国际护理科学（英文）2021，Vol.8Issue(3)：271-278,后插2-后插3,10.
缅甸社区卫生护士在实现全民健康覆盖中面临的挑战
Challenges faced by community health nurses to achieve universal health coverage in Myanmar:A mixed methods study
摘要
Abstract
Objective:This study aimed to identify the challenges of community health nurses (CHNs) in delivering effective community health care to achieve universal health coverage (UHC) in Myanmar.Methods:A total of 30 CHNs from township health centers in the northeastern,southern,and western parts of Myanmar were purposefully recruited for quantitative and qualitative interviews.Quantitative data were processed using Microsoft Excel software,and qualitative data were analyzed using thematic analysis.This study is registered with researchregistry6201.Results:Around the country,30 CHNs uncovered their hardships in implementing primary health care to achieve UHC.Over 90％ of the participants agreed to the problem of inadequate health infrastructure,while half of them felt unmotivated when they encountered role conflicts among various cadres of healthcare providers and poor opportunities for career promotion.Major problems arose from the lack of standard professional education at the entry point to community settings because most CHNs did not achieve specialized training in providing public health services.Complications are incapable of evalu-ating health services for policy-making and the inability to conduct health research to develop evidence-based practices.Insecure work and living conditions,unsupportive community relationships,and undereducation in professional practices were supportive major themes explored by CHNs to achieve a deeper understanding of the barriers to UHC.Not only the health system itself but also the population and other geographical factors have contributed to many challenges to CHNs.Conclusion:Myanmar's CHNs face many challenges in achieving UHC.These challenges are not confined to the health sector.Some situations,such as geographical barriers and transportation problems,remain persistent challenges for healthcare providers.This study highlights the fact that current health systems should be strengthened by qualified healthcare providers and sufficient infrastructure.Meanwhile,public empowerment plays a critical role in promoting health development.关键词
社区保健护士/社区卫生服务/卫生专业人员/缅甸/初级卫生保健/专业实践/社会条件/全民健康覆盖Key words
Community health nurses/Community health services/Health personnel/Myanmar/Primary health care/Professional practice/Social conditions/Universal health coverage引用本文复制引用
Sein Yaw May,Naw Clara,Ohn Khin Khin,Win Win Mar,Aye Nandar Han,Su Su Maw..缅甸社区卫生护士在实现全民健康覆盖中面临的挑战[J].国际护理科学（英文）,2021,8(3):271-278,后插2-后插3,10.基金项目
This work was supported by the Ministry of Health and Sports,Republic of the Union of Myanmar (MOHS IR Grant 2019,Research ID No.501). （MOHS IR Grant 2019,Research ID No.501）
