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Policy Note #2: Myanmar Health Systems in Transition Policy Notes Series
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. more
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. more
TAG’s HIV Project works to maximize equitable, affordable access to the tools, services, policies, and approaches
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to care that we know can end HIV. Ending the Epidemic (EtE) advocacy is at the core of the HIV Project’s work, from driving the nation’s first EtE initiative in New York to leading the Act Now: End AIDS coalition’s support for partners in heavily burdened jurisdictions in the Southern U.S. TAG’s HIV and policy teams tackle issues around drug pricing, funding for evidence-based HIV programming, access to healthcare, and policies that promote safe, inclusive environments free of stigma and discrimination for people to seek prevention and care for HIV and related infections, including sexually transmitted infections.
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These guidelines provide a framework for effective action to facilitate access to safe and ethical
testing services for different population group
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s. The implementation of the a comprehensive
approach, known as HIV Testing Services (HTS) is cardinal as an effective package of services
that diminishes the impact of the HIV epidemic in our country. All forms of HTS adhere to
the 5Cs: Confidentiality, Counselling, Consent, Correct results and Connection, or linkage
to care, with all based within a human right context. In addition to the 5Cs, however, the
MOHCDGEC emphasizes the use of a variety of approaches to HTS that will reduce the
number of missed opportunities. These include Provider-Initiated Testing and Counselling
testing, Couple counselling and testing, Index testing, and infant and children counselling and
testing in alignment to the revised WHO guidelines. Furthermore, these guidelines accentuate
on the continual provision of integrated HTS service at all levels of the public and private
health service delivery system.
The HTS Providers, managers and other stakeholders
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3 June 2021. After 40 years of AIDS, charting a course to end the pandemic.
The report shows that countries with progressive laws and policies and strong and inclusive health systems have had the best outcomes against HIV. In those countries, peopl
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e living with and affected by HIV are more likely to have access to effective HIV services, including HIV testing, pre-exposure prophylaxis (medicine to prevent HIV), harm reduction, multimonth supplies of HIV treatment and consistent, quality follow-up and care.
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This special issue on Newborn Health in Global Health Action is being launched to share the experience of how to scale up a cost-effective package of newborn
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care that involves families, community health workers and health facilities. The results of this community randomized trial, the Uganda Newborn Study (UNEST), show that home visits in pregnancy and soon after delivery resulted in improved breastfeeding practices, skin-to-skin care immediately after birth, delaying a baby’s first bath, and hygienic care of the baby’s umbilical cord among the poorest households with lowest access to care.
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It provides guidance on care for use in resource-limited settings or in settings where families with sick young infants do not accept or cannot access referral
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care, but can be managed in outpatient settings by an appropriately trained health worker. The guideline seeks to provide programmatic guidance on the role of CHWs and home visits in identifying signs of serious infections in neonates and young infants.
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Countries reported disruptions in all health-care settings. In more than half of countries surveyed, many people are still unable to access
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care at the primary care and community care levels. Significant disruptions have also been reported in emergency care, particularly concerning given the impact on people with urgent health needs. Thirty-six per cent of countries reported disruptions to ambulance services; 32% to 24-hour emergency room services; and 23% to emergency surgeries.
Elective surgeries have also been disrupted in 59% of countries, which can have accumulating consequences on health and well-being as the pandemic continues. Disruptions to rehabilitative care and palliative care were also reported in around half of the countries surveyed.
Major barriers to health service recovery include pre-existing health systems issues which have been exacerbated by the pandemic as well as decreased demand for care.
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The full-scale invasion of Ukraine has caused a deterioration in the level of access to health-care services and medicines in the country, particul
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arly for people living in regions close to the front line and areas that are not partially or fully controlled by the Government of Ukraine, and for people who have been internally displaced. Cost and time constraints involved in getting to and from health facilities, as well as limited transportation options were the main barriers to accessing essential health-care services. At the same time, the findings show that the country’s health system remains resilient and that overall access to health services is fairly high.This report is based on data collected through a quantitative cross-sectional survey of self-reported health needs of the general population in Ukraine. It presents results of the first round survey conducted in September 2022 and could help to address the specific health-care needs of the population groups concerned.
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This Global Competency Standards sets the benchmark for the health workforce in providing equality of care to refugees and migrants. Refugee and migrant populations are highly diverse, with signific
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ant variation in life experiences, health needs and access to health care. The standards described outline expected behaviours of health workers in delivering quality care to refugees and migrants and can be used to inform the outcomes of education programmes aligned with standards for care. The Competency Standards is designed to provide a foundation to support the development of competency-based curricula tailored to the local context and for health workers to achieve a minimum level of competence. The importance of person-centred, culturally responsive care is emphasized in the nine competency standards, which recognize the need for health workers to be trained, supported and empowered within strong health systems
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The publication is designed to provide Ipas staff, trainers, partners and other health-care providers with access
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to up-to-date, evidence-based recommendations. In general, the recommendations are the same as those in the World Health Organization’s 2012 Safe Abortion: Technical and Policy Guidance for Health Systems, Second edition. In rare cases, the recommendations have been modified due to the settings where Ipas works. In addition, if there is more current evidence to inform the recommendations, they will be updated here.
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Managing possible serious bacterial infection in young infants when referral is not feasible
recommended
It provides guidance on care for use in resource-limited settings or in settings where families with sick young infants do not accept or cannot access referral
...
care, but can be managed in outpatient settings by an appropriately trained health worker. The guideline seeks to provide programmatic guidance on the role of CHWs and home visits in identifying signs of serious infections in neonates and young infants.
more
According to official figures from Migración Colombia by the end of June 2019, there were more than 1.4 million Venezuelan refugees and migrants living in Colombia. The majority of people have settled in the border departments of La Guajira and Nor
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te de Santander, continuing to cities along the Caribbean coast, or larger cities inland such as Medellin and Bogotá. Significant numbers of Venezuelans continue to cross Colombia by foot, heading for larger cities with more opportunities and better services or towards the southern border with Ecuador to continue their onward journey to a third country. Refugees and migrants arrive in Colombia with immediate humanitarian needs including access to safe accommodation, food, basic health care, but the prolonged nature of their displacement also requires longer term solutions including access to formal employment, education and social integration. The Interagency Group for Mixed Migration Flows (GIFMM) works closely with the Government at both the national level, and across 11 of the most affected departments, to deliver direct emergency assistance, protection, socio-economic integration activities and seeks to build the capacity of the host government.
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Many migrants find themselves with limited access, if any, to information about risks, prevention measures, health care and other essential service
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s. Migrants in transit, those in need of international protection or without legal status are likely to be particularly vulnerable, as well as those who are homeless, held in detention, living in camps, formal or informal settlements or otherwise precarious conditions
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Estimated number of pregnant women, number with access to at least four antenatal care visits, and those delivering in hospital settings in the Ame
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ricas, 2019...
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The Policy Guidelines and Service Standards for National Sexual and Reproductive Health Programme document outlines the steps on how to offer and deliver services. Improving quality of care is criti
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cal to improving clients' health status as well as increasing access to, and utilization of Sexual and Reproductive Health services. Service Standards and Guidelines are intended to be used by programme managers, implementers, trainers, surpervisors, and service providers as a tool for delivering quality care measures.
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Developmental disabilities are common. Yet, children with developmental disabilities have been neglected in health systems planning and policy provisions for health and continue to experience stigmatization, institutionalization, barriers
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to access health care and inequalities in health and education outcomes.
Using findings from research and practice and guided by the tenets of international human rights conventions, this WHO-UNICEF Global Report on children with developmental disabilities provides principles and approaches to intentionally include the needs and aspirations of children and young people with developmental disabilities in policy, programming and public health monitoring. It makes the case for greater accountability and proposes 10 priority actions to accelerate changes towards inclusive environments and responsive multisectoral care systems for children with developmental disabilities.
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The EHSP in Botswana seeks to attain universal coverage of high-quality package of essential health services. The EHSP is an integrated collection of cost-effective interventions, promotive, preventive, curative, and rehabilitative, that address the
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main diseases, injuries and risk factors that affect the population. The EHSP has two key purposes:
1) Provide a standardized package of basic services which forms the core of service delivery in all primary health care facilities
2) Promote a redistribution of health services by providing equitable access, especially in underserved areas, population, etc.
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The overall goal of the Kenya Health Sector Referral Strategy is to improve client access to referral. The objectives of the strategy are
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to realise improved capacity of health providers to identify clients who require referral, develop protocols that will lead to referral system efficiency and effectiveness, and promote and facilitate information and communication technology (ICT) to manage referrals, improve care, enhance capacity of the referral system in Kenya, provide communication and related equipment, and promote research and innovation for referrals.
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Background: Cardiovascular disease (CVD), mainly heart attack and stroke, is the
leading cause of premature mortality in low and middle income countries (LMICs).
Identifying and managing individuals at high risk of CVD is an important strategy to
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prevent and control CVD, in addition to multisectoral population-based interventions to reduce CVD risk factors in the entire population.
Methods: We describe key public health considerations in identifying and managing individuals at high risk of CVD in LMICs.
Results: A main objective of any strategy to identify individuals at high CVD risk is to maximize the number of CVD events averted while minimizing the numbers of
individuals needing treatment. Scores estimating the total risk of CVD (e.g. ten-year risk of fatal and non-fatal CVD) are available for LMICs, and are based on the main CVD risk factors (history of CVD, age, sex, tobacco use, blood pressure, blood cholesterol and diabetes status). Opportunistic screening of CVD risk factors enables identification of persons with high CVD risk, but this strategy can be widely applied in low resource settings only if cost effective interventions are used (e.g. the WHO Package of Essential NCD interventions for primary health care in low resource settings package) and if treatment (generally for years) can be sustained, including continued availability ofaffordable medications and funding mechanisms that allow people to purchase medications without impoverishing them (e.g. universal access to health care). Thisalso emphasises the need to re-orient health systems in LMICs towards chronic diseases management.
Conclusion: The large burden of CVD in LMICs and the fact that persons with high
CVD can be identified and managed along cost-effective interventions mean that
health systems need to be structured in a way that encourages patient registration, opportunistic screening of CVD risk factors, efficient procedures for the management of chronic conditions (e.g. task sharing) and provision of affordable treatment for those with high CVD risk. The focus needs to be in primary care because that is where most of the population can access health care and because CVD programmes can be run effectively at this level.
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Protecting the fundamental rights of people affected by HIV
Under the Constitution of the Republic of the Union of Myanmar (2008), every citizen - including people living with HIV - has the right to work, ... access health care, and receive basic education.
However, stigma and discrimination remains, preventing people living with HIV (PLHIV) from accessing health services, maintaining employment and receiving education – denying them of the fundamental rights that all Myanmar citizens are entitled to under the law.
No publication year indicated. more
Under the Constitution of the Republic of the Union of Myanmar (2008), every citizen - including people living with HIV - has the right to work, ... access health care, and receive basic education.
However, stigma and discrimination remains, preventing people living with HIV (PLHIV) from accessing health services, maintaining employment and receiving education – denying them of the fundamental rights that all Myanmar citizens are entitled to under the law.
No publication year indicated. more