Chapter I Contextual Information 1. Introduction Along with measures taken in conformity with political, economic and social objectives for all round development of the nation, the State has formed the National Health Committee to provide leadership and guidance in undertaking health development activities in more systematic ways. The National Health Committee is providing leadership and guidance to ensure health activities are implemented effectively in accordance with the National Health Policy to achieve one of the social objectives namely, "uplift of health, fitness and education standard of the entire nation". In implementing the social objective laid down by the State, and the National Health Policy, the Ministry of Health is taking the responsibility of providing promotive, preventive, curative and rehabilitative services to raise the health status of the population. It is essential that health plans are developed systematically on the basis of activity, time period, and locality and administrative level so that available resources in terms of man, money and material, are utilized most efficiently and distribution of resources and health benefits are equitable. In developing National Health Plans the Ministry of Health has formed the central committee and work committee, comprising responsible persons from the departments under the ministry, related ministries and social and non-governmental organizations to undertake plan formulating activities in a coordinated way. Based on Primary Health Care approaches the Ministry has formulated four yearly People's Health Plans from 1978 to 1990 followed by the National Health Plans from 1991-1992 to 2001-2006. The government is now formulating and implementing the fourth five yearly short terms National Development Plan covering the period 2006-2007 to 2010-2011 and the National Health Plan (2006- 2011) is also to be formulated as a five year plan in relation to that plan. In addition, current plan is developed as a continuation to the previous National Health Plan (2001-2006) and also in the framework of objectives for the short term second five year period of the Myanmar Health Vision 2030, a 30 year long term health development plan. National Health Plans have been developed and implemented successfully with the leadership of the State, guidance and supervision of the National Health Committee, support of the mass and class organizations and collaboration of the whole community. Upholding these practices the Ministry of Health will keep on striving in further raising the health status of the entire population. 2. Policy Basis The State has laid down political, economic and social objectives (Annex-1) to build a modern and developed nation. In implementing the National Health Policy (Annex-2) in conformity with the objectives laid down by the State, the Ministry of Health is undertaking the activities for health sector development effectively, under the leadership and guidance of the National Health Committee. In implementing activities for health sector development the objectives of the Ministry of Health are "to enable every citizen to attain full life expectancy and enjoy longevity" and "to ensure that every citizen is free from diseases". (Annex-3) For fulfilling these objectives in accordance with the National Health Policy, priority will be given to border areas where development had been lagging behind, in addition to the rural areas, to ensure universal access to health services based on Primary Health Care. In accordance with market economy practiced in national development activities, involvement of cooperatives and private sector in health sector development will be necessary. Taking this into account collaboration with health related organizations, involvement of social and non-governmental organizations in their 2 respective roles and community involvement will be ensured to realize the health objectives more effectively. Measures will have to be taken to make the health system responsive to the legitimate expectations of the people, which will be changing and growing with improvement in the social and living standards. It will also be necessary to establish a system for financing health that will protect people from financial burden in seeking health care, is equitable and ensure access to all with different socio-economic and demographic background and that will be suitable to the socio- economic situations of the country. Though facing and tackling problems relating to communicable diseases like other developing nations, small pox and poliomyelitis could be declared free and leprosy is no longer a public health problem in the country and these achievements will be sustained and made progress further by bringing about remaining communicable diseases no longer public health problems with the ultimate aim of total elimination or eradication. Measures for preventing communicable diseases emerging internationally from getting into the country and controlling the spread will be undertaken both in the country and also in collaboration with international partners. Prevalence, disability and deaths from non-communicable diseases like cardiovascular diseases, malignancies and mental illness will also be on the rise with changes in social status and life styles of the people following development and affluence of the country. With the aim to see that people are leading a lifestyle conducive to health, health promotion activities will be undertaken in collaboration with related departments, volunteer organizations and the community. As there will be negative impact on environment consequent to industrialization and urbanization, partnership with related departments and organizations will be promoted so that environmental health problems including water and air pollution and occupational health problems in addition to those consequent to existing environmental hazards can be solved. Progress and achievements had been witnessed thanks to the support of the State in the development of the health professional, equipment and technology to ensure curative services are of quality and up to the international standard. Likewise, private provision of health services that have been growing are to be encouraged and regulated to protect the interest of the people and to see that services are developing systematically and are of quality and high standard. As information play important roles in developing policies and plans so that health services can be implemented effectively and resources are utilized efficiently, routine collection of data and information and, surveys and research will have to be undertaken with the objectives of getting timely information, which are valid, reliable and complete. Similarly, capacity building and support will be needed to see that information and communication technology is utilized effectively. At the same time as providing health services using allopathic medicine, measures will be taken for modernization, perpetuation and extensive utilization of traditional medicine that has been trusted and relied upon by the people and have a long tradition. Measures will also be taken to ensure traditional medical practice can be utilized in combination with allopathic medicine and to expand research activities to modernize and develop traditional medicine further. Training, deployment and strengthening of capacities through continued education of human resources for health will be undertaken to develop a health workforce that is appropriate and capable to meet the needs in relation to disease and health problems prevailing in the country, technology developing and advancing over the period and health needs of the country. Managing service provision and production of human resources for health will be undertaken in a coordinated way. 3 National Health Plans have been developed and implemented within the policy basis of the objectives of the State, National Health Policy and objectives of the Ministry. In the same token collaboration in international health agenda with organizations under the United Nations like the World Health Organization, United Nations Children's Fund, United Nations Population Fund, and other international organizations has been in place and this is to be continued in accordance with international health declarations and commitments. Emphasis will be given for attainment of health related goals under the United Nations Millennium Declaration. Within this policy framework the broad objectives of the National Health Plan (2006-2011) are as follows: - To facilitate the successful implementation of the social objective, "uplift of health, fitness and education standards of the entire nation". - To implement the National Health Policy - To strive for the development of a health system, that will be in conformity with political, economic and social evolutions in the country as well as global changes. - To enhance the quality of health care and coverage - To accelerate rural health development activities 3. Implementation Status of the National Health Plan (2001-2006) In conformity with the third five year short term national development plan, the National Health Plan (2001-2006) comprising 12 programmes and 78 projects had been formulated and implemented. With the objectives of identifying the status, strengths and weaknesses encountered in implementing the projects, and support and coordinative measures that will be necessary, meeting on evaluation of the National Health Plan 2001-2006 was held in Yangon on September 2005. His Excellency