respiratory syndrome (SARS) and Avian Influenza (AI) are stationed at the port of entries to Myanmar health care situations. plans for highly infectious diseases occurring worldwide. Rapid response teams for severe acuteWhile the health authorities are combating normally occurring disease it has made contingency to check and to respond if found. Health personnel and facilities are at ready to face the emergency While the government is undertaking the health resources development it also conducts and emphasizes on health promotion and diseases prevention and control in parallel.
Prevention and control of diseases To the basic health care services, concept of prevention is better than cure, the Ministry of Health has been carrying out preventive measures as a focal in
health care delivery. Myanmar is still facing the health problem of Malaria which is the most prevalent disease locally. Malaria control is carried out by using the strategies and techniques of health education, distribution of impregnated bed-nets, personal hygiene, vector (mosquito) control, early diagnosis and effective treatment, capacity building, prevention of epidemics and collaboration with related organizations and communities. The effective application of these strategies resulted in declining of malaria mortality rate since 1990. Incidence rate dropped from (2400) per 100,000 in 1988 to (900) per 100,000 in 2005. At the same period Mortality rate also dropped from (10) to (3) per 100,000. Impregnated bed-nets were introduced in 2000 to far flung malaria endemic areas and distributed 50,000 nets yearly. It also made available moquitocides for net impregnation to villages amounting to 3-400,000 yearly. Starting from 2000, microscopic confirmation of malaria can be done in (700) rural health centres whereas only at the Township hospitals available in 1988. According to the new treatment regimen rapid
diagnosis test kits and artemesinin based combination therapy were made available to all rural health centres in 2006. Tuberculosis is also one of the major health problems in Myanmar. It is estimated that there are 120,000 TB patients in Myanmar and about half of them are transmittable sputum positive cases. Since 1997, Myanmar started introducing WHO recommended DOTS programme to townships and gradually increasing coverage so that it covered all 325 townships at the end of 2003.
Myanmar had constructed 5 years national strategic plan for TB control according to the guidelines of new stop TB initiative and International Standard for TB care. The success of this can be seen by the falling rate of case detecting rate (32%) and cured rate (78%) in 1994 to (86%) and (85%) respectively in 2006.
Tuberculosis is also one of the major health problems in Myanmar. It is estimated that there are
120,000 TB patients in Myanmar and about half of them are transmittable sputum positive cases. Since 1997, Myanmar started introducing WHO recommended DOTS programme to townships and gradually increasing coverage so that it covered all 325 townships at the end of 2003. Myanmar had constructed 5 national strategic plan for TB control according to the guidelines of new stop TB initiative and International Standard for TB care. The success of this can be seen by the falling rate of case detecting rate (32%) and cured rate (78%) in 1994 to (86%) and (85%) respectively in 2006.
The objectives of AIDS control programme are to reduce HIV transmission, socio-economic consequences and burdens and the morbidity and mortality rates. To fulfill these objectives, AIDS control programs and basic health staff has been carrying out the following 10activities.
(i) counseling
(ii) health education for prevention and control
(iii) reducing sexually transmitted HIV
(iv) reducing HIV transmission among IVDU
(v) reducing HIV transmission from mother to
child.
(vi) safe blood availability
(vii) medical care to AIDS patients.
(viii) multi-sectoral partnership.
(ix) special programme and projects
(x) work review and evaluation
Using the advance statistical methods of UNAIDS it is estimated in August 2007 that adult infectivity rate of HIV has fallen from (0.95%) in 2000 to (0.67%) in 2007. According to this estimation Myanmar has 240,000 HIV positive cases including AIDS patients and among them 14,000 are newly infected cases.
National level HIV/AIDS prevention and control exhibitions, one of its own kind in the region, were held in Yangon and Mandalay in 2003 and 2004 respectively. Since 2004, blood safety programme of the blood banks and hospitals covered the whole country and 200,000 blood bottles were screened yearly for HIV infection. According to “access for ace” policy, counseling of AIDS patients and their families, treating with ART and domiciliary care have been implemented.
In 2006, 6500 AIDS patients have received drug therapy that control HIV. Ministry of health, in
collaboration with other related ministries, national and international organizations, social organizations have been implementing the community based effective domiciliary care of chronic diseases including HIV and TB. Community based National Social Organizations such as Union Solidarity and Development Association, Myanmar Women’s Affairs Federation, Myanmar
Maternal and Child Welfare Association, Myanmar Red Cross Society, Myanmar Medical Asociation, Myanmar Nurses Association, Myanmar Health Assistants Association and other societies are collaborating and actively participating in this programme.
In Myanmar, Leprosy has been an infectious disease for years. Among the consequences of leprosy, deformities and disabilities are the cause of socioeconomic burdens for the families. Therefore the government is taking a great effort to lessen these burdens by treating the patients with multidrug regimen MDT resulting in great reduction of the new case detection rate from 54.4 per 100,000 in 1987 to (1.40) per 100,000 in 2004 and further reduction to (0.48) in 2005 and (0.47) in 2006. It can be assumed that Leprosy is removed from the list of immediate health problems. At present, the WHO had recognized Myanmar for eradicating the Leprosy since 2003.
In developing countries, there are high rates of child mortalities due to infectious diseases most of which are preventable with immunization. To prevent the infections, the government laid down the expended programme of immunization making all children to take Diphtheria, Chickenpox, Tetanus, Polio, Measles, Tuberculosis and Hepatitis vaccinations covering all townships of the country.
For polio eradication, the ministry of health hosted national polio immunization days (8) times, regional polio eradication days (4) times since 1996. There was no reporting of new polio cases between 2000 and early 2006 and thus Myanmar is free from polio during that period and WHO recognizes Myanmar as polio free country. But there were isolated cases of polio in 2006 May at Pyin-Oo-Lwin and in 2007 May at Kayan, Hpaan and Pyu townships resulting from mutated strains of polio vaccine virus. Observing these situation and to control the spread of diseases and to promote immunity, national immunization days (additional) was observed in 2007 to vaccinate new born and to fortify the under 5 children.
One of the commonest causes of under 5 children mortality is due to diarrhoeal infections resulting from contaminated food, unclean drinking water, poor environmental sanitation and poor personal hygiene. To prevent this it will be effective only if there is participation by the community. Starting from 1998 the national sanitation week was held yearly on every month of May. From this activity the community realizes the importance of environmental sanitation
and the health personnel were able to impart the technique of constructing fly proof latrines with the locally available materials.
Diseases can occur not only from infection of the pathogenic organisms but also due to nutritional deficiencies. These deficiency diseases are prevented by fortifications of the deficient nutrients in food such as by legislation of the compulsory iodination of household common salt for Iodine deficient goitre and low IQ condition, Vitamin A administration at National immunization days for prevention of Vitamin A deficient night blindness and acute respiratory tract infections. “These measures resulted in dropping of visible goitre rate from 14.5% in 1990 to 1% in 2007, night blindness from (0.6%) to (0.03%) and significant reduction of acute respiratory tract infections.
While the health authorities are combating normally occurring disease it has made contingency plans for highly infectious diseases occurring worldwide. Rapid response teams for severe acute respiratory syndrome (SARS) and Avian Influenza (AI) are stationed at the port of entries to Myanmar to check and to respond if found. Health personnel and facilities are at ready to face the emergency health care situations.
Prevention and control of diseases To the basic health care services, concept of prevention is better than cure, the Ministry of Health has been carrying out preventive measures as a focal in
health care delivery. Myanmar is still facing the health problem of Malaria which is the most prevalent disease locally. Malaria control is carried out by using the strategies and techniques of health education, distribution of impregnated bed-nets, personal hygiene, vector (mosquito) control, early diagnosis and effective treatment, capacity building, prevention of epidemics and collaboration with related organizations and communities. The effective application of these strategies resulted in declining of malaria mortality rate since 1990. Incidence rate dropped from (2400) per 100,000 in 1988 to (900) per 100,000 in 2005. At the same period Mortality rate also dropped from (10) to (3) per 100,000. Impregnated bed-nets were introduced in 2000 to far flung malaria endemic areas and distributed 50,000 nets yearly. It also made available moquitocides for net impregnation to villages amounting to 3-400,000 yearly. Starting from 2000, microscopic confirmation of malaria can be done in (700) rural health centres whereas only at the Township hospitals available in 1988. According to the new treatment regimen rapid
diagnosis test kits and artemesinin based combination therapy were made available to all rural health centres in 2006. Tuberculosis is also one of the major health problems in Myanmar. It is estimated that there are 120,000 TB patients in Myanmar and about half of them are transmittable sputum positive cases. Since 1997, Myanmar started introducing WHO recommended DOTS programme to townships and gradually increasing coverage so that it covered all 325 townships at the end of 2003.
Myanmar had constructed 5 years national strategic plan for TB control according to the guidelines of new stop TB initiative and International Standard for TB care. The success of this can be seen by the falling rate of case detecting rate (32%) and cured rate (78%) in 1994 to (86%) and (85%) respectively in 2006.
Tuberculosis is also one of the major health problems in Myanmar. It is estimated that there are
120,000 TB patients in Myanmar and about half of them are transmittable sputum positive cases. Since 1997, Myanmar started introducing WHO recommended DOTS programme to townships and gradually increasing coverage so that it covered all 325 townships at the end of 2003. Myanmar had constructed 5 national strategic plan for TB control according to the guidelines of new stop TB initiative and International Standard for TB care. The success of this can be seen by the falling rate of case detecting rate (32%) and cured rate (78%) in 1994 to (86%) and (85%) respectively in 2006.
The objectives of AIDS control programme are to reduce HIV transmission, socio-economic consequences and burdens and the morbidity and mortality rates. To fulfill these objectives, AIDS control programs and basic health staff has been carrying out the following 10activities.
(i) counseling
(ii) health education for prevention and control
(iii) reducing sexually transmitted HIV
(iv) reducing HIV transmission among IVDU
(v) reducing HIV transmission from mother to
child.
(vi) safe blood availability
(vii) medical care to AIDS patients.
(viii) multi-sectoral partnership.
(ix) special programme and projects
(x) work review and evaluation
Using the advance statistical methods of UNAIDS it is estimated in August 2007 that adult infectivity rate of HIV has fallen from (0.95%) in 2000 to (0.67%) in 2007. According to this estimation Myanmar has 240,000 HIV positive cases including AIDS patients and among them 14,000 are newly infected cases.
National level HIV/AIDS prevention and control exhibitions, one of its own kind in the region, were held in Yangon and Mandalay in 2003 and 2004 respectively. Since 2004, blood safety programme of the blood banks and hospitals covered the whole country and 200,000 blood bottles were screened yearly for HIV infection. According to “access for ace” policy, counseling of AIDS patients and their families, treating with ART and domiciliary care have been implemented.
In 2006, 6500 AIDS patients have received drug therapy that control HIV. Ministry of health, in
collaboration with other related ministries, national and international organizations, social organizations have been implementing the community based effective domiciliary care of chronic diseases including HIV and TB. Community based National Social Organizations such as Union Solidarity and Development Association, Myanmar Women’s Affairs Federation, Myanmar
Maternal and Child Welfare Association, Myanmar Red Cross Society, Myanmar Medical Asociation, Myanmar Nurses Association, Myanmar Health Assistants Association and other societies are collaborating and actively participating in this programme.
In Myanmar, Leprosy has been an infectious disease for years. Among the consequences of leprosy, deformities and disabilities are the cause of socioeconomic burdens for the families. Therefore the government is taking a great effort to lessen these burdens by treating the patients with multidrug regimen MDT resulting in great reduction of the new case detection rate from 54.4 per 100,000 in 1987 to (1.40) per 100,000 in 2004 and further reduction to (0.48) in 2005 and (0.47) in 2006. It can be assumed that Leprosy is removed from the list of immediate health problems. At present, the WHO had recognized Myanmar for eradicating the Leprosy since 2003.
In developing countries, there are high rates of child mortalities due to infectious diseases most of which are preventable with immunization. To prevent the infections, the government laid down the expended programme of immunization making all children to take Diphtheria, Chickenpox, Tetanus, Polio, Measles, Tuberculosis and Hepatitis vaccinations covering all townships of the country.
For polio eradication, the ministry of health hosted national polio immunization days (8) times, regional polio eradication days (4) times since 1996. There was no reporting of new polio cases between 2000 and early 2006 and thus Myanmar is free from polio during that period and WHO recognizes Myanmar as polio free country. But there were isolated cases of polio in 2006 May at Pyin-Oo-Lwin and in 2007 May at Kayan, Hpaan and Pyu townships resulting from mutated strains of polio vaccine virus. Observing these situation and to control the spread of diseases and to promote immunity, national immunization days (additional) was observed in 2007 to vaccinate new born and to fortify the under 5 children.
One of the commonest causes of under 5 children mortality is due to diarrhoeal infections resulting from contaminated food, unclean drinking water, poor environmental sanitation and poor personal hygiene. To prevent this it will be effective only if there is participation by the community. Starting from 1998 the national sanitation week was held yearly on every month of May. From this activity the community realizes the importance of environmental sanitation
and the health personnel were able to impart the technique of constructing fly proof latrines with the locally available materials.
Diseases can occur not only from infection of the pathogenic organisms but also due to nutritional deficiencies. These deficiency diseases are prevented by fortifications of the deficient nutrients in food such as by legislation of the compulsory iodination of household common salt for Iodine deficient goitre and low IQ condition, Vitamin A administration at National immunization days for prevention of Vitamin A deficient night blindness and acute respiratory tract infections. “These measures resulted in dropping of visible goitre rate from 14.5% in 1990 to 1% in 2007, night blindness from (0.6%) to (0.03%) and significant reduction of acute respiratory tract infections.
While the health authorities are combating normally occurring disease it has made contingency plans for highly infectious diseases occurring worldwide. Rapid response teams for severe acute respiratory syndrome (SARS) and Avian Influenza (AI) are stationed at the port of entries to Myanmar to check and to respond if found. Health personnel and facilities are at ready to face the emergency health care situations.
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