DOCSLIB.ORG

Review of 200-Bedded Hospitals in Myanmar: Challenges and Recommendation

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Review of 200-Bedded Hospitals in Myanmar: Challenges and Recommendation Republic of the Union of Myanmar Ministry of Health REVIEW OF 200-BEDDED HOSPITALS IN MYANMAR: CHALLENGES AND RECOMMENDATION AUGUST 2015 JAPAN INTERNATIONAL COOPERATION AGENCY (JICA) FUJITA PLANNING CO., LTD. DAIKEN SEKKEI, INC. HM JR 15-071 ACKNOWLEDGMENTS This report presents the review of 200-bedded General Hospitals in Myanmar – through assessment of their health service provision, health workers, financing and infrastructures and equipment. The production of this report was not possible without the contribution of the Ministry of Health officials indicated below. JICA gratefully acknowledges their effort in supplying the necessary information and provided support for smooth implementation of the field survey. Ministry of Health Department of Health Dr. Than Win Deputy Director General Planning Division Dr. New Ni Oo Director Dr. Myint Myint Wai Deputy Director Medical Care Division Dr. Khin Win Than Director Dr. Moe Khaing Deputy Director Dr. Win Mih Thin Assistant Director Dr. Myint Zaw Assistant Director Finance Division Mr. Win Oo Deputy Director Department of Health Planning Planning Division Dr.San San Aye Director Dr. Thant Zin Htoo Deputy Director General HIMS Division Dr. Thet Thet Mu Director Dr. Ohnmar Kyi Deputy Director Department of Medical Science Dr. Tin Tin Lay Deputy Director General Nursing Division Ms. Nwe Nwe Khin Director Central Medical Supply Depot (CMSD) Dr. Aung Gyi Maung Deputy Director Dr. Kyaw Soe Min Deputy Director State/ Region Health Department Bago Region Dr. Tun Min Director Ayeyarwady Redion Dr. Aung Kyi Swe Director Dr. Thiha Aung Deputy Director Kayin State Dr. Aung Kyaw Htwe Director Mon State Dr. Than Htun Aung Director Rakhine State Dr. Aye Nyein Director Dr. Aung Thurein Deputy Director Thanintharyi Region Dr. Kyaw Zay Ya Director Shan State-South Dr. Sai Win Zaw Hlaing Deputy Director Sagain State Dr. Win Lwin Deputy Director Shan State-East Dr. Win Kyaw Director Kachin State Dr. Win Lwin. Director EXECUTIVE SUMMARY The purposes of the review were to assess current conditions and challenges of 200-bedded State/Region General Hospital in Myanmar, so that information can be used 1) by the government of Myanmar for national planning and strategy for medical services, and 2) as a basis for future Japanese cooperation with Myanmar in health sector. Field surveys began in August 2014 until February 2015, targeting 14 general hospitals that selected from 35 general hospitals with 200-bedded or more, in order to assess its infrastructure (building structure and facility), medical equipment, human resources and services they provide. Additional data via questionnaires were provided by 5 hospitals. Assessment was also complemented by the information provided through interviews of officials in the Ministry of Health, other donors and international organizations. (1) Identified Challenges for State/Region General Hospitals to Become People-Centered Hospital 1) Medium-/Long-term Infrastructure Development Plan for Hospitals is Needed a. In many hospitals, the several buildings were constructed on ad-hoc bases in order to respond to the demand because of the availability of fund. Different buildings are not situated with planning and consideration, and as a result, there are safety and quality of care concerns as well as loss in efficiency in delivering hospital services. b. Currently, Ministry of Health develops the annual infrastructure investment plan based on request submitted by each State/Region General Hospitals. There is a need to develop a longer-term investment/master plan for each hospital, together with State/Regional Government, Ministry of Health and State/Regional General Hospital, in order to create environment that people-centered care can be delivered 2) Construction and Facility Standards are Needed for General Hospitals a. Construction and facility standard for hospital building and other infrastructure need to be developed and enforced by the Ministry of Health, in order to improve safety in the delivery of care. b. Many hospitals, even newly constructed buildings, have been observed water leakage from the roof; which makes hospitals a breeding ground for mold (obvious health hazard towards patients) and for long-term structural damage to the building. c. Some buildings, especially ones built in 1960’s have relatively thin pillars and their resistance to earthquake is concern. d. Many slopes are too steep (compared to Japanese standards) and some buildings do not even have slopes, but only steps; causing safety concerns for wheelchair and patients on stretcher. i e. Allocation of beds for different ward is not optimal in several hospitals: Ob and Gyn, pediatrics, medical and surgical wards tend to be crowded, while ophthalmology and otolaryngology wards have very few inpatients. In the crowded wards, there are too many beds in very limited space and some hospital have beds on the corridor or two babies /children sharing one cot/bed, which create concerns for safety and quality of care for patients. f. Segregation of clean and dirty area is not standardized, and cleanness in operation theatre and the delivery rooms is not ensured. Infection control for post-operation room and critical care unit (ICU) are not sufficient. These can have critical consequences for patients’ prognosis. g. Medical store is so narrow and pharmaceuticals have been stacked in the staff rooms, causing inefficiency and danger in its working environment. 3) Equipment Distribution and Maintenance Needs Improvement a. Distribution of medical equipment needs to be better managed – especially for large equipment (e.g. MRI, CT scanner, X-ray machine) – which require special buildings to be built or old-equipment to be removed before the installment of equipment. b. There are several cases observed the medical equipment that is not requested by the hospitals are delivered and left unused in the hospital. c. While CT scanner, X-ray, ultrasonography, infant incubator and laboratory equipment are distributed from CMSD last year, but there are insufficient number of equipment, such as patient monitor, ECG, ventilator, suction pump in many hospitals. 4) Improved Allocation of and Training for Health Workforce are Needed a. There is a need to improve the match between services they can provide (with its infrastructure and equipment) and skills of health staff, especially consultants. Especially where referrals to tertiary hospitals are difficult due to distance, there are substantial needs to train and appoint consultants. b. Emergency/ICU training is not provided for nurses; and there were request for such training including how to use medical equipment in Emergency/ICU. c. There is no maintenance person of medical equipment in General Hospital, and laboratory technicians and nurses have to manage the maintenance of medical/laboratory equipment. However, they are not trained nor have skills to fix those issues, and they have to ask CMSD or Medical equipment agent even for minor breakdown. For short-term, there needs to be more proper training for health workers how to use those equipment, and for long-term assignment of medical equipment personnel (biomedical engineers) for each hospital should be considered. ii (2) Assessment of 14 State/Region General Hospitals State/Region Hospital Assessment Ayeyawady Pathein General Hospitals are well-used and crowded, but there are buildings/wards that is Hospital not fully utilized. By reallocating patients between different departments, patient congestion can be improved. Bago Bago General ･ Overcrowded at surgical patient waiting area Hospital ･ Patients (even critically ill patients) and medical staffs need to be transferred or walk long way to reach their designated places because of fragmented allocation of rooms and equipment. ･ Due to water leakage and damaged structure, it is difficult to maintain high level of cleanness in delivery room and operation room. ･ Insufficient high care unit and isolation rooms in pediatric ward (In order to build new building, land space needs to be secured) Taungngu Pediatric ward are crowded, but there are buildings/wards that is not fully General Hospital utilized. By reallocating patients between different departments, patient congestion can be improved. (In order to build new building, land space needs to be secured) Kachin Myitkyina Building of Maternal and Child Health department General Hospital ･ Significant structural damage in the building (the cracks on the beam, floor deflection and a roof leak) ･ Insufficient operation rooms (5,000 surgeries per year with 4 operation rooms (Security concerns exist) Kayin Hpa-an General 3-story building is already in construction. Hospital Magway Magway ･ Not enough space for inpatients (beds are placed on the corridor) General Hospital ･ Insufficient space in delivery room and surgical department ･ Due to water leakage and damaged structure, it is difficult to maintain high level of cleanness in operation rooms ･ Significant damage in the outpatient department building (damage on the pillars) (OT and MRI building is in construction) Mon Mawlamyinaing Ob and Gyn and Pediatrics Ward General Hospital ･ Extremely crowded; and not enough space for patients (In order to build new building, land space needs to be secured) Significant damage in the several buildings which houses pediatric wards, medical ward, surgical ward, ophthalmology ward, and orthopedic ward Sittwe General Rakhine (Concrete has fallen off from pillars and reinforcing bars (rebar) is exposed.) Hospital (In order to build
Load more

Recommended publications
  • What Every Physician Should Know About Doping and Doping Control O Que Todo Médico Deveria Conhecer Sobre Doping E Controle Antidoping
    WHATCOMMUNICATION EVERY PHYSICIAN SHOULD KNOW ABOUT DOPING AND DOPING CONTROL What every physician should know about doping and doping control O QUE TODO MÉDICO DEVERIA CONHECER SOBRE DOPING E CONTROLE ANTIDOPING JOSÉ KAWAZOE LAZZOLI1 1Adjunct Professor, Instituto Biomédico, Universidade Federal Fluminense. Specialist in Sports Medicine from Sociedade Brasileira de Medicina do Exercício e do Esporte (SBMEE) and Cardiology from Sociedade Brasileira de Cardiologia (SBC). Former President of the Brazilian Society of Sports Medicine (2009/2011). Secretary General of the Panamerican Confederation of Sports Medicine (Copamede). Treasurer of the International Federation of Sports Medicine (FIMS), Rio de Janeiro, RJ, Brazil http://dx.doi.org/10.1590/1806-9282.62.02.101 Probably the medical professional who is closer to the teria are present in a substance or a method, the theoret- daily life of an athlete, who participates regularly in com- ical possibility of listing occurs. petitions, whether or not high-performance, is the expert Examples of artificial performance enhancement in- in exercise and sports medicine. However, occasionally clude anabolic steroids, which also cause serious risks to the athlete may need to resort to other medical profes- the health of the athlete. This group of substances in- sionals, for various reasons, such as a general practitio- cludes two of the three basic principles of the concept of ner, a dermatologist, a cardiologist, an orthopedist or a doping, and therefore makes the list. gastroenterologist. Therefore, every physician is subject The concept of “violating the spirit of sport” can give to come across a patient who is an intermediate level or rise to subjective interpretations, but these values are ex- high-performance athlete, and will need to go through plained in WADA World Anti-Doping Code as follows: eth- doping controls throughout his sporting life.
    [Show full text]
  • Freediving Catalog 2014
    Freediving 2014 760B2EG 760B3EG 760B4EG 760B5EG E-GLASS DESCRIPTION Our most popular and all around bifins. The lenght of the blade is compatible with dynamic and constant weight apnea. Composite blades to stock up on maximum energy throughout the bending. TECHNOLOGY Technology : prepreg curing process Fabric : E-glass Resin : epoxy Performance : 30 to 40% more responsive than plastic SPECIFICATIONS Height of blade : 760 mm Width of blade : 210 mm Flat blade for made-to-measure footpocket (free heel) Blade with an angle of 15° to fit in full footpocket 4 kinds of varying hardness that are most likely to suit your style and body type : 760B2EG : soft, dynamic apnea 760B3EG : medium, dynamic and constant weight apnea 760B4EG : hard, constant weight 760B5EG : very hard, constant weight for big guys + 90kg Weight with made-to-measure footpocket = 1,5kg Weight with full footpocket = 1,9kg T profiles along the edges to ensure a good drive and a channeling of the water FOOTPOCKETS 2 kinds of footpockets : - Made-to-measure footpocket : Size 35 to 50 (3 to 15), free heel for better stroke - Tuned full footpocket : cut out footpocket to get a lighter and more responsive swimfin. Beuchat Mundial : 41-42, 43-44, 45-46, 47-48 Imersion : 38-40, 40-42, 42-44, 44-46 Omer : 36-38, 38-40, 40-42, 42-44, 44-46, 46-48, 48-50 760B2SG 760B3SG 760B4SG 760B5SG S-GLASS DESCRIPTION Our most popular and all around bifins. The lenght of the blade is compatible with dynamic and constant weight apnea. Composite blades to stock up on maximum energy throughout the bending.
    [Show full text]
  • International Handbook on Tourism and Peace
    CORDULA WOHLMUTHER WERNER WINTERSTEINER (Eds.) International Handbook on Tourism and Peace Centre for Peace Research and Peace Education of the Klagenfurt University/ Austria in cooperation with the World Tourism Organization ( UN WTO ) DRAVA Disclaimer: e opinions contained in this publication are exclusively those of the authors and do not necessarily reect the point of view of the editors or the UNWTO. e designations employed and the presentation of material in this publication do not represent any opinions whatsoever on the part of the Centre for Peace Research and Peace Education of Klagenfurt Uni- versity or the Secretariat of the World Tourism Organization concerning the legal status of any country, territory, city or area, or of its au thorities or concerning the delimitation of its frontiers or boundaries. is book is the Yearbook Culture of Peace , edited by the Centre of Peace Research and Peace Education of the Klagenfurt University/Austria · Klagenfurt/Celovec, Austria www.drava.at © Copyright by Drava Verlag/Založba Drava Cover design by Walter Oberhauser, cover art by Sim Jun Han Interior design and printing by Drava Print GmbH ---- CORDULA WOHLMUTHER WERNER WINTERSTEINER Eds. International Handbook on Tourism and Peace Centre for Peace Research and Peace Education of the Klagenfurt University/ Austria in cooperation with World Tourism Organization ( UN WTO ) DRAVA Centre for Peace Research and Peace Education Printed with the support of: Forschungsrat of Klagenfurt University with sponsoring provided by the Carinthian Federal State Government Swedish Tourism Innovation Centre Austrian Federal Ministry for European and International Aairs Austrian Federal Ministry for Education, Arts and Culture TPA-Horwath Group, Tax Advisory and Auditing Services Kärntner Universitätsbund is book is published within the framework of the Project “Tourism and Peace”, an Initiative of the World Tourism Organization (UNWTO) and the Klagenfurt University, Austria and its Centre for Peace Research and Peace Education.
    [Show full text]
  • The Minnesota Electrical Association, Inc. the Voice of Electrical Contractors
    The Minnesota Electrical Association, Inc. The Voice of Electrical Contractors www.electricalassociation.com Electrical Toolbox Talks The MEA Safety Committee is pleased to present you with your set of Electrical Toolbox Talks. This collection of safety topics is a collaborative effort betweenMEA’s Safety Committee, Federated Insurance Associated Risk Management Services Team, and Minnesota OSHA Consultation. This is a series of short, concise, industry specific topics. We are including a sign-in form for OSHA documentation; please make copies of this sheet as needed. These talks may be used as topics for your short safety meetings, as a salary stuffer for your employees, or as a handout at your safety meetings. Your new Electrical Toolbox Talks topics are enclosed: • Aerial Lifts • Emergency Preparedness • Ladder Safety • Arc Blasts • Excavations • Liquefied Petroleum Gas • Asbestos • Extension Cords • Lockout/Tagout • Back Safety • Eye and Face Safety • Power Tools & Equipment Safety • Bloodborne Pathogen Safety • Fall Protection • PPE Assessment • Boom Trucks • Fatigue • PPE for Respirators • Carbon Monoxide • Fire Extinguisher Safety • Safe Lifting & Material Handling • Cold Stress • Foot Protection • Safety Data Sheets • Competent vs. Qualified Person • Fork Lift Drivers • Scaffolding Safety • Compressed Gas Safety • Guardrail Requirements • Security Safety • Confined Space Safety • Hand Safety • Temporary Heating • Construction Sites • Head Protection • Temporary Lighting • Controlling Electrical Hazards • Hearing Safety • Temporary Wiring Panels • Core Drilling • Heat Stress • Trips, Slips, and Falls • Crystalline Silica • High-Visibility Vests • Winter Driving • Driving Safety • Injuries & Emergency Situations Acknowledgements: MEA Safety Committee Members, including our MN OSHA Consultation team members Andy Smoka and Tim Brown, and our Federated Insurance team members Jeff Stevenson and Pat Swetala.
    [Show full text]
  • Animal Genetic Resources Information Bulletin
    The designations employed and the presentation of material in this publication do not imply the expression of any opinion whatsoever on the part of the Food and Agriculture Organization of the United Nations concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Les appellations employées dans cette publication et la présentation des données qui y figurent n’impliquent de la part de l’Organisation des Nations Unies pour l’alimentation et l’agriculture aucune prise de position quant au statut juridique des pays, territoires, villes ou zones, ou de leurs autorités, ni quant au tracé de leurs frontières ou limites. Las denominaciones empleadas en esta publicación y la forma en que aparecen presentados los datos que contiene no implican de parte de la Organización de las Naciones Unidas para la Agricultura y la Alimentación juicio alguno sobre la condición jurídica de países, territorios, ciudades o zonas, o de sus autoridades, ni respecto de la delimitación de sus fronteras o límites. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying or otherwise, without the prior permission of the copyright owner. Applications for such permission, with a statement of the purpose and the extent of the reproduction, should be addressed to the Director, Information Division, Food and Agriculture Organization of the United Nations, Viale delle Terme di Caracalla, 00100 Rome, Italy. Tous droits réservés. Aucune partie de cette publication ne peut être reproduite, mise en mémoire dans un système de recherche documentaire ni transmise sous quelque forme ou par quelque procédé que ce soit: électronique, mécanique, par photocopie ou autre, sans autorisation préalable du détenteur des droits d’auteur.
    [Show full text]
  • Modern Living in Southeast Asia
    Appreciating Asian modern : mASEANa Project 2015-2020 mASEANa Project 2017 modern living in Southeast Asia The Report of mASEANa Project 2017 4th & 5th International Conference 2015 - 2020 The Report of mASEANa project 2017 : 4th & 5th International Conference modern living in Southeast Asia Introduction Why Are We So Interested in modern architecture in Asia? -The Story behind mASEANa Project 2015-20 and a Report on its Fiscal 2017 Activities- Shin Muramatsu 09 The Housing Question Ana Tostões 11 CONTENTS Part1: modern living in Southeast Asia Part2: Inventory of modern Buildings modern living in Southeast Asia - Inventory of modern Buildings in Yangon - Setiadi Sopandi, Kengo Hayashi 16 History of modern architecture in Yangon Friedrich Silaban Inventory & Research, 2006-2018 Win Thant Win Shwin, Su Su 65 Setiadi Sopandi 18 Inventory of modern Buildings in Yangon 67 - 1. Sports and Modern Urbanisim - - Inventory of modern Buildings in Jakarta - The Role of Sports Facilities in Metro Manila’s Urban Living from the 1930s to 1970s History of modern architecture in Jakarta Gabriel Victor Caballero 22 Setiadi Sopandi, Nadia Purwestri 77 The Shape of Sports Diplomacy: Inventory of modern Buildings in Jakarta 79 Gelora Bung Karno, Jakarta, and the Fourth Asian Games Robin Hartanto 26 Modern Architecture Literacy Development: The mASEANa Project in 2017 Kengo Hayashi 88 PHNOM PENH 1964: Architecture and Urbanism of GANEFO Masaaki Iwamoto 30 Transformation of modern Living in Japan after WWII: Washington Heights, Tokyo Olympic and Yoyogi Sports Complex Saikaku Toyokawa 34 Acknowledgment 92 - 2. Modern Projects, Changing Lifestyles, Resilience - Living in KTTs – the Formation of Modern Community in Vietnam Pham Thuy Loan, Truong Ngoc Lan, Nguyen Manh Tri 36 Pulomas: A Social Housing Project which Never Was Mohammad Nanda Widyarta 40 Modernization of Tatami, Shoji, & En Yasuko Kamei 44 Collective Housing in Japan Toshio Otsuki 48 - 3.
    [Show full text]
  • COOPERATIVE INSTITUTE for RESEARCH in ENVIRONMENTAL SCIENCES University of Colorado at Boulder UCB 216 Boulder, CO 80309-0216
    CELEB ra TING 0 OF ENVI R ONMENT A L RESE arc H years 4 COOPERATIVE INSTITUTE FOR RESEARCH ANNU A L REPO R T IN ENVIRONMENTAL SCIENCES University of Colorado at Boulder i 00 2 8 COOPERATIVE INSTITUTE FOR RESEARCH IN ENVIRONMENTAL SCIENCES University of Colorado at Boulder UCB 216 Boulder, CO 80309-0216 Phone: 303-492-1143 Fax: 303-492-1149 email: [email protected] http://cires.colorado.edu ANNU A L REPO R T ST A FF Suzanne van Drunick, Coordinator Jennifer Gunther, Designer Katy Human, Editor COVE R PHOTO Pat and Rosemarie Keough part of traveling photographic exhibit Antarctica—Passion and Obsession Sponsored by CIRES in celebration of 40th Anniversary ii From the Director 2 Executive Summary and Research Highlights 4 The Institute Year in Review 12 Contributions to NOAA’s Strategic Vision 13 Administration and Funding 16 Creating a Dynamic Research Environment 21 CIRES People and Projects 26 Faculty Fellows Research 27 Scientific Centers 58 Education and Outreach 68 Visiting Fellows 70 Innovative Research Projects 73 Graduate Student Research Fellowships 83 Diversity and Undergraduate Research Programs 85 Theme Reports 86 Measures of Achievement: Calendar Year 2007 146 Publications by the Numbers 147 Refereed publications 148 Non-refereed Publications 172 Refereed Journals in which CIRES Scientists Published 179 Honors and Awards 181 Service 185 Appendices 188 Governance and Management 189 Personnel Demographics 193 Acronyms and Abbreviations 194 CIRES Annual Report 2008 1 From the Director 2 CIRES Annual Report 2008 am very proud to present the new CIRES annual report for fiscal year 2008. It has been another exciting year with numerous accomplishments, Iawards, and continued growth in our research staff and budget.
    [Show full text]
  • Federico Mana -100
    SHARM october . 2009 . COMPLEMENTARY COPY VOLUME 016 TIME EXCELLENCY DEED Only One Apnea Centre, a record factory in Sharm: Federico Mana -100 - You feel very small, almost insig- the calm waters of Sodfa, straight nificant being down there…- said in front of the Sharm Club Hotel. Federico Mana being back from 100 Ten humans only in the world can metres depth holding his breath. say: I have been that deep without Cristal clear waters, excellent weath- the help of a sled to descend, only er conditions, and a mild in water relying on my fins and lungs - and temperature all year round, are an now Federico is one of them. In a BLUE TIME outstanding setting for outstanding three minutes dive Federico swam performances in free-diving training. down to the depth to 40 metres, For these reasons Umberto Pelizzari, where his body become less buoy- the Italian free-diving living legend, ant, and sunk to the abyssal depth in 2003 decided to start in Sharm el of one hundred metres. He swam Sheikh the Red Sea branch of his up again holding the -100 tag in his Apnea Academy, the prestigious free hand, a timeless swim toward the diving school and instructor develop- surface, and the air. From the float- ment agency. ing platform two AIDA judges eval- - The Red Sea has fantastic reefs, is uated Federico’s performance and, within easy reach from Europe, it of- after the canonical thirty seconds, fers the possibility to find current-free issued their verdict: Federico Mana spots, a very important issue when is the new Italian Record holder.
    [Show full text]
  • Myanmar Situation Update (12 - 18 July 2021)
    Myanmar Situation Update (12 - 18 July 2021) Summary Myanmar detained State Counsellor Daw Aung San Suu Kyi, President U Win Myint and former Naypyitaw Council Chairman Dr. Myo Aung appeared at a special court in Naypyitaw’s Zabuthiri township for their trial for incitement under Section 505(b) of the Penal Code. The junta filed fresh charges against Suu Kyi, bringing the number of cases she faces to ten with a potential prison sentence of 75 years. The next court hearings of their trial have been moved to July 26 and 27, following the junta’s designation of a week-long public holiday and lockdown order. Senior National League for Democracy (NLD) patron Win Htein was indicted on a sedition charge by a court inside a Naypyitaw detention center with a possible prison sentence of up to 20 years. The state- run MRTV also reported the Anti-Corruption Commission (AAC) made a complaint against the former Chief Minister of Shan State, three former state ministers, and three people under the anti-corruption law at Taunggyi Township police station while the junta has already filed corruption cases against many former State Chief Ministers under the NLD government. During the press conference on 12 July 2021 in Naypyitaw, the junta-appointed Union Election Commission (UEC) announced that 11,305,390 voter list errors were found from the investigation conducted by the UEC. The UEC also said the Ministry of Foreign Affairs is investigating foreign funding of political parties and the investigation reports will be published soon with legal actions to be taken against the parties who violate the law.
    [Show full text]
  • Geographic Distribution and Utilisation of CT and MRI Services at Public Hospitals in Myanmar
    Khaing et al. BMC Health Services Research (2020) 20:742 https://doi.org/10.1186/s12913-020-05610-x RESEARCH ARTICLE Open Access Geographic distribution and utilisation of CT and MRI services at public hospitals in Myanmar Moe Khaing1,2, Yu Mon Saw1,3* , Thet Mon Than1,2, Aye Myat Mon2, Su Myat Cho1, Thu Nandar Saw4, Tetsuyoshi Kariya1,3, Eiko Yamamoto1 and Nobuyuki Hamajima1 Abstract Background: Diagnosis by computed tomography (CT) and magnetic resonance imaging (MRI) is important for patient care. However, the geographic distribution and utilisation of these machines in countries with limited resources, such as Myanmar, have not been sufficiently studied. Therefore, this study aims to identify the geographic distribution and utilisation of CT and MRI services at public hospitals in Myanmar. Methods: This nationwide, cross-sectional study was conducted at 43 public hospitals in Myanmar. Data were collected retrospectively using a prepared form from 1st January 2015 to 31st December 2017 at public hospitals in Myanmar. A descriptive analysis was performed to calculate the number of CT and MRI units per million population in each state and region of Myanmar. The distribution of CT and MRI units was assessed using the Lorenz curve and Gini coefficient, which are indicators of inequality in distribution. Results: In total, 45 CT and 14 MRI units had been installed in public hospitals in Myanmar by 2017. In total, 205, 570 CT examinations and 18,981 MRI examinations have been performed within the study period. CT units per million population in 2017 varied from 0.30 in Rakhine State to 3.22 in Kayah State.
    [Show full text]
  • On Health Risks of Ambient PM in the Netherlands
    Section 0 0 - 1 On health risks of ambient PM in the Netherlands Full Report Netherlands Aerosol Programme October 2002 RIVM report 650010 032 Editors: Eltjo Buringh and Antoon Opperhuizen Authors: Aben, J.1;Ameling, C.B.1; Beck, J.1; Boere, A.J.F.; Breugel, P.B. van1; Brink, H.M. ten3; Brink, R.M.M. van den1; Buijsman, E.1; Brunekreef, B.4; Buringh, E.1; Cassee, F.R.1; Dekkers, A.L.M.1; Dolmans, J.1; Eerens, H.C.1; Fischer, P.H.1; Harmelen, A.K. van2; Keuken, M.P.2; Kooter, I.M.1; Loon, M. van2; Loveren, H. van1; Marra, M.1; Matthijsen, J.1; Noordijk, H.1; Opperhuizen, A.1; Schaap, M.2,3; Schlesinger, R.B.5; Slanina, J.3; Smeets, P.1; Smeets, W.L.M.1; Spoelstra, H.2; Steerenberg, P.A.1; Visschedijk, A.J.H.2; Visser, H.1; Vries, W.J. de1; Weijers, E.3; Winter, R. de1; 1) Rijksinstituut voor Volksgezondheid en Milieu, Bilthoven 2) Nederlandse Organisatie voor Toegepast Natuurwetenschappelijk Onderzoek, Apeldoorn 3) Energieonderzoek Centrum Nederland, Petten 4) Institute of Risk Assessment Studies, University of Utrecht 5) Department of Biological Sciences, Pace University, Pleasantville, NY, USA On health risks of ambient PM in the Netherlands Full Report October 2002 Section 0 0 - 2 Abstract Particulate Matter (PM) in the ambient air can lead to health effects and even to premature mortality. This result has been found in a score of epidemiological studies, but their cause is not yet clear. It is certain, however, that these effects are so serious and so extensive that further action is warranted.
    [Show full text]
  • Monofin 2015
    MONOFIn 2015 THE SWIMFINS COMPANY ME1EG / ME2EG / ME3EG DESCRIPTION A very good monofin introduction for childs. A small blade to avoid strain. Made-to-measure footpocket starting at size 3 TECHNOLOGY Technology : prepreg curing process Fabric : E-glass Resin : epoxy Performance : 30 to 40% more responsive than plastic SPECIFICATIONS Height of blade : 600 mm Width of blade : 600 mm Surface area of the pair of blades : 2700 cm2 Flat blade for made-to-measure footpocket (free heel) Blade with an angle of 15° to fit in full footpocket 3 kinds of varying hardness that are most likely to suit your style and body type : ME1EG : soft ME2EG : medium ME3EG : hard Weight with made-to-measure footpocket = 1,5kg Weight with full footpocket = 1,9kg U-shaped sections along the edge to ensure a good protection of the blade and the swimmer FOOTPOCKETS 2 kinds of footpockets : - Made-to-measure footpocket : Size 35 to 50 (3 to 15), free heel for better stroke optional extra : velcro strap for instep fine tuning - Tuned full footpocket : cut out footpocket to get a lighter and more responsive swimfin. Imersion : 38-40, 40-42, 42-44, 44-46 Pathos : 36-38, 38-40, 40-42, 42-44, 44-46, 46-48, 48-50 ME1SG / ME2SG / ME3SG DESCRIPTION A very good monofin introduction for childs. A small blade to avoid strain. Made-to-measure footpocket starting at size 3 Better strength and improved resistance to impact and crack propagation thanks to S Glass. TECHNOLOGY Technology : prepreg Fabric : S-glass fibre Resin : epoxy Performance : 4 to 5% more responsive than E-glass
    [Show full text]