The Road to Universal Health Coverage in Myanmar Runs through Non-Communicable Disease Risk Factors: Supporting Evidence from WHO in 2009 and 2014 and the Global Burden of Disease Study 2016

摘要

Background: The recent surge in economic development in Myanmar will also contribute to accelerating the health burden shift from acute infectious to chronic non-communicable diseases (NCDs) across the country. With just 11 years to achieve its goal of universal health coverage by the year 2030, significant efforts will be needed to quantify the scale of the burden facing decision-makers about health system strengthening and redevelopment. Convergence of the health systems will be an additional challenge in Myanmar. Methods: Results from a WHO study in 2009 and 2014, combined with data from the 2016 Global Burden of Disease Study, were compiled and analysed for Myanmar to assess the levels and trends of selected NCDs and NCD risk factors. Results: The prevalence of major NCDs in Myanmar are in general higher than global and regional averages, with a significant increase in diabetes mellitus and chronic obstructive pulmonary diseases in the last 25 years. Major NCD risk factors in Myanmar include smoking, use of smokeless tobacco, alcohol consumption among men, low level of fruit and vegetable consumption, hypertension, and emerging of overweight and obesity, especially among women. Tobacco use increased in both sexes between 2009 and 2014, but only significantly in men. Rates of hypertension increased for both men and women, including those currently on medications—suggesting a need for better treatment regimens. Overweight and obesity rates increased in both men and women, although the increase in obesity for men was not significant. Alcohol consumption results were mixed—with lower levels of high level drinking in men, but generally increased consumption by women. Intake of fruit and vegetables increased slightly between 2009 and 2014 and rates of high levels of physical activity also increased. Diabetes prevalence rates increased significantly in women (X~(2) = 11.3; p = 0.01) and men (X~(2) = 9.6; p = 0.02) between 2009 and 2014. Conclusions: Improved awareness of risk factors, coupled with early diagnosis and effective treatment of conditions and risks, is paramount to keeping the population healthy and economically active, and maintaining health care costs. Proven cost-effective interventions to prevent and control NCD-related risk factors, notably increasing tobacco taxes, should be endorsed and implemented in the population. Inaction could hamper the country’s effort to achieve universal health coverage by the year 2030.