Human resources for health: task shifting to promote basic health service delivery among internally displaced people in ethnic health program service areas in eastern Burma/Myanmar

For over 50 years, Burma/Myanmar’s ethnic areas lacked access to basic health services due to military rule. Ethnic health organizations (EHOs) and community-based health organizations (CBHOs) filled this gap by providing care in border regions. This case study focuses on how these groups reach vulnerable populations, particularly in 14 townships of Karen/Kayin State. Using surveys, interviews, and document reviews, the study found that despite limited skilled professionals, health coverage was achieved through task shifting and well-organized mobile and clinic-based teams. Human resource density ranged from 1.8 to 3.9 health workers per 1,000 people. Over 20 years, EHOs and CBHOs built a functioning health system in conflict-affected areas. However, they remain vulnerable due to limited international recognition and political complexities, especially amid ongoing peace negotiations and ASEAN integration, which could affect migration and healthcare access.