ArticleConflict and health2021
Conflict affected, parallel health systems: challenges to collaboration between ethnic and government health systems in Kayin State, Myanmar.
Article in Conflict and health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed, 10 citations in OpenAlex.
- A village health worker intervention to reduce cardiovascular disease risk in remote areas of armed conflict in Myanmar-results from a feasibility study in three villages.Conflict and health · 2026Article
- Getting unstuck: reframing health systems strengthening and resilience in fragile and conflict-affected settings.BMJ global health · 2026Review
- Detection of Wencheng shrew virus and cardiovirus from small mammals in Myanmar.Scientific reports · 2026Article
- Decolonizing Local Health: Advancing from Participation to Equitable Partnership along the Thailand-Myanmar Border.Annals of global health · 2026Article
- Health system efficiency and equity in ASEAN: an empirical investigation.Cost effectiveness and resource allocation : C/E · 2024Article
- Assessing the role of non-state actors in health service delivery and health system resilience in Myanmar.International journal for equity in health · 2024Article
- Insights and inspirations: A qualitative exploration of community health workers' motivations in Myanmar and Bangladesh.PLOS global public health · 2024Article
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3 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundMyanmar has had a long history of civil wars with its minority ethnic groups and is yet to see a sustainable peace accord. The conflicts have had a significant impact on health in Myanmar, with ethnic populations experiencing inequitable health outcomes. Consequently, to meet the health needs of ethnic people, Ethnic Health Organisations and Community-Based Health Organisations (EHO/CBHOs) created their own health system. The EHO/CBHO and Government health systems, provided by the Myanmar Ministry of Health and Sports (MoHS), remain parallel, despite both stakeholders discussing unification of the health systems within the context of ongoing but unresolved peace processes. EHO/CBHOs discuss the 'convergence' of health systems, whilst the MoHS discuss the integration of health providers under their National Health Plan.
methodsA qualitative study design was used to explore the challenges to collaboration between EHO/CBHOs and the MoHS in Kayin state, Myanmar. Twelve health workers from different levels of the Karen EHO/CBHO health system were interviewed. Semi-structured, in-depth interviews were digitally recorded, transcribed, and coded. Data was analysed thematically using the Framework method. Topic guides evolved in an iterative process, as themes emerged inductively from the transcripts. A literature review and observation methods were also utilised to increase validity of the data.
resultsThe challenges to collaboration were identified in the following five themes: (1) the current situation is not 'post conflict' (2) a lack of trust (3) centralised nature of the MoHS (4) lack of EHO/CBHO health worker accreditation (5) the NHP is not implemented in some ethnic areas.
conclusionsUltimately, all five challenges to collaboration stem from the lack of peace in Myanmar. The health systems cannot be 'converged or 'integrated' until there is a peace accord which is acceptable to all actors. EHO/CBHOs want a federal political system, where the health system is devolved, equitable and accessible to all ethnic people. External donors should understand this context and remain neutral by supporting all health actors in a conflict sensitive manner.
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