Myanmar 2015 ACTwatch Outlet Survey Results

Download File

Abstract

In the past decade, Myanmar has made significant progress in reducing malaria morbidity and mortality. The number of malaria deaths has dropped steadily year by year from 1,707 in 2005 to just 37 in 2015 (greater than a 98% reduction over 10 years)1 reflecting major improvements in access to early diagnosis and appropriate treatment. Despite these achievements, malaria remains a leading cause of morbidity and a cause of mortality in Myanmar, and in 2015, the country’s malaria burden still accounts for around 70% of reported cases in the GMS. Compounding this issue and threatening recent progress is the independent emergence and geographical spread of multi-drug resistant malaria throughout the country. Myanmar is thus critical to global efforts to contain resistance and towards the progress of regional and national elimination efforts.

Sources of treatment for malaria
At present, the private sector plays a very significant role in malaria case management in Myanmar. An estimated 70% of people seek malaria treatment in the private sector in Myanmar. The private health sector in Myanmar is vast; in 2014 it included an estimated 18,443 medical practitioners, either in private for-profit facilities or after official hours in the public service, as well as licensed and unlicensed pharmacies, general retail shops, and informal providers (also known as itinerant drug vendors). The last three categories are largely unregulated, and have lower availability of ACT and dispense most of the oral artemisinin monotherapy in Myanmar. In 2010, there were an estimated 103 private hospitals, 192 specialty clinics, and 2,891 general clinics. Of the 31,542 doctors in 2013-2014, 18,443 worked as private practitioners and the remainder operated in the public sector. However it is acknowledged that many doctors and other staff in the public health service are engaged in private practice after official working hours to supplement their income. Treatment seeking in the private sector is largely due to the historical underfunding of the public sector, and difficulties of service delivery in remote, border, and conflict affected areas. To date, private sector involvement in public sector health programs has been limited