Background
Human resources for health (HRH) are the cornerstone of health systems, enabling the improvement of health service coverage. The systematic fortification of healthcare in Myanmar has accelerated since a new ruling party took office. Since 2006, Myanmar has been listed as one of the 57 crisis countries facing critical health workforce shortages. Therefore, this study aimed to assess the current situation of HRH in the public health sector where major healthcare services are provided to the people of Myanmar.
Methods
A cross-sectional study was conducted from January to May 2017 by collecting secondary data from the official statistic of the Ministry of Health and Sports (MoHS), official reports, press-releases, and presentations of Government officials. The data were collected using a formatted excel spreadsheet. A descriptive analysis was applied and the density ratio per 1,000 population for medical doctors and health workers was calculated.
Findings
In total, 16,292 medical doctors and 36,054 nurses working at 1,134 hospitals were under the management of MoHS in 2016. The finding revealed that 13 out of 15 States and Regions were below the WHO recommended minimum number of 1 per 1,000 population for medical doctor. The distribution of medical doctors per 1,000 population in the public sector showed a gradually decreasing trend since 2006. Urban and rural medical doctor ratios observed wide disparities.
Interpretation
The HRH shortage occurred in almost all State and Regions of Myanmar, including major cities. Wide disparities of HRH were found in urban and rural areas. The Myanmar government needs to consider the proper cost-effective HRH supply-chain management systems and retention strategies. The projection of health workforce, distribution of workforce by equity, effective management, and health information systems should be strengthened.
Myanmar has higher prevalence of tobacco use among students, especially among boys. The study provides evidence-based information for developing comprehensive tobacco control programs - both education and policy interventions to reduce smoking rate among young people in Myanmar.
Thailand is classified by the World Health Organization as one of a few countries in the world with the highest tuberculosis (TB) burden. The Thai Ministry of Public Health has implemented the ‘Tuberculosis Case Management’ (TBCM) as the main database for the national TB surveillance. TBCM is designed for case registration and management as well as case reporting and notification. This study thus aimed to evaluate TBCM for its surveillance function. A cross-sectional descriptive study was conducted to review the surveillance function of TBCM during 1 Jan to 30 Jun 2017 at Mae Sot Hospital, Thailand. The study team reviewed the protocols and guidelines of TBCM. The practice of health personnel at the TB clinic was observed to determine the data flow of TBCM. Qualitative and quantitative study methods were employed in accordance with the Center for Disease Control and Prevention’s Guidelines for Evaluating Surveillance Systems. We found that TBCM reporting system at Mae Sot Hospital was acceptable, stable and useful in achieving the objectives of TB control program. Sensitivity and positive predictive value of TBCM accounted for 80.8% and 99.4% respectively. The most common reason of miss-reporting was a loss to follow-up after admission or after health exam, particularly amongst non-Thai patients. Timeliness and data quality were concerned attributes that required improvement. TBCM and the in-house medical recording system should be harmonized to mitigate the risk of erroneous coding.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.