title: An approach to health system strengthening in the Union of Myanmar.
abstract: OBJECTIVE
  In 2007 and 2008, Myanmar developed a health system strengthening (HSS) strategy and proposal through funding support from the Global Alliance for Vaccines and Immunization (GAVI). The aim of this paper is to identify critical success factors in the development of the HSS strategy in Myanmar.
  
  
  METHODS
  The main source of information for this review includes international and national literature, and participant observation by the authors in the health systems analysis and HSS strategy development in Myanmar between 2007 and 2009.
  
  
  RESULTS
  Critical success factors in the development of the HSS strategy included evidence-based development of the strategy through a sector analysis, and a long-term approach to strategy development with wide stakeholder participation. This contributed to important strategy breakthroughs in the areas of health planning, health financing, human resource management and civil society partnerships.
  
  
  CONCLUSIONS
  Implementation of the HSS strategy in Myanmar should position the MOH and partners well to implement challenging system reforms in the areas of health planning, financing and human resource management in the coming years, as well as support more coordinated efforts for relief and recovery effort following the Nargis natural disaster in 2008. These innovations in Myanmar, with evidence of similar breakthroughs in other countries of the Asian region including North Korea, Cambodia, Nepal and Sri Lanka, provides promising evidence of the potential of the HSS approach as an emerging health development paradigm, particularly in relation to responding to the issue of "within country" inequities in access to health care.
authors.affiliation: Department of Health, Ministry of Health, Nay Pyi Taw, Myanmar. nittin@mptmail.net.mm
authors.forename: Nilar
authors.initials: N
authors.lastname: Tin
authors.forename: Saw
authors.initials: S
authors.lastname: Lwin
authors.forename: Nyo Nyo
authors.initials: NN
authors.lastname: Kyaing
authors.forename: Thein Thein
authors.initials: TT
authors.lastname: Htay
authors.forename: John
authors.initials: J
authors.lastname: Grundy
authors.forename: Margareta
authors.initials: M
authors.lastname: Skold
authors.forename: Thomas
authors.initials: T
authors.lastname: O'Connell
authors.forename: Siddharth
authors.initials: S
authors.lastname: Nirupam
mesh_terms: D003906:Developing Countries; D055317:Evidence-Based Practice; D018166:Health Care Reform / Q000458:organization & administration*; D006284:Health Plan Implementation / Q000458:organization & administration*; D006297:Health Services Accessibility; D006305:Health Status Indicators; D054625:Healthcare Disparities; D006801:Humans; D017589:Immunization Programs / Q000458:organization & administration*; D007390:International Agencies; D002052:Myanmar / Q000453:epidemiology; D020380:Needs Assessment; D016730:Program Development; D017749:Total Quality Management / Q000458:organization & administration