https://orcid.org/0000-0002-1365-704X
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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.
Responsible Editor Stig Wall, Ume University, Sweden
Responsible Editor Stig Wall, Ume University, Sweden
Acknowledgments
We acknowledge the contributions of Dr. Pa Pa Win Htin (UNICEF Myanmar); and Dr. Myo Yarzar (UNOPS Myanmar) for their valuable input into this manuscript and participation in the study governance group.
Author contributions
This analysis is a result of a collaboration between researchers and policy makers in Myanmar and Australia. KC, PMW, and PA conceptualised and led the writing of this article. KC and PA led the data extraction, analysis, and interpretation. KC, NW, PA, PMW and ZYS reviewed the existing literature. AHM supported access to modelled data from the Institute of Health Metrics and Evaluation and assisted with interpretation. All authors contributed to interpretation of the data, drafting the manuscript and approved the final manuscript and were responsible for the decision to submit the manuscript.
Disclosure statement
No potential conflict of interest was reported by the authors.
Ethics and consent
Ethics committee approval was not sought for these secondary analyses of openly available datasets.
Paper context
Rapid epidemiological transition in Myanmar has resulted in complex health needs for adolescents. Limited population health data for adolescents has been a barrier to the alignment of policy to need. We found a large emergent burden of injuries and non-communicable diseases in the context of ongoing communicable, nutritional and reproductive health needs. To have the greatest impact on death and disability, adolescent health policies should now focus on investments which target non-communicable disease and injuries.
Data availability statement
The data that support the findings of this study are openly available in an online repository, references and weblinks available in supplementary material Table A1.
Supplemental material
Supplemental data for this article can be accessed here.