Assessing the role of non-state actors in health service delivery and health system resilience in Myanmar DOI Creative Commons

KK Than,

Maria Paola Bertone,

Tarasishin La

et al.

International Journal for Equity in Health, Journal Year: 2024, Volume and Issue: 23(1)

Published: Oct. 24, 2024

Abstract Background Due to the weaknesses of public health system and its low reach, especially in border areas, provision services by non-state actors (NSAs) has historically played an important role Myanmar. NSAs include local international NGOs civil society organisations (CSOs), but also Ethnic Health Organisations (EHOs) as well private (for profit) sector. This study aims understand changing shifting political environment Myanmar between 2010 2022, explore their contribution resilience. Methods Our includes three main components: a documentary review ( n = 22), key informant interviews (KIIs) at central level 14) two township-level case studies (13 KIIs, 4 FGDs). Mostly qualitative data were collected 2022 synthesized, using resilience framework structure analysis. Results During transition period (2010–2014) new era (2015–2020), while country gradually transitioned democratic system, government increasingly recognized NSAs. Initially, engagement with remained focused on disease-specific activities oversight was limited, later it expanded strengthening, including start “convergence” ethnic systems. Progress relatively slow, defined clear vision plans. The military coup February 2021 brought halt this progress. Collaboration interrupted, restored previous practices parallel most service stopped, time coping strategies emerged, which showed capacity absorb shocks (focusing basic services; informal communication channels; maintaining buffer stocks supplies) adapt (changing modes delivery supply chains, adjusting HRH training). Conclusions highlights during crises, provides insights how capacities built over provide adverse circumstances have informed response latest crisis. While absorption adaptation are noted study, we did not identify any transformation strategy – might indicate difficulty introduce radical changes when subjected multiple hostile environment.

Language: Английский

Assessing the role of non-state actors in health service delivery and health system resilience in Myanmar DOI Creative Commons

KK Than,

Maria Paola Bertone,

Tarasishin La

et al.

International Journal for Equity in Health, Journal Year: 2024, Volume and Issue: 23(1)

Published: Oct. 24, 2024

Abstract Background Due to the weaknesses of public health system and its low reach, especially in border areas, provision services by non-state actors (NSAs) has historically played an important role Myanmar. NSAs include local international NGOs civil society organisations (CSOs), but also Ethnic Health Organisations (EHOs) as well private (for profit) sector. This study aims understand changing shifting political environment Myanmar between 2010 2022, explore their contribution resilience. Methods Our includes three main components: a documentary review ( n = 22), key informant interviews (KIIs) at central level 14) two township-level case studies (13 KIIs, 4 FGDs). Mostly qualitative data were collected 2022 synthesized, using resilience framework structure analysis. Results During transition period (2010–2014) new era (2015–2020), while country gradually transitioned democratic system, government increasingly recognized NSAs. Initially, engagement with remained focused on disease-specific activities oversight was limited, later it expanded strengthening, including start “convergence” ethnic systems. Progress relatively slow, defined clear vision plans. The military coup February 2021 brought halt this progress. Collaboration interrupted, restored previous practices parallel most service stopped, time coping strategies emerged, which showed capacity absorb shocks (focusing basic services; informal communication channels; maintaining buffer stocks supplies) adapt (changing modes delivery supply chains, adjusting HRH training). Conclusions highlights during crises, provides insights how capacities built over provide adverse circumstances have informed response latest crisis. While absorption adaptation are noted study, we did not identify any transformation strategy – might indicate difficulty introduce radical changes when subjected multiple hostile environment.

Language: Английский

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