Description
Authors: Dr. Kyaw Myint Myat Thein1, Dr. Thida Lin2
Acknowledgements: We would like to thank WHO for funding support.
Introduction – Objectives: Non-communicable diseases (NCDs) are a major public health concern in Myanmar3. One-third of the population is affected by hypertension, and one in ten has diabetes. NCDs are responsible for 24% of deaths, and if proper measures are not implemented, fatalities due to NCDs are expected to double in the next decade4. To address these challenges this project aims to improve the use of NCD-related health services at primary healthcare centers by 1) increasing the capacity building of community-based volunteers and service providers for service provision; 2) improving access to NCD investigations and treatment across all health facilities; 3) creating a referral system with public and private sector networks for secondary and tertiary services; 4) developing a system for patient tracking and monitoring of NCDs and mental health services.
Methodology: The project was implemented in the peri urban area of Yangon Region and conflict-affected areas of Kayah State targeting 15,000 people, with equal numbers from each area. In three clinic models, involving charity clinics, private clinics of general practitioners (GPs), and faith-based clinics in emergency crisis areas, PATH provided capacity-building training for 51 healthcare providers and 34 community health volunteers on effective treatment of hypertension, diabetes, and mental health based on World Health Organization’s package of essential NCD (PEN) interventions guidelines. The project collaborated with mental health experts for webinars and counseling sessions. Monthly monitoring and evaluation were conducted with technical visits, online monitoring, clinical guidance, and regular training.
Results and Discussions: From June to December 2022, more than 14,000 people were screened for hypertension and diabetes, with approximately 5,600 cases of early detection for these diseases in the community, and then properly referred for further treatment by community volunteers. Around 3,700 patients received additional treatment through “Three clinic models” by a variety of healthcare providers. Both the screening and treatment guidelines were adopted from the PEN interventions implemented in Myanmar. In the capacity building of NCDs screening, care, treatment, and tobacco cessation, 34 community volunteers and 51 healthcare providers were trained. Patients with mental health issues received services through face-to-face consultations or virtual group webinars. One-on-one counseling was provided at least five times to 20 patients who urgently needed mental health support, and more than 150 people received mental health awareness through three virtual webinars. With significant challenges in Myanmar, innovative community-based approach is impressively filled gaps and assistance to communities in NCD intervention at primary health care level.
Conclusions: Myanmar has a high prevalence and incidence of NCDs. Timely screening services, prompt referrals, and effective treatment are needed to reduce NCD morbidity and mortality rates. Through community engagement of the primary health care systems in different settings both private and public sectors, we can work together to create a more sustainable and equitable future for NCD prevention and control, ultimately improving the health and well-being of our communities.
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