Matching action to need: an analysis of Global Burden of Disease 2017 and population health data to focus adolescent health policy and actions in Myanmar

Karly Cini ,Elissa Kennedy ,Su Mon Myat ,Phone Myint Win,Lia J Burns,Thin Mar Win ,Aung Ko Ko ,Aye Aye Myint ,Ye Win Aung ,Ali H Mokdad,George C Patton ,Zay Yar Swe,Yadanar Yadanar,Sanda Sanda,Sithu Swe,Margaret Hellard,Kate Francis ,Kyu Kyu Than,Chad Hughes ,Nisaa Wulan ,Peter Azzopardi

doi:10.1080/16549716.2020.1844976

Abstract

ABSTRACT Background: Myanmar is a country undergoing rapid transitions in health. Its national strategic policy for young people’s health is being revised but there is a paucity of population data to inform local priorities and needs. Objective: In this paper we describe a comprehensive profile of adolescent health in Myanmar to focus policy and health actions. Methods: We used available primary data, and modelled estimates from the GBD 2017, to describe health outcomes (mortality and morbidity), health risks and determinants for adolescents in Myanmar between 1990–2017. A governance group of key stakeholders guided the framing of the study, interpretation of findings, and recommendations. Results: Overall health has improved for adolescents in Myanmar since 1990, however adolescent mortality remains high, particularly so for older adolescent males; all-cause mortality rate for 10–24 years was 70 per 100,000 for females and 149 per 100,000 for males (16,095 adolescent deaths in 2017). Overall, the dominant health problems were injuries for males and non-communicable disease for females in a context of ongoing burden of communicable and nutritional diseases for both sexes, and reproductive health needs for females. Health risks relating to undernutrition (thinness and anaemia) remain prevalent, with other health risks (overweight, binge alcohol use, and substance use) relatively low by global and regional standards but increasing. Gains have been made in social determinants such as adolescent fertility and modern contraception use; however, advances have been more limited in secondary education completion and engagement in employment and post education training. Conclusions: These results highlight the need to focus current efforts on addressing disease and mortality experienced by adolescents in Myanmar, with a specific focus on injury, mental health and non-communicable disease.

Highlights

Myanmar is a country undergoing rapid transitions in health
Consistent with best practice in global health research and to ensure appropriate interpretation and transla tion [20], this work was governed by a group of key stakeholders including: Myanmar Ministry of Health and Sports (MoHS); youth representatives including NGOs engaged in adolescent health; UN agencies (WHO, UNICEF, UNFPA) and donor partners (UNOPS – Access to Health Fund)
Mortality rate has fallen since 1990, after 2015 the rate plateaued for females, and there was a marked increase for males 15–24 years (Supplementary Figure A1)

Summary

Introduction

Myanmar is a country undergoing rapid transitions in health. Its national strategic policy for young people’s health is being revised but there is a paucity of population data to inform local priorities and needs. There have been substantial gains in health made, with life expectancy increasing 13.8 years for females and 12.4 years for males since 1990, and under-five mortality reducing from 141 per 1,000 births in 1990 to 44 per 1,000 in 2017 [2]. These transitions have brought rapid demographic shifts, with adoles cents (aged 10–24 years) representing 30% of the total population.

Objectives

Methods

Results

Discussion

Conclusion