Tackling Chronic Disease in Primary Care – Reporting Back from Yangon

When we were first approached to work with local partners to strengthen clinical knowledge of diabetes and hypertension amongst primary care practitioners in Yangon, Myanmar, it sounded straightforward enough. Then when we learnt about the myriad of tiny private GP practices and the challenges of obtaining consistent advice and efficient referrals to secondary care, the challenges became apparent. The importance of a solid primary care system as a backbone to a well-functioning and equitable health system is widely under-estimated, as it is, indeed, in many parts of the world.

One of our local partners, the GP Society of Myanmar, is working hard to increase recognition of the role of General Practitioners and the value that well-supported General Practitioners can add to health systems nationally. Meanwhile Population Services International Myanmar are seeking to ensure their primary care clinic franchise is equipped to deal with the increasing burden of chronic disease amongst its patients.

Two PCI trainers worked with partners in advance of their visit to develop a relevant programme. Both having had prior experience working in Myanmar, they were able to ensure that the programme matched with operational realities and that their recommendations were realistic and pragmatic. They focused particularly on some critical cornerstones to chronic disease care. These are not necessarily, as people often think, about drug doses and blood tests, but about consultation skills, motivational interviewing, clinic appointment systems (call/recall) and data collection. These are critical to the realisation of consistent high quality care yet they are often the least understood in environments where primary care services have not yet realised their full potential.

Participants shared that “the teaching demonstrated an awareness of their actual working context which was rarely present in training they had experienced with other external trainers.”

The training programme, which was delivered by PCI last month, was an opportunity for the two organisations to come together, with great potential for meaningful ongoing collaboration.