Who continues to stock oral artemisinin monotherapy? Results of a provider survey in Myanmar.

BackgroundArtemisinin-based combination therapy (ACT) is a key strategy for global malaria elimination efforts. However, the development of artemisinin-resistant malaria parasites threatens progress and continued usage of oral artemisinin monotherapies (AMT) predisposes the selection of drug resistant strains. This is particularly a problem along the Myanmar/Thailand border. The artemisinin monotherapy replacement programme (AMTR) was established in 2012 to remove oral AMT from stocks in Myanmar, specifically by replacing oral AMT with quality-assured ACT and conducting behavioural change communication activities to the outlets dispensing anti-malarial medications. This study attempts to quantify the characteristics of outlet providers who continue to stock oral AMT despite these concerted efforts.MethodsA cross-sectional survey of all types of private sector outlets that were stocking anti-malarial drugs in 13 townships of Eastern Myanmar was implemented from July to August 2014. A total of 573 outlets were included. Bivariate and multivariable logistic regressions were conducted to assess outlet and provider-level characteristics associated with stocking oral AMT.ResultsIn total, 2939 outlets in Eastern Myanmar were screened for presence of any anti-malarial drugs in August 2014. The study found that 573 (19.5 %) had some kind of oral anti-malarial drug in stock at the time of survey and among them, 96 (16.8 %) stocked oral AMT. In bivariate analyses, compared to health care facilities, itinerant drug vendors, retailers and health workers were less likely to stock oral AMT (33.3 vs 12.9, 10.0, 8.1 %, OR = 0.30, 0.22, 0.18, respectively). Providers who cut blister pack or sell partial courses (40.6 vs 11.7 %, OR 5.18, CI 3.18-8.44) and those who based their stock decision on consumer demand (32.8 vs 12.1 %, OR 3.54, CI 2.21-5.63) were more likely to stock oAMT. Multivariate logistic regressions produced similar significant associations.ConclusionPrivate healthcare facilities and drug shops and providers who prioritize consumers' demand instead of recommended practices were more likely to stock oral AMT. Malaria elimination strategies should include targeted interventions to effectively reach those outlets

The Measurement of Student Achievements For Capacity Building On Higher Education

Capacity building is the phenomenon by which individuals and organizations obtain, improve and retain the skills, knowledge and other resources needed to do their jobs competently. Capacity building framework is not only for teachers but also for students. In this framework, there is a need to be synchronized with system policies and performance management. Moreover teacher improvement is based on student improvement and student outcomes. This paper aims to focus on improving effective teaching and professional learning. Professional learning without depth in evidence or theories or feedback does not enable effective growth or change that, in turn, builds capacity and develops quality in achieving student learning outcomes. In a country, future-oriented education system is needed to plan and to be higher education system. Because helping students developed a futureoriented perspective allows them to manage the uncertainly of the future logically in academic settings. In this paper, it intends to explore the perception of students and teachers for higher education. Some attributes such as learning outcomes and assessments are used as research tool from one Myanmar University included as population for higher education. In this study, achievements of studentsare mainly analyzed on two academic years. According to the basis of findings, the conclusions can be drawn. So the measurement of student achievements is very important to prepare for future needs and challenges of higher education. Capacity building and planning should be carried out better education

High rate of virological failure and low rate of switching to second-line treatment among adolescents and adults living with HIV on first-line ART in Myanmar, 2005-2015.

BACKGROUND: The number of people living with HIV on antiretroviral treatment (ART) in Myanmar has been increasing rapidly in recent years. This study aimed to estimate rates of virological failure on first-line ART and switching to second-line ART due to treatment failure at the Integrated HIV Care program (IHC). METHODS: Routinely collected data of all adolescent and adult patients living with HIV who were initiated on first-line ART at IHC between 2005 and 2015 were retrospectively analyzed. The cumulative hazard of virological failure on first-line ART and switching to second-line ART were estimated. Crude and adjusted hazard ratios were calculated using the Cox regression model to identify risk factors associated with the two outcomes. RESULTS: Of 23,248 adults and adolescents, 7,888 (34%) were tested for HIV viral load. The incidence rate of virological failure among those tested was 3.2 per 100 person-years follow-up and the rate of switching to second-line ART among all patients was 1.4 per 100 person-years follow-up. Factors associated with virological failure included: being adolescent; being lost to follow-up at least once; having WHO stage 3 and 4 at ART initiation; and having taken first-line ART elsewhere before coming to IHC. Of the 1032 patients who met virological failure criteria, 762 (74%) switched to second-line ART. CONCLUSIONS: We found high rates of virological failure among one third of patients in the cohort who were tested for viral load. Of those failing virologically on first-line ART, about one quarter were not switched to second-line ART. Routine viral load monitoring, especially for those identified as having a higher risk of treatment failure, should be considered in this setting to detect all patients failing on first-line ART. Strategies also need to be put in place to prevent treatment failure and to treat more of those patients who are actually failing

Entomophagy in Myanmar : factors influencing edible insect consumption behavior

As the world population rapidly increases, food security and malnutrition are becoming ever more significant concerns, as well as challenges to achieving sustainable development. These global problems are exacerbated by other persistent factors, such as decreased arable land, water scarcity, and changing climatic conditions. Edible insects promise an alternative protein source with fewer land and water requirements, as well as lower greenhouse gas emissions than conventional animal husbandry. Thus, the concept of entomophagy—consuming insects as food—has become particularly important. One country with a long history of consuming insects is Myanmar, yet where the problem of chronic malnutrition also persists. The growing significance of entomophagy has drawn the attention of researchers recently. However, the paucity of existing research into the topic of entomophagy makes it difficult to understand people's behavior regarding eating edible insects as well as their motives and aversions, particularly in the local culture of Myanmar. This knowledge gap emphasizes the need for consumer studies of edible insects; thus, this dissertation examines people’s behavior towards entomophagy to understand the current and future prospects, specifically in Myanmar. Data collection was conducted through telephone interviews, acquiring 872 respondents. The conceptual framework was based on the extended Theory of Planned Behavior (TPB) and Randall and Sanjur’s food consumption model. Consumer acceptance and consumption frequency of edible insects were explored using Poisson regression with sample selection analysis (Heckpoisson model). With the help of structural equation modelling analysis, consumption intention towards edible insects and reared crickets were then predicted. Results revealed that 67% were already insect consumers, indicating that entomophagy is pervasive. Consumer acceptance towards edible insects as food was 67%—a moderately high percentage in Myanmar, where consumption frequency is occasional. Twenty-three (23) types of edible insects have been documented, where crickets, bamboo worms, and bees were identified as the most eaten and preferred among them. Consumer acceptance was found to be influenced by ethnicity, religion, opinion towards entomophagy, insect phobia, nutritional properties, social concerns, and discomfort. Meanwhile, consumption frequency was influenced by respondents’ income, ethnicity, family size, taste, smell, and safety concerns. There was a significant positive effect of attitude, subjective norm, and perceived behavioral control on consumption intentions towards edible insects. Environmental concern, however, had a significant negative impact. On the other hand, consumption intention towards reared crickets was directly influenced by consumers’ attitudes, perceived behavioral control, and trust in producers. At the same time, it was indirectly influenced by consumer knowledge about the environmental friendliness of cricket farming. Being the first consumer analysis in Myanmar, this research supported the appropriateness of TPB as well as Randall and Sanjur’s food consumption model for analyzing insect consumption behavior. This study also highlighted the importance of raising public awareness of the benefits of entomophagy, creating a positive impression, and reducing social fears about insect consumption. Providing novel insect-based foods, such as flour, could boost consumption. A gradual shift from mere collection to insect farming would improve the all-year availability of edible insects and reduce the difficulties consumers face in accessing them. As trust in producers is the new key predictor, insect producers should build public trust by bringing transparency to the cricket production process, thereby achieving a more favorable attitude towards reared insects, leading to higher consumption levels. Government and non-governmental organizations are recommended to hold public fora to raise public awareness on the environmental and health benefits of consuming edible insects. Furthermore, the government should set good manufacturing practices for edible insects to ensure food safety,and the actors along the value chain should prioritize food safety by following laid-down policies

Analysis of Groundnut Sown Acre, Harvested Acre and Production in Myanmar (Thu Zar Aung, 2022)

Groundnut is the basic requirement crop in Myanmar. This study concentrates on the estimated trend equations like linear, quadratic, cubic models for groundnut sown acre, harvested acre and production in Myanmar. In this thesis, the sown acre, harvested acre and production of groundnut over the last 30 years (1988-89 to 2017-18) are studied and forecast values for next three years (2018-2019 to 2020- 20201) are made using best fitted cubic model. The required annual time series data are obtained from the Central Statistical Organization (CSO) of Myanmar. This study is intended to be able to choose the best model among models namely Linear, Quadratic, Cubic. The best fitted model for the future projection was chosen based upon the highest coefficient of determination (R2 ), and the values of smallest MSE, RMSE and MAPE by comparing with other models. The cubic model was chosen as the best fitted model for sown acre, harvested acre and production of groundnut data series. Using the cubic model, the values of groundnut production were predicted. It was also found that the assumptions concerned with the production function model are satisfied. In addition, the multiple regression model for groundnut production was also obtained using sown acre, yields per harvested acre and irrigation. The double log multiple linear regression model was chosen for the analysis

Factors Influencing Customer Attitude and Behavioural Intentions Towards JJ Express (Aung Thu Swe, 2022)

The purpose of this study is to examine factors that influence the customer attitude and behavioural intentions towards JJ Express. The data for this study is collected from 384 respondents by using a structured questionnaire. This research uses descriptive and analytical research methods. Both primary and secondary data are utilized in this research. To collect the primary data, the respondents are chosen by using systematic random sampling method and the first week of January, 2022 is identified as the data collection period. During this week, from morning (8:00 am) to evening (6:00 pm) everyday, the data are collected from passengers of every 5th outgoing JJ Express. The questionnaires are distributed to all passengers on selected JJ Express. Complete responses are obtained from 384 passengers. The findings of the study show that all influencing factors including perceived value, perceived service quality and brand image have positive effect on customer attitude towards JJ Express. Among these factors, perceived service quality is the most influential factor in improving customer attitude. The result also indicates that customer attitude has significant influence on behavioural intentions towards JJ Express. In this study, there are two variables: cognitive attitude and affective attitude are used to measure customer attitude. Out of these two variables, affective attitude is the most influential factor in enhancing favourable behavioural intentions. Therefore, JJ Express should try to continuously improve its service quality in order to form positive emotions that can enhance customer satisfaction and loyalty

The Effect of Organizational Learning and Organizational Innovation on Organization Performance of Byblos Pub & Grill (Htet Nay Thu Aung, 2024)

The objectives of the study are to analyze the effect of organizational learning on organizational performance and to analyze the indirect effect of organizational learning on organizational performance through organizational innovation in Byblos Pub & Grill. The study was used both primary and secondary data. In this study, 52 employees were selected as respondents using a census sampling method. The primary data were collected by using a structured questionnaire with five-point Likert scale. Secondary data are gathered from academic journals, academic websites, and research papers. Both descriptive statistics and linear regression analysis are used to analyze the primary data. According to the results of multiple regression, the study found that organizational learning has a positive and significant effect on organizational performance in Byblos Pub & Grill. Moreover, the study found that organizational innovation acts as a mediator in the relationship between organizational learning and organization performance. These results underscore the importance of fostering both organizational learning and innovation to enhance overall performance. Byblos Pub & Grill should encourage to prioritize continuous learning initiatives and innovative practices as essential strategies for maintaining competitiveness and achieving long-term success in Yangon’s food and beverage sector

Long-term outcomes of second-line antiretroviral treatment in an adult and adolescent cohort in Myanmar.

BACKGROUND: Myanmar has a high burden of Human Immunodeficiency Virus (HIV) and second-line antiretroviral treatment (ART) has been available since 2008 in the public health sector. However, there have been no published data about the outcomes of such patients until now. OBJECTIVE: To assess the treatment and programmatic outcomes and factors associated with unfavorable outcomes (treatment failure, death and loss to follow-up from care) among people living with HIV (aged ≥ 10 years) receiving protease inhibitor-based second-line ART under the Integrated HIV Care Program in Myanmar between October 2008 and June 2015. DESIGN: Retrospective cohort study using routinely collected program data. RESULTS: Of 824 adults and adolescents on second-line ART, 52 patients received viral load testing and 19 patients were diagnosed with virological failure. However, their treatment was not modified. At the end of a total follow-up duration of 7 years, 88 (11%) patients died, 35 (4%) were lost to follow-up, 21 (2%) were transferred out to other health facilities and 680 (83%) were still under care. The incidence rate of unfavorable outcomes was 7.9 patients per 100 person years follow-up. Patients with a history of injecting drug use, with a history of lost to follow-up, with a higher baseline viral load and who had received didanosine and abacavir had a higher risk of unfavorable outcomes. Patients with higher baseline C4 counts, those having taken first-line ART at a private clinic, receiving ART at decentralized sites and taking zidovudine and lamivudine had a lower risk of unfavorable outcomes. CONCLUSIONS: Long-term outcomes of patients on second-line ART were relatively good in this cohort. Virological failure was relatively low, possibly because of lack of viral load testing. No patient who failed on second-line ART was switched to third-line treatment. The National HIV/AIDS Program should consider making routine viral load monitoring and third-line ART drugs available after a careful cost-benefit analysis