Scaling up epilepsy care in Myanmar
8 February 2019 - When sixteen-year-old Ma Shwe Zin Moe visited the rural health centre near her village, she was suffering from several unprovoked seizures per month, her attention often wandered and she was unable to walk without support. Since her seizures started at the age of three, her parents had taken her to several traditional medicine practitioners and conducted rituals as instructed by various faith healers and astrologers to please the “spirits causing the ailment”.
In her first visit to the rural health centre, she was diagnosed by a trained primary care provider with epilepsy, probably due to a central nervous system infection. After about three months of regular treatment the number of seizures she was experiencing dropped by more than a half and her general condition improved.
Ma Shwe Zin Moe received treatment through the Myanmar Epilepsy Initiative, launched in 2013 as a collaboration between WHO and Myanmar’s Ministry of Health and Sports. In 5 years, well over 2000 health care providers have been trained and some 1700 new cases of epilepsy identified and treated in the community.
In Myanmar, it is estimated that around 500 000 people live with epilepsy, many of whom do not receive the care that they require. The country has just 18 neurologists in public health services; a clear rationale for the Myanmar Epilepsy Initiative to focus on strengthening community-based care for epilepsy.
The Myanmar Epilepsy Initiative has led to increased coverage in implementing areas from 2% to 47%. The project’s advocacy efforts have proved successful; there is now a Five-year National Strategic Plan for Epilepsy (2016–2020) and a National Framework for Epilepsy Care in Myanmar.
The evidence generated and lessons learned by the Myanmar Epilepsy Initiative are now being applied in a scale up programme to ensure long-term sustainability of accessible, affordable and quality care for epilepsy in Myanmar. The scale up programme is expected to lead to full coverage of all townships in five states/regions by the end of 2021.