Health in Myanmar

The general state of healthcare in Myanmar (also known as Burma) is poor. The military government of 1962-2011 spent anywhere from 0.5% to 3% of the country's GDP on healthcare. Healthcare in Myanmar is consistently ranked among the lowest in the world. In 2015, in congruence with a new democratic government, a series of healthcare reforms were enacted. In 2017, the reformed government spent 5.2% of GDP on healthcare expenditures. Health indicators have begun to improve as spending continues to increase.[1][2] Patients continue to pay the majority of healthcare costs out of pocket. Although, out of pocket costs were reduced from 85% to 62% from 2014 to 2015. They continue to drop annually. The global average of healthcare costs paid out of pocket is 32%. Both public and private hospitals are understaffed due to a national shortage of doctors and nurses. Public hospitals lack many of the basic facilities and equipment. WHO consistently ranks Myanmar among the worst nations in healthcare.[3]

Health infrastructure

Burma has 6 medical universities: 5 civilian and one military. All are operated by the government and recognised by the Myanmar Medical Council. They are:

  1. University of Medicine-1, Yangon
  2. University of Medicine-2, Yangon
  3. Defence Services Medical Academy
  4. University of Medicine, Mandalay
  5. University of Medicine, Magway
  6. University of Medicine, Taunggyi
  7. University of Community Health, Magway

In March 2012, Okayama University announced it was planning to build a medical academy in the country, tentatively named the Rinsho Academy, which would be the first foreign-run medical school in the country.[4]

Health status

Maternal and child healthcare

The 2015 maternal mortality rate was 178 deaths per 100,000 live births. This is compared with 240 in 2010, 219.3 in 2008, and 662 in 1990. The under 5 mortality rate, per 1,000 births is 73 and the neonatal mortality as a percentage of under 5's mortality is 47. In Myanmar the number of midwives per 1,000 live births is 9 and the lifetime risk of death for pregnant women 1 in 180.[5]

Abortion is illegal in Myanmar. Although the maternal mortality rate has decreased since 1970 in regards to pregnancy and childbirth, death due to abortion remains high due to attempts at obtaining illegal abortion.[6]

HIV/AIDS

HIV/AIDS recognised as a disease of concern by the Burmese Ministry of Health, is most prevalent among sex workers and intravenous drug users. In 2005, the estimated adult HIV prevalence rate in Burma was 1.3% (200,000 - 570,000 people), according to UNAIDS, and early indicators show that the epidemic may be waning in the country, although the epidemic continues to expand.[7][8][9] The National AIDS Programme Burma found that 32% of sex workers and 43% of intravenous drug users in Burma have HIV.[9]

The national government spent US$137,120 (K150,831,600) in 2005 on HIV, while international donors (the governments of Norway, the Netherlands, United Kingdom, and Sweden) donated US$27,711,813 towards HIV programmes in Burma.[10] Burma (ranked 51 out of 166 countries) has one of Asia's highest adult HIV prevalence rates, following Cambodia and Thailand. An estimated 20,000 (range of 11,000 to 35,000) die from HIV/AIDS annually.[11]

Malaria

Myanmar made significant progress in malaria control in the 2010s, with an 80 percent reduction in the number of confirmed malaria cases registered from 2011 to 2016 (from 567,452 to 110,146 respectively) and a 96 percent reduction in the number of deaths attributable to malaria has been reported in the same period (from 581 to 21 respectively).[12] Yet the malaria burden in Myanmar remains the highest among the six countries of the Greater Mekong Subregion, and an early warning sign of artemisinin resistance – delayed parasite clearance – has been reported in several parts of the country.[12]

Despite this, the annual monitoring of the therapeutic efficacy of first- and second-line recommended artemisinin-based combination therapies (artemether-lumefantrine and dihydroartemisinin-piperaquine) has shown that both are still fully efficacious with an adequate clinical and parasitological response above 95 percent.[12] P. falciparum, accounting for 60 percent of all malaria cases, and P. vivax are the major parasite species, and there are 10 malaria-transmitting mosquito species.[12] Analysis of the age and the sex distribution of malaria cases shows that the majority of cases occur in adult males, reflecting the risk associated with occupations such as mining, rubber tapping, construction, and forest-related activities.[12]

The ultimate goal of Myanmar’s National Strategic Plan for Intensifying Malaria Control and Accelerating Progress Towards Malaria Elimination (2016–2020) is to eliminate P. falciparum malaria by 2025 and all forms of malaria by 2030.[12]

See also

References
  1. "PPI: Almost Half of All World Health Spending is in the United States". 17 January 2007. Archived from the original on 5 February 2008.
  2. Yasmin Anwar (28 June 2007). "Burma junta faulted for rampant diseases". UC Berkeley News.
  3. "MYANMAR Myanmar faces medical emergency with unusable drugs and shortage of doctors". M.asianews.it. Retrieved 16 January 2018.
  4. Tsujita, Hideki (18 March 2012). "Okayama University extends hand to Myanmar". The Daily Yomiuri. Retrieved 17 March 2012.
  5. "The State Of The World's Midwifery". Unfpa.org. United Nations Population Fund. Retrieved 15 August 2011.
  6. Ba-Thike, Katherine (May 1997). "Abortion: A public health problem in Myanmar". Reproductive Health Matters. 5 (9): 94–100. doi:10.1016/s0968-8080(97)90010-0.
  7. "At a glance: Myanmar - statistics". UNICEF. Retrieved 9 January 2007.
  8. "A scaled-up response to AIDS in Asia and the Pacific" (PDF). UNAIDS. 1 July 2005. Archived from the original (PDF) on 23 February 2007. Retrieved 10 January 2007.
  9. "Asia" (PDF). UNAIDS. December 2006. Archived from the original (PDF) on 16 January 2007. Retrieved 9 January 2007.
  10. "Fund for HIV/AIDS in Myanmar - Annual Progress Report" (PDF). UNAIDS. 1 April 2005. Retrieved 9 January 2007.
  11. "Myanmar: Epidemiological Fact Sheets" (PDF). UNAIDS. 2004. Retrieved 10 January 2007.
  12. "Burma" (PDF). President's Malaria Initiative. 2018. This article incorporates text from this source, which is in the public domain.
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