Myanmar's Human Resources for Health Development in Response to…….. HIV/AIDS, TB and Malaria Avian Influenza, Millennium Development Goals.

Myanmar's Human Resources for Health Development

in Response to……..

HIV/AIDS, TB and Malaria

Avian Influenza,

Millennium Development Goals.

Background Information

Total population 52.125 millions

Women of Reproductive Age 25%

MWRA 12%

Young people (10-24) 39%

17 States/Divisions, 52 districts, 325 townships,

over 65,000 villages

More than 120 ethnic groups

75% rural

Emerging Infectious Diseases (EID)

HIV/AIDSTBMalaria

Challenges are :-Access to healthGeographical equityAppropriate recruitment policyIncentive sytem

Challenges for Equitable HWF

Lack of explicit human resource policy

Maldistribution of staff between urban and rural

Need to strengthen posting, transfer, well defined incentive system

Challenges for HWF

Discordance between personal and the organization objectives

Weakness in Human Resource management system

Under utilisation of the currently available human resources due to mal distribution

Need for redefining job profiles of Basic Health workers at grass root level

HRH for HIV/AIDS

HIV/AIDS is a disease of national concern. National Strategic Paln for HIV/AIDS 2006-2010 was developed in coordination with all partners. Challenges are quality assurance with increased number of training programs for HIV/AIDS prevention, control and care activities.

HRH Challenges for HIV/AIDS

Limited resources for training, supplies and equipments to practice. Policy for HRH promotion / transfer and reallocation of staff so that those who have already been trained will not take up other jobs. Need for an incentive system to motivate health staff to continue working in the National HIV program.

HRH response to TB relating to MDG

The NTP in Myanmar achieved full geographic coverage with DOTS in 2003 with case detection and treatment success rates of 74% and 82% respectively.

Planning – Tuberculosis response- National Strategic Plan (2006-2011),

Scaling up activities and HRH requirements (categories), DOTS, TB /HIV

integrated activities.

Challenges

Staffing and infrastructure at all levels within the NTP are overstretched.

Nearly a quarter of posts at various levels are vacant in the face of high staff turnover

Situational analysis needs to be carried out on human resource development plan developed

Curricula for training to be standardized.

HRH for Malaria

The National Strategic Plan (2006-2011) was developed which includes national programs integrated with NGO activities for malaria.

There is a need to address the inadequacy of health personnel trained for Vector Borne Disease Control program at all levels.

HRH Challenges for Malaria

Research capacity building on entomology and vector control for field staff.

Weakness in capability in the field of training methodology, training tools and follow-up training

skill development in program management

improved monitoring and evaluation skills at all levels.

HRH response to AI

Myanmar being one of the developing countries of South East Asia, bordered by Thailand, China and Laos on the eastern boundary is a country at risk.

Potentially all countries can be affected if a pandemic occurs thus containing the threat of avian influenza poses a multi sectoral, cross border challenge

Myanmar as part of the global family is also committed to prevent the occurrence of a pandemic.

National Strategic Plan for AI

The plan cover planning and coordination,

reducing human exposure, surveillance and

early warning , rapid containment and response,

health system response and

social measures and risk communication.

AI Situation in Myanmar

There have been no new outbreaks in poultry reported since April 6 and the restrictions and bans imposed after the virus was first detected, have been lifted on 26 April 2006.

As of today, there have been no confirmed human avian influenza cases reported.

HRH Challenges for AI

Knowledge and Skills for surveillance and rapid response (early warning information, reporting)Diagnostic capacityRisk communicationKnowledge, Skill and practice of infection control ( use of PPE)Knowledge and skill of effective management of human AI case

Indicator Urban Rural Union

U5MR 37.3 72.5 66.1

IMR 27.8 53.2 49.7

NMR 11.5 16.5 16.3

IMR and U5MR were found almost doubled in rural areas.NMR was relatively high in urban as well and it calls for the implementation of ENC in both settings.

Indicator Hilly Coastal Delta Central Plains

Union

1. Household Size 5.2 4.9 4.6 5.0 4.9

2. Sex Ratio at Birth 100.3 109.1 103.0 104.1 104.0

3. Crude Birth Rate 21.03 19.30 18.24 16.60 18.39

4. Maternal Mortality Ratio

1.32 2.64 3.37 4.49 3.16

Maternal Mortality Ratio

Causes of Maternal Death (n=71)

8.45%

4.23% 7.04%

1.41%

16.90%16.90%

9.86%

35.21%

1. Haemorrhage2. Hypertensive disease of pregnancy in cluding eclar3. Abortion related4. Prolonged/obstructed labour5. Puerperal sepsis6. Postpartum anaemia causes7. Embolism8. Indirect causes

8

1

23

4

5

67

Man power(As of September 2006)ManpowerTHA 92HA1 320 HA 1440MW 9102LHV 1693 PHS1 631

PHS2 1391Vaccinator 1290

Trained Functioning

CHWs 42896 26450AMW 30296 21429

Coverage of Basic Health Services

Sr Services 2001 2005

1 RHC : population 1: 2,6700 1: 2,2700

2 Sub-RHC: pop 1 : 6000 1 : 5000

3 Midwife: pop 1: 5200 1: 4800

4 Midwife: village

1: 10 1: 8

HRH requirement for MDG's

Every delivery should be attended by skilled birth attendant (Estimated 1.2 millions birth per year)Every village should have a midwifery trained personnel (Over 65,000 villages)Recruitment: Capacity building through regular and refresher training on pregnancy, child birth, postnatal and newborn care (pre-service, in-service and international training)Management of HRH: deployment, retainment, sustaining incentives, attrition rate

Future Plan for Improvement of HRH situation in Myanmar

Develop a comprehensive HRH policy in general and well planned rotation/transfer policy.

Develop comprehensive HRH Data Base system

Strengthen co ordination between all stakeholders

Develop feasible incentive system (financial and non financial)

Improve networking for HRH

Future Plan (contd.)Skill mix balance

Introduce research for HRH to improve planning, production and management of HRH

Review recruitment policies, job profiles, work load, accountability