Na­tional plan to cover ‘whole health sys­tem’

The Myanmar Times - - Front Page - SWAN YE HTUT swanye­htut@mm­times.com – Trans­la­tion by Thiri Min Htun and Win Thaw Tar

Pol­i­cy­mak­ers will craft a na­tional health plan for 2016-21 with the ul­ti­mate goal of achiev­ing uni­ver­sal health­care cov­er­age by 2030.

POL­I­CY­MAK­ERS will craft a na­tional health plan for the next five years with the ul­ti­mate goal of achiev­ing uni­ver­sal health­care cov­er­age by 2030, Health Min­is­ter Dr Myint Htwe said yes­ter­day.

The Union min­is­ter was giv­ing open­ing re­marks at an event to of­fi­cially launch the draft­ing process for the na­tional health plan 2016-21, held at Grand Amara Ho­tel in Nay Pyi Taw.

“The plan we are go­ing to draw up will not fo­cus on health­care ser­vice projects. It will be a plan to cover the whole health sys­tem,” he said. “It can fur­ther the goal of Myan­mar hav­ing uni­ver­sal health cov­er­age by 2030.”

Dr Thant Zin Htoo, as­sis­tant sec­re­tary for the Min­istry of Health and Sport, told me­dia that pre­vi­ous five-year na­tional health plans had been un­suc­cess­ful due to a lack of co­op­er­a­tion with rel­e­vant or­gan­i­sa­tions and a top-down bot­tle­neck that saw lower-level health of­fi­cials of­ten wait­ing on or­ders from their su­pe­ri­ors.

“The pre­vi­ous plans were weak in terms of abil­ity to im­ple­ment them in prac­tice. Then there was weak­ness in re­view­ing the plans. So we are try­ing to avoid such a sit­u­a­tion with the plan we are now draw­ing up,” he said.

Dr Myint Htwe said the bud­get for the na­tional health plan for 201621 would be an­nounced after de­tailed cal­cu­la­tions were made.

Three com­mit­tees have been formed to de­velop the plan, chaired by the Union health min­is­ter, and his min­istry’s per­ma­nent and as­sis­tant sec­re­taries.

Health of­fi­cials say they in­tend for the plan – the first drawn up un­der a gen­uinely civil­ian ad­min­is­tra­tion – to be not “min­istry-owned” but rather the cre­ation of a par­tic­i­pa­tory ap­proach that seeks in­put from rel­e­vant stake­hold­ers, in­clud­ing civil so­ci­ety and the gen­eral pub­lic.

A snap­shot from Py­in­mana town­ship re­veals how chal­leng­ing it may be for the Na­tional League for Democ­racy gov­ern­ment to strengthen a health sys­tem that was ne­glected for decades.

Though part of the sprawl­ing Nay Pyi Taw Union Ter­ri­tory cap­i­tal re­gion, Py­in­mana is largely ru­ral and its res­i­dents are an as­sort­ment of ven­dors, farm­ers and daily wage earn­ers.

For many, af­ford­able health­care op­tions are lim­ited to ba­sic phar­ma­ceu­ti­cals. Daw Hmat Gyi, who sells thapyay leaves in Th­e­gyun vil­lage, Py­in­mana town­ship, said daily profit from her busi­ness is typ­i­cally K5000 (US$4), and is spent on food and other house­hold ex­pen­di­tures for her fam­ily of four.

“If we have a headache, we take Decol­gen or Mix­a­grip ... We never get med­i­cal check-ups,” she said, adding that she did not suf­fer from di­a­betes, hy­per­ten­sion or other “rich peo­ple dis­eases”.

A visit to the 200-bed Py­in­mana Hos­pi­tal is re­served for bro­ken limbs and other se­ri­ous health prob­lems, she said.

An­other woman, a 30-year-old from Py­in­mana town­ship’s Min­galar ward who asked for anonymity, de­scribed how, ex­pe­ri­enc­ing preg­nancy com­pli­ca­tions, she once “se­cretly” checked her­self out of Py­in­mana Hos­pi­tal and went to a lo­cal clinic in­stead. Doc­tors at the hos­pi­tal, she said, had failed to al­le­vi­ate her pain with a treat­ment reg­i­men of the mild pain re­liever parac­eta­mol and an in­jec­tion that had no ef­fect.

“My aunt cared for me at the hos­pi­tal,” she said. “I told my aunt to ask for help from the doc­tors to re­lieve my pain but when my aunt told the doc­tors, they scolded her. When I asked my aunt a sec­ond time to go to the doc­tor, she dared not go.”

Ul­ti­mately, she spent three days at the Yezin clinic, had a mis­car­riage and was sad­dled with K287,000 in med­i­cal bills.

“The amount is two-thirds of our fam­ily’s in­come and we had to live with in­suf­fi­cient money for about three months,” she told The Myan­mar Times.

The na­tional health plan for the next five years will be di­vided into four spe­cific cat­e­gories, cov­er­ing projects re­lated to health in­fras­truc­ture, hu­man re­sources, health ser­vices and fi­nanc­ing.

The re­tired deputy di­rec­tor gen­eral of the Depart­ment of Pub­lic Health un­der the Min­istry of Health and Sport, Dr Ni­lar Tin, said th­ese projects’ suc­cess would be gauged in part on how ef­fec­tively they ben­e­fit re­mote and con­flict-af­fected parts of the coun­try.

“The re­mote re­gions are fac­ing a lack of health­care providers mainly be­cause of geo­graphic dif­fi­cul­ties, fi­nan­cial dif­fi­cul­ties, and dif­fer­ent cul­tures and opin­ions. Ev­ery­body knows this,” she said.

“We will dis­cuss with knowl­edge­able peo­ple from th­ese re­gions and get ad­vice from them and do projects [aimed at pro­vid­ing] full health ser­vices.”

Photo: EPA

Pa­tients wait for treat­ment at Paw Bu La Hta clinic in Kow Poe Kee vil­lage, Kayin State.

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