Policy Note #4: Myanmar Health Systems in Transition Policy Notes Series
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.
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.
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This year’s report should dispel any lingering doubts that the world is moving backwards in its efforts to end hunger, food insecurity and malnutrition in all its forms. We are now only eight years away from 2030, but the distance to reach many of the SDG 2 targets is growing wider each year. Ther...e are indeed efforts to make progress towards SDG 2, yet they are proving insufficient in the face of a more challenging and uncertain context. The intensification of the major drivers behind recent food insecurity and malnutrition trends (i.e. conflict, climate extremes and economic shocks) combined with the high cost of nutritious foods and growing inequalities will continue to challenge food security and nutrition. This will be the case until agrifood systems are transformed, become more resilient and are delivering lower cost nutritious foods and affordable healthy diets for all, sustainably and inclusively.
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Forcibly Displaced Myanmar National / Rohingya Refugee Response.
This document gives guidance for medical providers to understand the care of both healthy and COVID suspect or confirmed patients who present for antenatal (ANC), intrapartum (IP), postnatal (PNC), or emergency obstetric and neonatal ...care (EmONC) in the context of caring for the forcibly displaced Myanmar national (FDMN) / Rohingya refugee population.
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Pakistan, one of the countries that is most vulnerable to climate change, received more than three times its usual rainfall in August 2022. Torrential rains and flash-flooding began in early July 2022, severely damaging living areas, schools and other communal buildings in refugee villages and host ...communities. Unprecedented and unrelenting rainfall and flooding in late August 2022 worsened the already fragile humanitarian situation. Nearly 1,700 people are reported to have died, and over 12,800 were injured, including at least 4,000 children
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Standard Treatment Guidelines
A wide range of potential enablers and barriers were identified for influencing progress for the scale-up of severe wasting services within national health systems. Findings were categorised according to the six pillars of WHO’s health system strengthening framework.
The overall goal of the Kenya Health Sector Referral Strategy is to improve client access to referral. The objectives of the strategy are to realise improved capacity of health providers to identify clients who require referral, develop protocols that will lead to referral system efficiency and effe...ctiveness, 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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National Operational Guidelines
The current guidelines on Integrated Management of Acute Malnutrition (IMAM), addresses the issue of improved management of severe acute malnutrition (SAM), particularly in children under 5 years of age. In the absence of standard protocols, mortality in children admitted to hospital with SAM can ra...nge between 20 -30% with the highest levels of 50-60% among those with oedematous malnutrition. With modern treatment regimens and improved access to treatment, case-fatality rates can be reduced to less than 5%. These provincial guidelines on IMAM in KZN, includes inpatient care protocols on the management of SAM, and outpatient and community outreach components to manage moderate acute malnutrition (MAM) and prevent deterioration to SAM.
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Young people living in the Central African Republic, Chad, Nigeria, Guinea, and Guinea-Bissau are the most at risk of the impacts of climate change, threatening their health, education, and protection, and exposing them to deadly diseases. The report is the first comprehensive analysis of climate ri...sk from a child’s perspective. It ranks countries based on children’s exposure to climate and environmental shocks, such as cyclones and heatwaves, as well as their vulnerability to those shocks, based on their access to essential services.
Additional translations of the Executive Summary are available in the following languages, with thanks to Climate Cardinals: English, French, Arabic, Hausa, Portuguese, Spanish, Somali, Yoruba
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2nd edition. Children with TB comprise about 10-12% of the total TB cases diagnosed in the country. This burden is likely to be higher given the challenges in diagnosing TB in children. The symptoms of TB in children mimic those of other childhood diseases. Children do not readily expectorate and th...ey have pauci-bacillary TB hence some will be missed using bacteriological tests. The government has however introduced GeneXpert molecular testing that is more sensitive than microscopy in detecting TB. Health care workers therefore need a reference guide to obtaining sputum from children for testing. Treatment of TB in children has been reviewed and now includes Ethambutol. There are now improved paediatric friendly TB medicines for treatment of TB in children and health care workers need a reference guide to enable them accurately dispense the TB medicine to children. Malnutrition is a common predisposing factor for TB in children. On the other hand, TB predisposes children to malnutrition or worsens an existing state of malnutrition. Nutrition care and support forms an integral part of treatment for a child with TB disease.
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Cancer is an emerging public health problem in sub-Saharan Africa due to population growth, ageing and westernisation of lifestyles. In this piece, we use data from Mozambique over a 50-year period to illustrate cancer epidemiological trends in low-income and middle-income countries to hypothesise ...potential circumstances and factors that could explain changes in cancer burden and to discuss surveillance weaknesses and potential improvements. This epidemiological transition deserves increasing policy attention.
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A new version will be published in March 2021