1. “Improvement of National
Healthcare System in Myanmar”
Presented By:
So Pyay (571-9661)
Batch - 11

2. Content
• Introduction
• Research Objective
• Significance of the Study
• Literature Review
• Conceptual Framework
• Hypotheses
• Research Methodology
• Descriptive Analysis
• Hypotheses Testing
• Conclusion
• Recommendation
• Limitations of the study
• References

3. • The death rate is increased by the several types of disease since the
population is rising up in Myanmar compare to the last years.
• Healthcare System plays an important role in saving the lives of
people.
• Since the technologies and treatment methods are advancing rapidly
and appearances of new diseases are occurring, health care system
and providers of Myanmar are needed to improve.
• It is the workload for the Ministry of Health and needed to develop
the current Healthcare System.
Introduction

4. • To find out the factors which will strongly affect the improvement of
National Healthcare System in Myanmar and is relied on the
healthcare providers such as doctors, nurses, pharmacists, dentists,
physicians, surgeon and medical students etc.
• To examine which factors among technology, budget, training, work
environment, Healthcare providers-patients communication, hospitals
& clinics' facilities availability, Medical Training Institute & facilities
and patients' safety are strongly related to the improvement of
National Health Care System in Myanmar.
Research Objective

5. • It could find out what are the possible factors which can affect the
improvement of National Healthcare System.
• It can be beneficial to the medical students and healthcare providers
in Healthcare Services and also for the Ministry of Health as well.
• It can also provide recommendations on how to implement and
develop the National Healthcare System in Myanmar.
• It will also give the baseline information to the further researchers on
the topic of improvement of National Healthcare System.
Significance of the Study

6. • Compared to the manufacturing sector, the service sector –
particularly the healthcare sector–is widely regarded as lagging in
terms of adopting new management innovations (Christensen et al.,
2009; Greenhalgh et al., 2004; Walley, 2003).
• The question of how to improve healthcare system performance
leads to multiple possibilities. Strategies can be aimed at different
levels and components of a healthcare system such as how the
system is regulated and financed, and how services are organized and
provided (Evans et al., 2001; Rothgang et al., 2010).
Literature Review

7. • Some of the current issues in healthcare provision involve the training
for the adoption of progressive information technology (IT) systems.
There appear to be barriers in providing technical support and in the
computer skills of hospital staff including doctors and nurses together
with additional costs of transferring the traditional system of medical
records (Khalifa, 2013; Al-shorbaji, 2008).
• First, a system, which produces healthcare within a fixed frame of
money, will not produce care in proportion to demand (Berry and
Bendapudi, 2007).

8. • Health care systems have undergone major technological,
organizational and financial changes in many countries during the last
decades. These changes have had a substantial effect on the work
environment for employees, not the least for physicians (Axelsson,
2000).
• A comprehensive specification of public health education and training
requirements which is purposely designed for the new agenda would
require a full research program. This research would include task, job
and role analysis (Pearn and Kandola, 1988).

9. • New health care systems, the development of medical and
information technologies, multicultural medical staff and patients as
well as other changes in society have influenced the doctor-patient
relationship, and new consultation styles have emerged (Elwyn,
2004).
• Creating a positive patient safety climate inside an organization can
only be accomplished through managerial commitment, strong
communication, dedicated organizational resources and mutual trust
shared by organizational members (Fleming, 2005; Singer et al.,
2003).

10. Conceptual Framework

11. No. Description
1.
H1o : There is no relationship between age and the improvement of National
Healthcare System in Myanmar.
H1a : There is a relationship between age and the improvement of National
Healthcare System in Myanmar.
2.
H2o : There is no relationship between gender and the improvement of National
Healthcare System in Myanmar.
H2a : There is a relationship between gender and the improvement of National
Healthcare System in Myanmar.
3.
H3o : There is no relationship between marital status and the improvement of
National Healthcare System in Myanmar.
H3a : There is a relationship between marital status and the improvement of
National Healthcare System in Myanmar.
4.
H4o : There is no relationship between education level and the improvement of
National Healthcare System in Myanmar.
H4a : There is a relationship between education level and the improvement of
National Healthcare System in Myanmar.
Hypotheses

12. No. Description
5.
H5o : There is no relationship between profession and the improvement of
National Healthcare System in Myanmar.
H5a : There is a relationship between profession and the improvement of
National Healthcare System in Myanmar.
6.
H6o : There is no relationship between technology, budge, work environment,
training, healthcare providers & patients’ communication, medical training institutes
and patients’ safety and the improvement of National Healthcare System in
Myanmar.
H6a : There is a relationship between technology, budge, work environment,
training, healthcare providers & patients’ communication, medical training institutes
and patients’ safety and the improvement of National Healthcare System in
Myanmar.
Hypotheses(Continued)

13. Data Collection Procedure
• Self-administered and structured questionnaires.
• 300 Respondents within two weeks.
• Target Population - People who are working as healthcare providers such as
doctors, nurses, pharmacists, dentists, surgeons, physicians, medical
technicians, etc. in hospitals and other healthcare settings, students who are
studying in the Medical Universities.
• Medical University, University of Dental Medicine, University of Medical
Technology, University of Traditional Medicine, University of Pharmacy,
Mandalay General Hospitals, Mandalay Children Hospitals, Universities
Hospitals and Mandalay Orthopedic Hospitals. (Mandalay)
Research Methodology

14. • Statistical Package for the Social Sciences (SPSS)
• One-way Analysis of Variance (ANOVA) for Age, Marital Status, Education
level & Profession.
• Independent Sample T-test for Gender.
• Likert Scale (Five Points) ranging from strongly disagree to strongly agree.
• Multiple Regression Analysis for the independent factors affecting the
Improvement of National Healthcare System in Myanmar.
• Pilot Testing is done by 10 respondents.
• Reliability Test is done by 30 respondents.
Statistical Analysis Methods

15. Section Variables No. of Questionnaires Questionnaires No.
1.
Demographic Variables
• Age
• Gender
• Marital Status
• Education Level
• Profession
1 Questionnaire
1 Questionnaire
1 Questionnaire
1 Questionnaire
1 Questionnaire
1
2
3
4
5
2.
Independent Variables
• Technology
• Budget
• Work Environment
• Training
• Healthcare Providers & Patients’
Communication
• Medical Training Institutes &
Facilities
• Patients’ Safety
3 Questionnaires
3 Questionnaires
3 Questionnaires
3 Questionnaires
3 Questionnaires
2 Questionnaires
2 Questionnaires
6,7,8
9,10,11
12,13,14
15,16,17
18,19,20
21,22
23,24
3.
Dependent Variable
• Improvement of National
Healthcare System in Myanmar.
2 Questionnaires 25,26
Questionnaires Format

16. 20-30 years
52%
31-40 years
20%
41-50 years
23%
51-60 years
5%
Age
20-30 years 31-40 years
41-50 years 51-60 years
Descriptive Analysis
Male
48%Female
52%
GenderMale
Female

17. 169
131
0
20
40
60
80
100
120
140
160
180
Single Married
Marital Status
95
85
20
45
55
0
10
20
30
40
50
60
70
80
90
100
Education Level

18. 112
76
44
48
20
0
20
40
60
80
100
120
Doctor Nurse Pharmacist Dentist Others
Profession

19. Descriptive Statistics of Independent Variables
Descriptive Statistics
N Minimum Maximum Mean Std. Deviation
Technology 300 2.00 5.00 3.9000 .60929
Budget 300 3.00 5.00 3.3000 .65684
Work Environment 300 3.00 5.00 3.4000 .67937
Training 300 2.00 5.00 3.9433 .66453
Healthcare Providers-
Patient Communication 300 2.00 5.00 3.0867 .72762
Medical Institutes 300 2.00 5.00 3.9833 .78669
Patients' Safety 300 2.00 5.00 3.5967 .81005
Valid N (listwise)
300

20. The Reliability Test
Variables Cronbach's Alpha Value No. of items
Improvement of National Healthcare
system
0.720 2
Technology 0.655 3
Budget 0.639 3
Work Environment 0.808 3
Training 0.621 3
Healthcare Providers-Patients'
Communication 0.623 3
Medical Institutes & its Facilities 0.890 2
Patients' Safety 0.730 2

21. Hypotheses Testing
Hypotheses (1)- ANOVA Analysis of Age
ANOVA
Improvement of National Healthcare System
Sum of Squares df Mean Square F Sig.
Between Groups 1.302 3 .434 .934 .424
Within Groups
137.534 296 .465
Total
138.837 299
There is no significant relationship between Age and the Improvement of National
Healthcare System. (H1a is rejected)

22. Hypotheses Testing
Hypotheses (2)- Independent Sample T-test for Gender
There is no significant relationship between Gender and the Improvement of National
Healthcare System. (H2a is rejected)
Group Statistics
Gender
Group N Mean Std. Deviation
Std. Error
Mean
Improvement of National
Healthcare System
Male 145 3.9724 .70656 .05868
Female
155 4.0710 .65574 .05267

23. Hypotheses Testing
Hypotheses (3)- ANOVA Analysis of Marital Status
There is no significant relationship between Marital Status and the Improvement of
National Healthcare System. (H3a is rejected)
ANOVA
Improvement of National Healthcare System
Sum of Squares df Mean Square F Sig.
Between Groups 1.111 1 1.111 2.405 .122
Within Groups
137.725 298 .462
Total
138.837 299

24. Hypotheses Testing
Hypotheses (4)- ANOVA Analysis of Education Level
There is no significant relationship between Education Level and the Improvement of
National Healthcare System. (H4a is rejected)
ANOVA
Improvement of National Healthcare System
Sum of Squares df Mean Square F Sig.
Between Groups
.853 4 .213 .456 .768
Within Groups
137.984 295 .468
Total
138.837 299

25. Hypotheses Testing
Hypotheses (5)- ANOVA Analysis of Profession
There is no significant relationship between Profession and the Improvement of
National Healthcare System. (H5a is rejected)
ANOVA
Improvement of National Healthcare System
Sum of Squares df Mean Square F Sig.
Between Groups
.181 4 .045 .096 .984
Within Groups
138.656 295 .470
Total
138.837 299

26. Hypotheses Testing
Hypotheses (6)- Multiple Regression Analysis for Independent Variables
Model Summary
Model R R Square Adjusted R Square Std. Error of the Estimate
1 .625a .391 .376 .53824
a. Predictors: (Constant), Patient Safety, Training, Medical Institutes, Budget, Technology, Work
Environment, Healthcare Providers-Patient Communication
ANOVAb
Model
Sum of
Squares df Mean Square F Sig.
1 Regression 54.244 7 7.749 6.749 .000a
Residual
84.592 292 .290
Total
138.837 299
a. Predictors: (Constant), Patient Safety, Training, Medical Institutes, Budge, Technology, Work
Environment, Healthcare Providers-Patient Communication
b. Dependent Variable: Improvement of National Healthcare System

27. Coefficientsa
Model
Unstandardized
Coefficients
Standardized
Coefficients
t Sig.B Std. Error Beta
1 (Constant)
.215 .397 .542 .038
Technology .463 .057 .414 8.124 .000
Budget .075 .063 .072 1.197 .232
Work Environment -.087 .059 -.086 -1.477 .141
Training .111 .054 .108 2.058 .040
Healthcare Providers-
Patients'
Communication
.115 .044 .173 2.587 .010
Medical Institutes .239 .057 .205 4.216 .002
Patient’s Safety .085 .065 .101 1.303 .193
a. Dependent Variable: Improvement of National Healthcare System
Technology, Budget, Work Environment, Training, Healthcare Providers-Patients’
Communication, Medical Institutes and Patients’ Safety

28. Hypotheses Statement Significant Level Result
H1o
There is no significant relationship between age
and the improvement of National Healthcare
System in Myanmar.
0.424 > 0.05
Null Hypotheses is
accepted
H2o
There is no significant relationship between
gender and the improvement of National
Healthcare System in Myanmar.
0.857 > 0.05
Null Hypotheses is
accepted
H3o
There is no significant relationship between
marital status and the improvement of National
Healthcare System in Myanmar.
0.122 > 0.05
Null Hypotheses is
accepted
H4o
There is no significant relationship between
Education Level and the improvement of
National Healthcare System in Myanmar.
0.768 > 0.05
Null Hypotheses is
accepted
H5o
There is no significant relationship between
profession and the improvement of National
Healthcare System in Myanmar.
0.984 > 0.05
Null Hypotheses is
accepted
H6a
There is a significant relationship between
Technology and the improvement of National
Healthcare System in Myanmar.
0.000 < 0.05
Null Hypotheses is
rejected
Summary of Hypotheses Testing

29. Hypotheses Statement Significant Level Result
H6ob
There is no significant relationship between
budget and the improvement of National
Healthcare System in Myanmar.
0.232 > 0.05
Null Hypotheses is
accepted
H6oc
There is no significant relationship between
work environment and the improvement of
National Healthcare System in Myanmar.
0.141 > 0.05
Null Hypotheses is
accepted
H6d
There is a significant relationship between
training and the improvement of National
Healthcare System in Myanmar.
0.04 < 0.05
Null Hypotheses is
rejected
H6e
There is a significant relationship between
Healthcare Providers & Patient' Communication
and the improvement of National Healthcare
System in Myanmar.
0.01 < 0.05
Null Hypotheses is
rejected
H6f
There is a significant relationship between
Medical Institutes and the improvement of
National Healthcare System in Myanmar.
0.002 < 0.05
Null Hypotheses is
rejected
H6og
There is no significant relationship between
Patients' Safety and the improvement of
National Healthcare System in Myanmar.
0.193 > 0.05
Null Hypotheses is
accepted.

30. Conclusion
Demographic Variables
 Age, Gender, Marital Status, Education Level and Profession do not have
significant relationship with the Improvement of National Healthcare System
in Myanmar.
Independent Variables
 Budget, Work Environment and Patients’ Safety do not have significant
relationship with the Improvement of National Healthcare System in
Myanmar.
 Technology, Training, Healthcare Providers & Patient’s Communication and
Medical Institutes & its facilities have significant relationship with the
Improvement of National Healthcare System in Myanmar.

31. Recommendation
• Corporate with the Healthcare Organizations in other countries
and innovate technology development system and send the local
healthcare providers to get proper training on how to use the high
technology facilities effectively.
• Develop an advancing technology and contribute it to the public
and private Hospitals efficiently.
• Analyze what healthcare providers' skills & knowledge are needed
in the country and make implementation of the training models
required.

32. • Hire the healthcare trainers from overseas if there are no skillful and well-
experienced trainers in local or send the local healthcare providers to
overseas for training programs in order to provide the efficient and
effective training to the healthcare providers.
• Invest in training healthcare providers in effective communication skills and
related topics. Provide the role-play with 4 or 5 members in group
depending on the most encountered scenarios.
• Medical Institutes should provide high technology facilities for the future
generation of medical students to learn and develop the use of best
technology medical facilities.

33. • A sample setting of 300 total respondents.
• Time Constraints
• Could not reach the whole targeted areas.
• All the possible independent factors are not considered.
• Focused only on Mandalay, Myanmar.
Limitations of the Study

34. • Daniel P. Kessler, Deirdre Mylod, (2011),"Does patient satisfaction affect
patient loyalty?", International Journal of Health Care Quality Assurance, Vol.
24 Iss 4 pp. 266-273
• Piyali Ghosh, Jagdamba Prasad Joshi, Rachita Satyawadi, Udita Mukherjee,
Rashmi Ranjan, (2011),"Evaluating effectiveness of a training programme
with trainee reaction", Industrial and Commercial Training, Vol. 43 Iss 4 pp.
247-255
• Jane Cowan, (2000),"Consent and clinical governance: improving standards
and skills", British Journal of Clinical Governance, Vol. 5 Iss 2 pp. 124 – 128
• Vineet Sarode, Deborah Sage, Jenny Phong, John Reeves, (2015),"Intensive
care patient and family satisfaction", International Journal of Health Care
Quality Assurance, Vol. 28 Iss 1 pp. 75-81
• Muslim Amin, Siti Zahora Nasharuddin, (2013),"Hospital service quality and
its effects on patient satisfaction and behavioural intention", Clinical
Governance: An International Journal, Vol. 18 Iss 3 pp. 238-254
Reference

35. • Williams, S., Weinman, J. and Dale, J. (1998), “Doctor-patient
communications and patient satisfaction: a review”, Family Practice, Vol. 15
No. 5, pp. 480-492.
• Baker, J. (1998), ``Education, training and development'', Public Health
Forum, Vol. 2 No.1, p. 7.
• Wilson, T., Butler, F. and Watson, M. (1998), ``Establishing educational needs
in a new organization'', Career Focus, BMJ Classified,19/26 December, pp. 2-
3.
• Abrams, H.L. and Hessel, S., “Health technology assessment: problems and
challenges”, American Journal of Radiology, Vol. 149, 1987, pp. 1127-31
• Shani, M., “High technology: the Israeli perspective”, Israel Journal of Medical
Sciences, Vol. 22, 1982: pp. 169-72.

36. Thank You For Your Attention