EVIDEN

E
NCEFO
ORDECISION
N

HealtthInformation
nService
es

Healthinfformationis oneofthesixbuildingblo
ocksofHealtthSystemand
dwhichintu
urnplaysa
vitalrole fordecisionm
makingasstrrongevidencee.Healthinfo
ormationservvicesinMyan
nmarcover
ndHospitalCaareServices.
mainlyforrPublicHealtthServicesan
Morbidityy and mortaliity statistics in hospitals mainly
m
depen
nd on the qu
uality of diseaase coding
and thuss, training of medical reecord techniicians as weell as mediccal doctors on
o ICD10
(InternationalStatisticalClassificationofDiseaseesandRelateedHealthProblems10thR
Revision)is
ortant for qu
uality statisticcs. Two weekks ICD10 training of med
dical record technicians
very impo
andfourd
daystrainingofmedicaldo
octors,inchaargeorsupervvisorofmedicalrecorddeepartment,
were conducted in Naay Pyi Taw during
d
2013. In addition, 7 days ICD1
10 trainings of
o medical
dedandabovvehospitalsw
werealsocarrriedoutinNo
ovemberandDecember
doctorsfrrom150bedd
2013 acco
ording to Cou
untry Roadmaps formulatted from Nattional Worksh
hop on Comm
mission on
Informatio
on and Acco
ountability for Womens and
a Childrens Health (CO
OIA)being helld early in
2013.In2
2014,20med
dicaldoctorsaand30mediccalrecordtecchniciansfrom
m100bedded
dhospitals
weretrain
nedonICD10
0andCAMRSS.
Followup
p data quality assessm
ment on ho
ospital
statistics after trainiings was performed in
n five
ose were seending softco
opy of
hospitals in 2013, tho
oding in Hosp
pital Report Form II to ceentral.
ICD10 co
Overalldaataqualityon
nICD10codin
ngwasfound
dtobe
67.6% an
nd need more refresher training
t
as well
w as
moreclossesupervision
nonICD10coding.
Medicalrecorddocum
mentationwassalsocheckeedalongwith ICD10codin
ngassessmen
nt.Theuse
hebestuseo
ofstandardizeedMRwas
ofstandardizedformatofMR1toMR4wasassessedandth
revealedaasMR4with71.4%.

132
1

Data collection
c
fro
om private health
h
sectorr (licensed
privateehospitals)w
wasstartedat January2013tofigure
outtheewholepictu
ureofnationwidedata.O
Orientation
trainingg on private health secto
or data colleection was
conduccted for two
o days with the collabo
oration of
privatee hospital association; manual was
w
also
distribu
uted. Moreo
over, the tw
wo batches of basic
mediccalrecordtraiiningwascon
nducted;oneinYangon
andoneinMandallayduringJan
nuaryandMaarch2014.
Mediccal superinttendents, medical
m
offiicers, in
chargees/supervisorrs of medicaal record deepartment
and medical record technicians weree actively
particiipatedinthossetraining.
For quality improvvement of public
p
health statistics,
understanding of data definitiion and application of
indicatorsinrealtiimesituation
nareessentiaalforbasic
healthstaaff.TrainingsofBHSonHM
MISdataset anddatadicttionarywere providedto1
1348basic
healthstaafffrom22to
ownshipsin20
013and876basichealthsstafffrom13townshipsin
n2014.

Trainingo
oftrainersapproachforBH
HStrainingon
nHMIS
at Region
n/State levell was condu
ucted according to
country roadmaps
r
of COIA; it covvers 8 region
ns and
states. Altogether
A
290
2
township training team
membersfrom124to
ownshipsof8
8regionsand states
attendedandactivelyparticipated.

133

Evaluation
n is one of the
t most imp
portant processes in
managem
ment cycle an
nd therefore, evaluation on
o HMIS
was carrieed out in all states and regions
r
as well as in
central. Workshop on
o health related Millennium
ment Goals was
w held in Nay
N Pyi Taw on 21st
Developm
August,20
013.

As Hospital information
n System is now
imp
of electroniic medical
plementing development
d
reccord system,, the softw
ware used in public
hosspitals has beeen upgradin
ng. This softw
ware is not
only to be used
d for health care statisticcs but also
nuationofmeedicalcare
meeanttobeuseedforcontin
forthepatients..

Inthesam
meway,HMIISisnowtryingtoimplem
ment
eHMIS by using DHIS2,
D
whicch is the web
applicatio
ontobeused
din publicheealthinformaation
system, for more convenient and easy way to
o get
neousandtim
melydata.Traainingoftrainers
lesserron
onDHIS2
2wascarried
doutinNay PyiTawwith
hthe
participattion of statissticians from all Regions and
States an
nd basic he
ealth staff from two pilot
townshipss. In Septem
mber and Octtober 2014, basic
b
health staaff from each reporting unit of two pilot
townshipss; Patheingyyi and Nyaunglaybin, were
w
provided DHIS2 train
ning. The UR
RL for electrronic
public health
h
information system https://
www.health.gov.mm/d
dhis/ is now ready for offficial
launchan
nditwillbefu
unctioningfro
omJanuary20
015.

134
1

HealthResearch
The Department of Medical Research (Lower
Myanmar) has two remarkable events during the
year 2014 in support of collaborative research to
intensify knowledge management and networking.
Thelaunchingofthetriplewebsiteviz:Department
egovernment website, Central Biomedical Library
website and Ethics Review Committee website
could enhance further strengthening of health
research information system in Myanmar. Secondly, the Advanced Molecular Research Centre
(CommunicableDiseasesResearchLaboratory)builtbyKoreaInternationalCooperationAgency
(KOICA) has initiated the operations of Biosafety Level 2 + laboratory by means of trained
researcherstoimprovemolecularbaseddiagnosticmethodsforTuberculosis,MalariaandViral
Hepatitisaswellasfortechnologytransferforfurtherresearchcapacitybuilding.
UndertheguidanceofMinistryofHealth,DMRLMparticipatedinthirdwaveactivitiesinform
of hosting training workshops on Global Burden of disease, malaria modeling, cancer registry,
data quality assurance and good clinical practice etc. As a key component for the Universal
Health Coverage, there has been a nationwide survey that covered 166 public health care
facilities and 35 private hospitals from 132 townships to assess the service availability and
readinessinthecontextofmaternal,newbornandchildhealthbeingsupportedtechnicallyand
financially by WHO Country Office. Bottlenecks in health systems were identified in the
communitybasedemergencyreferralsystemformaternal,newbornandchildhealthinhardto
reachareasinAyeyarwaddyRegion.Multilevelcoordinationwasthemainfactorforsuccessof
thismechanism.
TherapeuticefficacystudiescoupledwithK13molecularsequencinginmonitoringArtemisinin
Combination Treatment (ACT) sensitivity approved that the resistance has not yet emerged at
Myanmar Bangladesh border. Regular monitoring of ACT efficacy is critical for timely action
and National Malaria Treatment Guidelines. As an input for the Dengue Population Genetics
Program,scientistsfromDMRLMcontributed500DengueHaemorrhagicFever(DHF)casesand
500 Dengue Fever (DF) cases. The hospitalbased surveillance of rotavirus diarrhea found the
significant change in genotype combination in 2014 as G9 P [8] compared to previous years
whichmayserveasthevaluableinformationforthefuturevaccinationprograminMyanmar.

135

Under th
he Departme
ent of Mediccal Research
h
(Upper Myanmar),
M
te
en research divisions
d
and
d
seven supportive diviisions are fu
unctioning att
present. Establishme
ent of Co
ommon and
d
Molecularr Laboratory has started in 2013 and
d
ithasalreeadyestablish
hedinNovem
mber2014.Itt
is equipped with macchines and eq
quipment forr
pathological, biochem
mical, immunological, celll
culture and
a
molecular biological techniquess
including modern macchines like geenetic sequen
ncers, realtim
me Polymerase Chain Reaaction (RT
PCR) macchines, nucle
eocounter and high speed
d amino acid
d analyzer. Now
N
training of above
mentioneedtechniquessisunderwayywithinthellimitofavailaablehumanrresources.No
otonlythe
existing machines
m
are being arrangged to be more useful, new
n
modern machines likke Fourier
Transform
mInfraRedSp
pectrophotom
meter(FTIR)haveinstalleedandhaveb
beenstartedttobeused
inresearcchworks.
Research areas coverred are: com
mmunicable diseases
d
like diarrhea an
nd dysenteryy diseases,
typhoid, Dengue Hemorrhagic Fever
F
(DHF), human inffluenza, neonatal sepsis, malaria,
tuberculo
osis, Human Immunodefficiency Virus (HIV), non
ncommunicaable diseasess such as
cancer, hypertension, hypothyroidism, reprodu
uctive health research succh as matern
nal thyroid
function study,
s
emerggency contraception, sociial and health systems reesearch such as health
facility asssessment fo
or reproductive health co
ommodities and
a
services,, traditional medicines
research such as study on acute and
a subacutee toxicity stu
udy and antiinflammatoryy study of
nal drugs, vecctor bionomics, elderly
herbal products, efficaacy of commercially availaable tradition
healthressearchanden
nvironmentalhealthreseaarch.
Besides, Department of Medical Research (Up
pper Myanm
mar) also invo
olved in promotion of
medicaleeducationbyh
helpingmedicalandparam
medicaluniveersitiesunderrMinistryofH
Healthand
universitiees of othe
er ministriess by condu
ucting workkshops, pracctical demon
nstrations,
presentattions,technicalassistanceandsharingo
ofresources.
Technical and research collaborration among research departmentss of both local and
onalinstitutio
onshasbeenregularlypracticed.Locally,DepartmeentofMedicalResearch
internatio
(Upper Myanmar)
M
is mainly collab
borating with
h University of Traditionaal Medicine and other
universitiees in Mandalay. Internationally, Japan Universitiees and Korea Universities are main
collaborattors.Collaborrativeworks involvedbetelchewingreelatedoralcaancer,human
ninfluenza
virus,mallariaresearch
handtechnicaaldevelopmeent.

136
1

Researchfindingsaresharedtootherdepartmentsforbetterimplementationofhealthservices
bythenationalprogramsofdepartmentofhealth. Presentationsonfindingsarealsomadein
healthseminars,medicalconferences,workshopsandcapacitybuildingtrainings.
Bythesevariousactivities,DepartmentofMedicalResearch(UpperMyanmar)activelymaking
itsendeavorstopromotethehealthresearchandhealthstatusofMyanmar.
DepartmentofTraditionalMedicinehasbeenconductingresearchanddevelopmentworks.It
has Research and Development (R&D) Division which is responsible for the scientific research
works and development tasks. Research section is conducting scientific investigations for
traditional and herbal medicines done by basic and applied scientists. Various developmental
tasks such as ancient literature surveys and traditional medicine health educations done by
traditionalmedicalpractitionersaretheresponsibilitiesofdevelopmentsection.Thereisalsoa
researchunitwithbasiclaboratoryfacilitiesintheUniversityofTraditionalMedicine,Mandalay.
Scientificresearchprojectswerealsobeingconductedasnecessary.Thegeneralobjectiveisto
increase the capabilities of research and
developmentfunctionsoftheDepartmentof
Traditional Medicine and that of the specific
objectivesaretoincreasehumanresourcesof
scientific researchers and traditional
medicine professionals, to upgrade the
abilities and skills of mentioned human
resources, and to facilitate the laboratory
equipment, chemicals and traditional
medicinehealtheducationaids.

137