Policy Note #1: Myanmar Health Systems in Transition Policy Notes Series
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 peop...le 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 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.
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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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Background Paper prepared for the 2015 Global Assessment Report on Disaster Risk Reduction
The aim of this paper is to help bring voluntary standards into the toolbox of disaster risk reduction, including both by encouraging their use by business and by enhancing their role in legislation and ...regulatory practice.
- Authorities can build awareness for standards in Disaster Risk Reduction (DRR), by facilitating access to relevant standards, encouraging education on DRR-related standards and involving the standardization community.
- Standards need to be sustained by a powerful infrastructure that allows for reliable inspections, audits and precise measurements to be conducted by skilled professionals.
- Risk management best practice needs to embed, as emdodies in standards, more fully in regulatory frameworks in sectors that are relevant.
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Myanmar is prone to various natural hazards that include earthquakes, floods, cyclones, droughts, fires, tsunamis, some of whichhave the potential to impact large numbers of people. In the event that large numbers of people are affected (such as was the case in 2008 following cyclone Nargis), the go...vernment may decide to request international assistance to respond to the disaster.
The overall goal of the ERPP is to mitigate the impact of disasters and save as many lives as possible from preventable causes. It aims to ensure that effective and timely assistance is provided to people in need through effective coordination and communication on emergency preparedness and humanitarian response between members of the HCTin Myanmar. The approach has been developed in collaboration with the Government, to facilitate a coordinated and effective support to people affected by humanitarian crises.
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Myanmar is prone to various natural hazards that include earthquakes, floods, cyclones, droughts, fires, tsunamis, some of whichhave the potential to impact large numbers of people. In the event that large numbers of people are affected(such as was the case in 2008 following cyclone Nargis), the gov...ernment may decide to request international assistance to respond to the disaster.
The overall goal of the ERPP is to mitigate the impact of disasters and save as many lives as possible from preventable causes. It aims to ensure that effective and timely assistance is provided to people in need through effective coordination and communication on emergency preparedness and humanitarian response between members of the HCTin Myanmar. The approach has been developed in collaboration with the Government, to facilitate a coordinated and effective support to people affected by humanitarian crises.
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In April and May 2015, Nepal was hit by two major earthquakes killing around 9,000 people and leaving many thousands more injured and homeless.
To optimize the speed and volume of critical humanitarian assistance, the HCT has developed this Plan to:
1. Reach a common understanding of earth...quake risk to ensure early action is taken when required.
2. Establish a minimum level of earthquake preparedness across clusters.
3. Build the basis for a joint HCT response strategy to meet the needs of affected people in the first 6 weeks to 3 months of a response.
4. Define considerations for detailed contingency planning on the basis of the worst-case scenario, especially around access and logistics.
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A recent survey of the literature and experience identified five broad actions that development institutions and governments, as well as their partners and stakeholders, can take to improve disability-inclusive disaster risk management. Those five actions are:
- Include persons with disabilitie...s as valued stakeholders in disaster risk management activities
- Help remove barriers to the full participation of persons with disabilities
- Increase awareness among governments and their partners of the safety and security needs of persons with disabilities
- Collect data that is disaggregated by disability
- Ensure that new construction, rehabilitation and reconstruction are accessible to persons with disabilities
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The BRACED Myanmar Alliance was a three-year project aiming to ‘build the resilience of 350,000 people across Myanmar to climate extremes’. The project worked in 7 states, 8 townships and 155 communities. The main impact for project populations was intended to be ‘improved well-being and reduc...ed loss and damage despite climate shocks’, and the project sought to do this by addressing immediate hazard-related needs at community level while encouraging longer-term solutions driven and delivered by communities and subnational and national government.
Community Resilience Assessments (CRAs) were the first activities delivered as part of the project, and the list of community-identified needs became the basis from which local-level project interventions were selected. The selection typically involved an infrastructure requirement (linked to addressing a natural hazard, and sometimes shared between communities); a package of livelihood support (assets and trainings); capacity-building on climate change/resilience topics; and village savings and loans association (VSLA) support. A particular emphasis was placed on women’s empowerment, and leadership trainings and support to women’s self-help groups were provided.
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The scope of the Guidance is primarily the education in rural settings in Myanmar, but it covers some of the issues which have pan Myanmar implication and relevance. Considering the importance, complexity and vastness of the subject, similar type of initiatives on urban school and education system a...nd other issues needs to be taken up in future.
The Guidance has four sections namely Introduction to this Guidance, Rationale for Mainstreaming DRR in the Education Sector, How to Mainstream Disaster Risk Reduction in Reconstruction Process of Education Sector in Myanmar and Creating an Enabling Environment for Safer Education. The Guidance also includes good practices of various agencies involved in Cyclone Nargis education sector recovery as example.
No publication year indicated.
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This gender analysis was conducted to understand the different risks and vulnerabilities but also opportunities and skills for Rohingya and host community women, men, boys and girls. Data collection was conducted over three weeks from 8 April to 29 April 2018. The work aimed to identify the differen...t needs, concerns, risks and vulnerabilities of women, girls, boys and men in both Rohingya refugee communities and host communities in the Cox’s Bazar district of Bangladesh. The analysis shows various gaps in the humanitarian response for both communities, especially in terms of accountability, communication with affected communities and disaster preparedness, but also in equitable access to services, in particular for women and girls, and especially for the Rohingya community. The key findings are presented below, along with recommendations for action.
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Research results of sexual and gender-based violence (SGBV) prevention and response before, during and after disasters in Indonesia, Lao PDR and the Philippines
This report contributes new evidence on why and how sexual and gender-based violence (SGBV) risks increase during humanitarian disasters.... It details how humanitarian actors can better prevent and respond to such escalation of SGBV, and better meet the needs of affected women, girls, men and boys. This research is based on community views of disaster-affected women, adolescent girls, men and adolescent boys in three South-East Asian countries: Indonesia, Lao PDR and the Philippines.
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Submitted to the US Agency for International Development by the Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program. Arlington, VA: Management Sciences for Health. Submitted to the United Nations Children’s Fund by JSI, Arlington, VA: JSI Research & Training Institute, Inc....
This guide will assist program managers, service providers, and technical experts when conducting a quantification of commodity needs for the 13 reproductive, maternal, newborn, and child health commodities prioritized by the UN Commission on Life-Saving Commodities for Women and Children. This quantification supplement should be used with the main guide—Quantification of Health Commodities: A Guide to Forecasting and Supply Planning for Procurement. * This supplement describes the steps in forecasting consumption of these supplies when consumption and service data are not available; after which, to complete the quantification, the users should refer to the main quantification guide for the supply planning step.
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The USAID | DELIVER PROJECT, Task Order 4, developed this guide for quantifying health commodities; it will assist technical advisors, program managers, warehouse managers, procurement officers, and service providers in (1) estimating the total commodity needs and costs for successful implementation... of national health program strategies and goals, (2) identifying the funding needs and gaps for procuring the required commodities, and (3) planning procurements and shipment delivery schedules to ensure a sustained and effective supply of health commodities.
The step-by-step approach to quantification presented in this guide is complemented by a set of product-specific companion pieces that include detailed instructions for forecasting consumption of antiretroviral drugs, HIV test kits, antimalarial drugs, and laboratory supplies.
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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 resp...onses 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.
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The five hepatitis viruses have different epidemiological profiles, and their impact, duration, and transmission route also vary. The most common transmission routes contributing to the spread of hepatitis are exposure to infected blood via blood transfusion or unsafe injection practices, consumptio...n of contaminated food and drinking water, and transmission from mother to child during pregnancy and delivery. Also, unsafe injection practices, including the use of unsterile needles and syringes, serve as a major pathway for the spread of hepatitis B and C, and reducing transmission of both diseases requires addressing these practices.
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Policy Brief, Updated in March 2017
Key messages
• The criminalisation of male-to-male sex heightens HIV and other sexually transmissible infection (STI) risks and vulnerabilities, and hinders access to HIV and STI services including HCT.
• Men who have sex with men (MSM) and tran...sgender persons (TG) are not a homogeneous group. As such, a variety of HCT service models are needed to reach the various segments of these populations.
• Stigma and discrimination remain ongoing issues at a number of service points. Targeted training of service providers is therefore needed so that MSM and TG are not discouraged from seeking HCT and high-quality prevention, treatment and care services.
• Specific guidelines on HIV prevention, treatment and care services for MSM or TG help improve the delivery of services.
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Policy Brief, Updated in March 2017
Key messages
• Meaningful involvement of sex workers in the HIV response through peer-based education and outreach and consultation in policy making and programme planning is vital to reduce their vulnerability to HIV and other sexually transmitted inf...ections (STIs) and ensure that the challenges they face are addressed adequately.
• Sex workers (female, transgender and male) have the right to protect their health through accessing comprehensive and evidence-informed HIV and sexual and reproductive health (SRH) interventions.
• Innovative HIV prevention strategies and creative use of combination interventions are needed to reach mobile and ”hard to reach” sex workers.
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This predominantly qualitative research on disability and development in Myanmar was conducted between August 2011 and February 2012, in three commercial centres of Yangon, Mandalay and Taunggyi. Stakeholders of service providers, persons with disabilities (PWDs) and families of disabled people were... interviewed in order to discover the needs and challenges that they face. Discoveries were made concerning independent living and adaptive education, vocational training and livelihoods challenges, community-based rehabilitation, organisational and human resource capacity, and information channels, networking and cooperation between organisations.
The study found that PWDS, especially those with intellectually disabilities, need training for independent living, adaptive special education, motor development programs and behaviour modification programs in special institutions. Effective services and programs are necessary in all of these areas of need.
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Commitment objective
The Government of Myanmar views family planning as critical to saving lives, protecting mothers and children from death, ill health, disability, and under development. It views access to family planning information, commodities, and services as a fundamental right for every... woman and community if they are to develop to their full potential.
• Increase CPR from 41 percent to 50 percent by 2015 and above 60 percent by 2020
• Reduce unmet need to less than 10 percent by 2020 (from 12 percent in 2013)
• Increase demand satisfaction from 67 percent in 2013 to 80 percent by 2020
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The Indonesian government has reformed its laws, policies, and institutions to better manage disaster risk since the significant 2004 Indian Ocean Tsunami. The Government of Indonesia now has contingency plans for every disaster-prone city which identifies its vulnerabilities, outlines the relief re...sponse, and builds overall preparedness. In 2007, the government introduced a disaster management bill that incorporated disaster management prevention into disaster management response. In 2008, Indonesia created the National Disaster Management Agency (Badan Nasional Penanggulangan Bencana, BNPB). The new shift led to the strengthening of the country’s disaster management agency, and the addition of district branches and representatives. Despite the progress made, more work is needed at the local level as well as integration of disaster risk reduction in government departments.11 Under Indonesia’s 2007 Disaster Management law, provincial and district administrations are mandated to head disaster management during a crisis.
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