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Policy Note #3: Myanmar Health Systems in Transition Policy Notes Series
A network of basic health facilities has been established in each of the 330 townships, covering both rural and urban ar ... eas. 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.
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. more
A network of basic health facilities has been established in each of the 330 townships, covering both rural and urban ar ... eas. 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.
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. more
Women and Health Initiative Working Paper No. 1. Women and Health Initiative
Improving maternal health in the context of the sub-Saharan African ... HIV epidemic requires greater understanding of the relationships between HIV disease and maternal morbidity and mortality, integrated and effective responses by the health system, and a social context which promotes quality care and encourages use of MCH and HIV services. Advancing the proposed research agenda will make an invaluable contribution by generating needed evidence for policy and practice that improves the maternal health of women who are living with HIV, as well as those who are not. Bringing together maternal health and HIV researchers, policy-makers and program implementers to reduce HIV-related maternal morbidity and mortality and improve the HIV response for women represents an opportunity and a challenge. more
Improving maternal health in the context of the sub-Saharan African ... HIV epidemic requires greater understanding of the relationships between HIV disease and maternal morbidity and mortality, integrated and effective responses by the health system, and a social context which promotes quality care and encourages use of MCH and HIV services. Advancing the proposed research agenda will make an invaluable contribution by generating needed evidence for policy and practice that improves the maternal health of women who are living with HIV, as well as those who are not. Bringing together maternal health and HIV researchers, policy-makers and program implementers to reduce HIV-related maternal morbidity and mortality and improve the HIV response for women represents an opportunity and a challenge. more
Mental disorders are a leading cause of the global burden of disease, and the provision of mental health services in developing countries remains very limited and far from equitable. Using the Credi
...
tor Reporting System, we estimate the amounts and patterns of development assistance for global mental health (DAMH) between 2007 and 2013. This allows us to examine how well international donors have responded to calls by global mental health advocates to scale up evidence-based services. Although DAMH did increase between 2007 and 2013, it remains low both in absolute terms and as a proportion of total development assistance for health (DAH). The average annual DAMH between 2007 and 2013 was US$133.57 million, and the proportion of DAH attributed to mental health is less than 1%. Approximately 48% of total DAMH was for humanitarian assistance, education, and civil services. More annual DAMH was channelled into the nonpublic sector than the public sector. Despite an expanding body of evidence suggesting that sustainable mental health care can be effectively integrated into existing health systems at relatively low cost, mental health has not received significant development assistance.
more
ABSTRACT
More than 500 million people worldwide live with cardiovascular disease (CVD). Health systems today face fundamental challenges in delivering optimal care due to ageing populations, health
...
care workforce constraints, financing, availability and affordability of CVD medicine, and service delivery.
Digital health technologies can help address these challenges. They may be a tool
to reach Sustainable Development Goal 3.4 and reduce premature mortality from
non-communicable diseases (NCDs) by a third by 2030. Yet, a range of fundamental barriers prevents implementation and access to such technologies. Health system governance, health provider, patient and technological factors can prevent or distort their implementation.
World Heart Federation (WHF) roadmaps aim to identify essential roadblocks on the pathway to effective prevention, detection, and treatment of CVD. Further, they aim to provide actionable solutions and implementation frameworks for local adaptation. This WHF Roadmap for digital health in cardiology identifies barriers to implementing digital health technologies for CVD and provides recommendations for overcoming them.
more
The purpose of this Strategy is to set out the way to meet the needs of the rural populations for improved domestic water supply services, access
...
to and use of improved sanitation with elimination of open defecation, and improved hygiene behaviour by the Year 2030. It also addresses water, sanitation and hygiene in schools up to high school level and health facilities up to township hospital level. The Strategy is supported by Investment Plans covering a financing period 2015 to 2030 in order to ensure sufficient funding for development and operation of services in accordance with the Strategy.
more
more
Every year, nearly 250 million people move across borders temporarily or permanently for a job opportunity, studying, to flee a crisis back home, or for other reasons. Another 750 million move for similar reasons within the borders of their countrie
...
s. With the understanding that human mobility affects public health, and health affects human mobility and migrants, for decades, IOM has been providing critical health services to women, children and men on the move, while standing by governments for technical and operational support as needed. In 2019, in lower-income settings and in complex emergencies, along the world’s most perilous migration routes, in the aftermath of natural disasters or in response to disease outbreaks, IOM’s health teams have provided hundreds of thousands with primary health-care consultations, mental health and psychosocial support, sexual and reproductive health care, pre-migration health services, and much more.
This year, more than ever before, as the world reels from the socioeconomic impact of COVID-19, we have experienced that health is a cross-cutting component of overall human development and well-being.
more
South Africa has a long history of community health workers (CHWs). It has been a journey that has required balancing constrained resources and competing priorities. CHWs form a bridge between communities and healthcare service provision within
...
health facilities and act as the cornerstone of South Africa’s Ward-Based Primary Healthcare Outreach Teams. This study aimed to document the CHW policy implementation landscape across six provinces in South Africa and explore the reasons for local adaptation of CHW models and to identify potential barriers and facilitators to implementation of the revised framework to help guide and inform future planning.
more
Neonatal mortality is a major challenge in reducing child mortality rates in Nepal. Despite efforts by the Government of Nepal, data from the last three demographic and health surveys show a rise in the contribution of neonatal deaths
...
to infant and child mortality. The Government of Nepal has implemented community-based programs that were piloted and then scaled up based on lessons learned. These programs include, but are not limited to ensuring safe motherhood, birth preparedness package, community-based newborn care package, and integrated management of childhood illnesses. Despite the implementation of such programs on a larger scale, their effective coverage is yet to be achieved. Health system challenges included an inadequate policy environment, funding gaps, inadequate procurement, and insufficient supplies of commodities, while human resource management has been found to be impeding service delivery. Such bottlenecks at policy, institutional and service delivery level need to be addressed incorporating health information in decision-making as well as working in partnership with communities to facilitate the utilization of available services.
more
Specific measures are being taken within the National Tuberculosis Control Programme (NTP) to address the MDR TB problem through appropriate management of patients and strategies to prevent the prop
...
agation and dissemination of MDR TB.
The term "Programmatic Management of Drug Resistant TB" (PMDT) refers to programme based MDR TB diagnosis, management and treatment. This guideline promotes full integration of basic TB control and PMDT activities under the NTP, so that patients with TB are evaluated for drug resistance and are placed on the appropriate treatment regimen and properly managed from the outset of treatment, or as early as possible. The guidelines also integrate the identification and treatment of more severe forms of drug resistance, such as extensively drug resistant TB (XDR TB).
At the end, the guideline introduces new standards for registering, monitoring and reporting outcomes of multidrug resistant TB cases. more
The term "Programmatic Management of Drug Resistant TB" (PMDT) refers to programme based MDR TB diagnosis, management and treatment. This guideline promotes full integration of basic TB control and PMDT activities under the NTP, so that patients with TB are evaluated for drug resistance and are placed on the appropriate treatment regimen and properly managed from the outset of treatment, or as early as possible. The guidelines also integrate the identification and treatment of more severe forms of drug resistance, such as extensively drug resistant TB (XDR TB).
At the end, the guideline introduces new standards for registering, monitoring and reporting outcomes of multidrug resistant TB cases. more
Peru − Progress in health and sciences in 200 years of independence
Carrillo-Larco; R.M.; Guzman-Vilca, W. C.; Leon-Velarde, F.; et al.
The Lancet Regional Health - Americas
(2021)
CC
Peru celebrates 200 years of independence in 2021. Over this period of independent life, and despite the turbulent socio-political scenarios, from internal armed conflict to economic crisis to polit
...
ical instability over the last 40 years, Peru has experienced major changes on its epidemiological and population health profile. Major advancements in maternal and child health as well as in communicable diseases have been achieved in recent decades, and today
Peru faces an increasing burden of non-communicable diseases including mental health conditions. In terms of the configuration of the public health system, Peru has also strived to secure country-wide optimal health care, struggling in particular to improve primary health care and intercultural services.
more
Strengthening rehabilitation in health emergency preparedness, response, and resilience: policy brief outlines the evidence for rehabilitation in emergencies and the need for greater preparedness of rehabilitation
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services. It shows how existing guidelines support the integration of rehabilitation in emergencies and sets out the steps that decision-makers can take to better integrate rehabilitation into health emergency preparedness and response.
more
This comprehensive HPFM report thoroughly explores Kenya’s health financing landscape. It provides an in-depth analysis of the current state of affairs and sheds light on required strategic changes in he
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alth financing. The report points out the need to improve public financial management within the health sector, for more efficient financial systems. It focuses on better resourceraising and utilization mechanisms. The matrix highlights the need for consolidation of fragmented health financing arrangements, for a more efficient health system. It also emphasizes the need for enhancing strategic purchasing of health services, to improve the overall efficiency and quality of care. Additionally, the report stresses the critical
role of leveraging data and information systems for more evidence-based informed decision-making. These recommendations are crucial for advancing Kenya’s health financing system and moving closer to the UHC goal.
more
This document, Programme and curriculum development guide, presents a systematic approach to developing programmes and curricula for implementation of the family planning (FP) and comprehensive abortion care (CAC) competencies,and the theory behind
...
the approach. Specifically, the aim is for effective implementation of these competencies in the context of pre-service education and training, post-graduate studies and continuing professional development (CPD). This guide is designed for programme and curriculum developers who are preparing or revising formal education and training programmes and curricula for the FP and CAC workforce.
This guide proposes a new FP and CAC Educational Design Model for programme and curriculum development. This model can support competency-based education (CBE) for current and future FP and CAC services, with a pre-service training pathway of at least 12 months, and can also support in-service training. CBE provides the most effective means to orient educational programmes and curricula towards effective health services that meet population health needs, and this Educational Design Model provides a guide for linking the competencies required to provide a range of health services
more
The Disability inclusion guide for action supports ministries of health and their partners in both advancing health equity for persons with disabilities by identifying entry points, and planning app
...
ropriate actions that strengthen the health system through disability inclusion. It focuses on addressing the contributing factors which relate to the health system – namely, the attitudinal,
institutional, and physical barriers faced by persons with disabilities across all health system building blocks. Such factors include the exclusion of persons with disabilities in governance and decision-making processes in the health sector; gaps in knowledge, negative attitudes, and discriminatory practices among the health and care workforce; inaccessible physical infrastructure, health
information and communication; and a lack of information or data collection and analysis on disability in monitoring and evaluation in the health system.
more
Monitoring and Evaluation Toolkit: HIV, TB and Malaria and Health Systems Strenghtening
The Global Fund
(2011)
The TB section of the toolkit presents selected (a) programmatic output and (b) outcome and impact indicators for TB. In addition to recommended monitoring programs and measuring the outcomes and impact of TB programs, indicators for the strengtheni
...
ng of health systems, strengthening of community systems and some indicators that measure quality of services are also included.
more
The WHO document "Integrating the prevention and control of noncommunicable diseases in HIV/AIDS, tuberculosis, and sexual and reproductive health programmes: implementation guidance" provides a framework for integrating noncommunicable diseases (NC
...
Ds) into existing health programs for HIV/AIDS, tuberculosis (TB), and sexual and reproductive health (SRH). It emphasizes the importance of a people-centered approach to enhance healthcare accessibility and efficiency, especially in low-resource settings. The document outlines strategies for strengthening policy, financing, capacity building, and health system infrastructure. It offers actionable steps, tools, and case studies to support countries in reducing the burden of NCDs through integrated, holistic care within primary health services.
more
Evidence- and rights-based national policies, guidelines and legislation play a key role in improving sexual, reproductive, maternal, newborn, child and adolescent health (SRMNCAH), framing the enabling environment for equitable provision and access
...
ibility of quality services. The SRMNCAH policy survey monitors the existence of national SRMNCAH laws, policies, strategies and guidelines and the extent to which they are aligned with WHO recommendations on SRMNCAH. This publication reports on the findings from the 2023 WHO SRMNCAH policy survey.
more
The chapter Closing the Gap: The Health Disparities of Older LGBTI People in the Americas, is part of the publication series titled ‘Decade of Healthy Aging: situation and challenges’. In order to
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outline the current knowledge available on the situation of health and well-being of older persons in the Americas at the beginning of the United Nations Decade of Healthy Aging (2021-2030), this document presents data and existing evidence different forms of discrimination and mistreatment older people face due to their sexual orientation and gender identities that ultimately increase health disparities. Previous studies on LGBTI older people offer valuable information on the lived experiences of these communities and demonstrate that they face unique challenges with aging, emphasizing the difficulties related to access to care. Very few studies on older people and aging include a focus on sexual orientation or gender identity; however, it is possible to point out that HIV/AIDS is one of the most significant health disparities confronting LGBTI older persons, followed by physical and mental health problems, substance use, social isolation, poverty, and the lack of access to quality healthcare, including long-term care facilities or other institutions. Closing the gap in access and quality of health and care services is an imperative to increase longevity, health status and quality of life of LGBTI older people.
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Fully functioning water, sanitation, hygiene (WASH) and health care waste management services are a critical aspect of infection prevention and control (IPC) practices, and ensuring patient safety a
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nd quality of care. Such services are also essential for creating an environment that supports the dignity and human rights of all care seekers, especially mothers, newborns, children and care providers.
WASH and waste services are also critical for preventing and effectively responding to disease outbreaks. The COVID-19 pandemic has exposed gaps in these basic services (Box 1). These gaps threaten the safety of patients and caregivers, and have environmental consequences, especially as a result of large increases in plastic health care waste. In short, WASH is a critical foundation for improving quality across the health system (1).
Many facilities lack plans and budgets for WASH, which has impacts on IPC. This lack of services, and of systems to improve them, compromises the ability to provide safe and quality care, and places health care providers and those seeking care at substantial risk of infection and loss of dignity. Unhygienic health care facilities without drinking water or functional toilets are also a disincentive to seeking care and undermine staff morale – these factors can have a critical impact on controlling infectious disease outbreaks.
Climate change and its impacts on WASH and health services, gender-specific needs, and equity in service provision and management all require rigorous attention, adaptable tools and regular monitoring.
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In 2006, the Special Session of African Union Health Ministers adopted the Maputo Plan of Action for implementing the Continental Policy Framework on sexual and reproductive health and rights (SRHR)
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, which expired at the end of 2015. The goal was for all stakeholders and partners to join forces and re-double efforts, so that together, the effective implementation of the Continental Policy framework including universal access to sexual and reproductive health by 2015 in all countries in Africa can be achieved. The Revised Maputo Plan of Action (MPoA) 2016 – 2030 was subsequently endorsed by the African Union Heads of State at the 27th AU Summit in July 2016 in Kigali, Rwanda. The plan reinforces the call for universal access to comprehensive sexual and reproductive health services in Africa and lays foundation to the Sustainable Development Goals, particularly Goal 3 and 5, as well as the African Union Agenda 2063.
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