Providing Primary Health Care in conflict-affected settings: the Myanmar Case

Abstract

Health systems are among the earliest casualties of conflicts. In this context, primary health care plays a crucial role in ensuring continuity of care and acting as a buffer against failure of service delivery. Scientific literature is rich of studies that have analysed the situation of primary health care in wartime conditions from a general point of view, but only a few studies have focused on specific situations. In this study, we have examined the specific situation of Myanmar, shedding light on the provision of primary health care in Myanmar conflict-affected setting. The study followed a qualitative research design. We conducted 21 semi-structured interviews to Myanmar healthcare providers and decision-makers. Data were analysed through thematic analysis. Despite the numerous difficulties encountered related to the specific context’s conditions, the interviews allowed to confirm what was evidenced by scientific literature and to highlight some peculiarities of the Myanmar case. Myanmar healthcare professionals, aligned in rejecting the coup, are building alternative routes to provide either online and/or frontline primary health care to the population in need. Further, the concentration of healthcare workers in liberated areas is such as to not only allowing primary health care to be provided, but even improved compared to the situation prior to the coup. Therein, PHC can be provided and structured to envisage an improvement in the organization of the primary health care system itself when a situation of peace is reached. The study hence provides stakeholders with updated information on the Myanmar’s primary health care situation and with practical indications for supporting primary health care delivery. These insights can also be useful for the reconstruction of the health system, as based on primary health care, after the conflict.