda Belak: Der Zugang zur medizinischen Versorgung; Johannes Achilles: Das Bildungswesen in Birma/Myanmar – Erfahrungen zum Engagement im Bildungsbereich; Ulrike Bey: Frauen in Bildung und Gesundheit; Michael Tröster: Die Wa in Gefahr. Nach dem Opiumbann droht in der Special Region eine humaitäre Katastrophe; Jackie Pollock: Die Lebensqualität von Migrant/innen in Thailand; Jasmin Lorch: Der Rückzug des UN Global Fund aus Burma; Alle Artikel dieses Bandes sind außerdem noch separat verlinkt. keywords: social security, health, education, humanitarian aid, migration, opium ban
Author/creator: Ulrike Bey (Hrsg.)
Language: Deutsch, German
Source/publisher: Asienhaus
Format/size: pdf 970k
Date of entry/update: 20 March 2006


Title: Das Gesundheitssystem in Burma/Myanmar - unter Ausschluss der ethnischen Minderheiten?
Date of publication: 29 December 2005
Description/subject: Status Quo des burmesischen Gesundheitssystems; UNAIDS Bericht 2005; Engagement von Ãrzte Ohne Grenzen; Artikel von Brenda Belak: Der Zugang zur medizinischen Versorgung keywords: health care, HIV/AIDS, UNAIDS report, ethnic minorities
Author/creator: Tankred Stöbe, Brenda Belak
Language: Deutsch, German
Source/publisher: Asienhaus Focus Asien Nr. 26; S. 23-30
Format/size: pdf (89k)
Date of entry/update: 20 March 2006


Title: Dimensionen sozialer Probleme in Myanmar - Ein Ãœberblick
Date of publication: 29 December 2005
Description/subject: Armut in Myanmar; Die Situation im Gesundheitswesen; Die AIDS-Problematik; Das Bildungssystem keywords: poverty, health system, HIV/AIDS, education, social problems
Author/creator: Marco Bünte
Language: Deutsch, German
Source/publisher: Asienhaus Focus Asien Nr. 26; S. 9-14
Format/size: pdf
Date of entry/update: 20 March 2006


Title: Political Triage: Health and the State in Myanmar (Burma)
Date of publication: 2004
Description/subject: Abstract: "In 1988, the military government in Myanmar abandoned the socialist ideology and isolationism that had shaped the state since independence, embarking on a transition to an open economy and engagement of the international community. ¶ Where socialism had failed, economic development and partnerships with former insurgent groups became the new strategy to advance the military’s security agenda. The primary goal of the security agenda is to promote state consolidation based on a unitary state structure, and according to military values and interests. However, the military’s goals are antagonistic to much of the country’s population, especially its ethnic minority groups. Consequently, the military lacks moral authority, and is preoccupied with maintaining its power and seeking legitimacy. The state is oriented to regime maintenance rather than policy implementation, leaving the regime without autonomy to pursue policy goals outside of its security agenda. ¶ The changing nature of the state, and state-society relations during the period of transition is revealed by trends in social development. Specifically, this thesis explores these issues through a case study of the health system. One impact of the economic transition and the military’s new nation-building strategy has been the abandonment of social equity as an ideological goal of the state. Even under socialism, state capacity to promote health was weak. In the transitional state, weak state capacity is now combined with a political incapacity of the regime to make public health a priority. In the quest for performance legitimacy, the military government is pursuing a narrow conception of development that values economic growth. Putting the state’s scarce resources into social development does not fit into this development strategy. Government expenditure on health has declined steadily since 1988, and health bureaucrats struggle to implement government policy. Standards in the public health system are very low, and most people seek health care in the private and informal health sectors. ¶ Therefore, the military regime’s inability to achieve state consolidation, which leaves it preoccupied with its own legitimacy crisis, is a significant factor in the inability of the Myanmar state to promote social development. The process of economic transition from a socialist economy has exacerbated this through the withdrawal of the state from financing and delivery of social services, resulting in increasing inequity of access to these services."
Author/creator: Emily Rudland
Language: Enbglish
Source/publisher: The Australian National University
Format/size: pdf
Alternate URLs: http://thesis.anu.edu.au/public/adt-ANU20070719.123952/
Date of entry/update: 25 November 2007


Title: An approach to health system strengthening in the Union of Myanmar
Description/subject: "PURCHASE ONLY" Article Outline 1. Introduction 1.1. Country and health system background 1.2. GAVI and health system strengthening 2. Materials and methods 3. Results 3.1. Development process of the HSS strategy 3.2. Health system barrier analysis content 3.3. Health system strategic framework 4. Discussion 4.1. Critical factors in quality improvement of health system strengthening strategy 4.2. Rethinking health development through health system strengthening approaches 5. Conclusion References
Author/creator: Nilar Tin, Saw Lwin, Nyo Nyo Kyaing, Thein Thein Htay, John Grundy, Margareta Skold, Thomas O’Connell and Siddharth Nirupam
Language: English
Source/publisher: Health Policy, Volume 95, Issues 2-3, May 2010, Pages 95-102
Format/size: html
Date of entry/update: 22 October 2010