15/05/2016
What health systems suit for Burma....................Looking at 5 components in current Burmese Healthcare System: ..........1) Leadership: Too much bureaucratic & authoritative, lack of transparency, lack of precise instruction....and no grassroots' view at all.................. 2.a) Healthcare Financing: Very little health care expenditure (2.4% of GDP which is the lowest in South East Asia, 2.b) Almost 100% self funded payment for health services............ 3) Healthcare personnel & Infrastructure: shortage of healthcare personnel in remote areas (much less than global healthcare standard of 2.3/1000 population) and limited hospitals and beds............ 4) Healthcare Information System & Technologies: very weak and far behind as being not computerised and no centralised data collection & data analysis, and unable to make correct decision based on evidence.............. 5) Service delivery: curative & preventive (rural: depends solely on Healthcare Centres or mid wives), Urban: can go any hospitals including private ones & Service Centres, and also can see and receive any types of Health Care Services if someone affords to pay the fees charged, there is "no gate control/keeping system"....means you don't need a GP's referral to see a specialist.....................................................What health systems can serve as models for Myanmar?...What to follow, how to follow, which system to be followed: Look at the similar background countries like Thailand and its healthcare system, and Cuba & Cuban healthcare system: The Cuban Universal health care system, aimed at preventative, very dedicated research and well developed health information technologies.............. ...What progress has Myanmar's healthcare system made in recent years??........(a) Myanmar government's health care expenditure: increased 2.4 in 2012 to 3.8% in 2015. some increase but still below ASEAN country standards. ......(b) Universal Health Coverage: Has done many reforms done to date, has done in Pay Tax assistance to some employees but still majority are poor and living in rural areas, poor social security policy,...... (c) Private Healthcare insurance system,........... (d) started collaboration with international health organizations more and more such as NGO organisations and how can Myanmar government ensures these NGOs are running effectively as per guidelines imposed. ...What consequences will these changes have for the people of Myanmar?....if decision was made correctly and the changes has been implemented effectively, many will be benefited and better quality of health, So it is extremely important for the future government has learnt from the past mistakes and not to make any more... Also another concern is the disparity/inequality between rural Vs urban health care system, allocation of future budget effectively to ensure the equity between rural and urban.reach.. .......................................How to reform Myanmar Healthcare System??? Topics needed to be discussed further: ...........(1) How to get more budget (reform taxation system including pay tax by every citizen by income threshold, collecting Good Service Tax (GST), especially for luxury items?, cut down military expenditure and spend more $ on Health Care System, introduction of retirement fund such as Superannuation contribution by employers as well employees), effective & adequate allocation between rural and urban, affordability, accessibility, equality,......(2) how to increase numbers of skilled personnel (for example, how to attract newly graduate young generation doctors to go to bush and prevent from brain drainage etc), better infrastructures and technologies, better training and Quality Assurance & maintain high standards with Continuing Professional Development (CPD/CME),.........(3) healthcare service delivery models (more concentrate on Primary Care/GP Based, make stronger GP referral system?, more Preventative, keeping patients away from Hospital Out Patient Department, so as to keep less admission to Public Hospitals rather than building too many), ...........(4)Service Fees: How to make affordable to every citizen, (Universal (free) for low incomer and the poor Vs Shared/Co-payment for high incomer and the rich via self funded or private health insurance), Private sector Vs Public sector health services & providers and finally how to improve Primary Care Vs Hospital Care, and Private Hospital Vs Public Hospital????.an many ?? Shall we look at Thailand, Australian and UK Healthcare Systems as well?...............Acknowledgement: Review based on Reforming Burma's Health System presented by Dr Phyu Phyu Thin Zaw.
