Reply To: Week 3 Topic discussion 2

[Soe Htike]

It’s difficult for me to definitively say which areas Myanmar might lack or need improvement the most because we need to improve all the themes discussed in the article. Let alone the digital health policy, we are facing one distinct challenge in any public health initiative, and that is a lack of transparency and trust.
Transparency and trust are crucial elements in any health system, and this is particularly true in the context of Myanmar, which has been affected by ongoing conflict. The conflict has had a significant impact on health in Myanmar, with ethnic populations experiencing inequitable health outcomes. Consequently, Ethnic Health Organizations and Community-Based Health Organizations (EHO/CBHOs) have created their health systems to meet the health needs of ethnic people. However, these systems remain parallel to the Government health system, provided by the Myanmar Ministry of Health (MoH), despite discussions about unification in the past.
The lack of trust between these parallel systems is a major challenge to collaboration. This mistrust is rooted in the ongoing conflict and the centralized nature of the MoH. The lack of accreditation for EHO/CBHO health workers also contributes to this mistrust.
Moreover, the military takeover in 2021 has further complicated the situation. It has led to a large civil disobedience movement, with many sectors of the civil service and general population participating in protests. This has resulted in a significant impact on the healthcare system in Myanmar, from the highest levels in the MoH to frontline community volunteers within the public sector.
In terms of transparency, there are challenges as well. The military council appointed its own Minister for the MoH. In contrast, the Committee Representing Pyidaungsu Hluttaw (CRPH), formed by elected members of parliament, appointed its own acting Union Minister for health. This dual leadership can create confusion and a lack of transparency about who is responsible for what in the health system.
In conclusion, enhancing transparency and building trust is critical for strengthening the health system in Myanmar. This involves addressing the root causes of conflict, ensuring equitable access to healthcare services for all ethnic groups, and fostering collaboration between different health systems.
Source:
https://conflictandhealth.biomedcentral.com/articles/10.1186/s13031-021-00396-z.
https://healthcluster.who.int/docs/librariesprovider16/meeting-reports/myanmar-public-health-situation-analysis-29-may-2021.pdf?sfvrsn=5fb3a66a_6&download=true.
https://link.springer.com/chapter/10.1007/978-981-15-9616-2_10.
https://gjia.georgetown.edu/2021/01/28/community-and-health-governance-in-myanmar-during-and-after-covid-19/.
Myanmar’s Healthcare System: Post Coup – The Borgen Project