ျမန္မာျပည္ MOH မွဆရာ႔ဆရာႀကီးမ်ားခင္ဗ်ာ... Health System Building Block 6 ခုအနက္မွမည္သည္႔အပိုင္းကိုအရင္ျပင္မွာပါလဲ၊ မျပင္တတ္လို႔လား၊ ဒါမွမဟုတ္မျပင္ခ်င္လို႔လား၊ တိုင္းသူျပည္သားေတြက်န္းမာေရးနဲ႔ပတ္သတ္ရင္စုတ္ျပတ္သတ္ေနတာပဲျမင္ခ်င္လို႔လား။ မေန႔က BANGKOK POST ထဲကစာသားေတြထိထိမိမိႏိုင္လြန္းလို႔ေရးျပလိုက္ပါရေစ။ ေတာ္ေတာ္ဖတ္လို႔ေကာင္းဗ်၊ ရစရာကိုမရွိဘူး။ While the recent political reform in Myanmar hold promise for the country’s future, it’s long neglected health care system faces a number of challenges before it can deliver effective and affordable care to the people. Although the government increased spending on health care in 2013, the rise brought health care spending to 3.9 % of total budget. While the increased is promising, Myanmar remains one the world’s lowest countries in term of total money allocated in health care. In comparison, spending on the Military remains high representing 20.1% of the country’s total budget. A recent Reuters report noted that Myanmar was the only developing country in South East Asia where spending on the Military is higher the combined spending on health care and Education. According to the study by the UK medical publication The Lencet, Myanmar has some of the worst health indicators in the world. Life Expectancy is 56 years, 40% of all children under the age of 5 are moderately stunted, and Myanmar has more than 50% of all malaria-related death in southeast asia. This is in part due to poor diagnosis and treatment but also to the widespread prevalence of counterfeit anti-malaria medication. Although the majority of Myanmar’s population lives in rural areas, most health services continue to be concentrated in larger towns and cities. For example, according to the 2012 annual report published by the Myanmar Ministry of Health, rural health centers have only increased from 1,337 to 1,565 since 1988. Patients claim many of these centers lack basis supplies, medications and equitments. Patients with complex medical conditions frequently travel great distances, often to the larger city like Yangon, in the hope of finding treatment that is unaffordable or unavailable in their villages of towns. There are few hospitals that are able to provide treatment for complex cases and even at those facilities in Yangon that do offer care, treatment continue to be cost-prohibitive. Even with increased investment in health sector, Myanmar faces a long list of challenges when it comes to improving healthcare in the country. Widespread corruption can mean that the government’s increased spending on the healthcare system may disappear before it reaches its intended targets. At the other end of spectrum, patients are frequently expected to make under-the-table payments to ensure their quality care. Patients seeking care on Thai-Myanmar border report that the bribery is the common and a widely accepted aspect of getting healthcare in Myanmar. In addition to the upfront costs of doctor visits, medications and supplies, patients report having to pay from extra blankets to using the washrooms. Families also say that if they want to ensure their loved one receives quality care from hospital staffs, they must be prepared to pay extra. Those that are not prepared to pay bribes can expect longer wait times, poor quality care and some patients report that the hospital staff simply ignore them altogether. Another key challenge is the lack of reliable health indicators as data collection is difficult during the junta years. The lack of reliable data is likely to change as more health and Humanitarian organization start working within the country. However it is important that the government also play a role in contributing to reliable, consistent, and long term data collection and analysis that can help identified the priorities in healthcare delivery and investment. Because Myanmar faces a long road in rebuilding it’s ailing healthcare system, a strategic and measured approaches must be employed. In addition to continuing to increase spending, the government must address the needs of resource-starved rural health clinics and hospitals. Additionally, tackling corruption will be essential. Without better monitoring and oversight at the local level, there are few guarantees that funds allocated to healthcare will be used as intended and the most efficient and effective way possible. Finally it is essential to have better understanding the challenges facing the country. Better data collection and reporting are necessary to get an accurate picture of rates of disease, current healthcare outcomes, and the true resource constraints facing local clinics and hospitals. Where there is a long list of challenges facing the country’s health care system, attempting to address these issues are important first steps in the right direction. © to Ah Ba.
Posted on: Wed, 26 Jun 2013 08:04:05 +0000
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