Challenges faced by community health nurses to achieve universal health coverage in Myanmar: A mixed methods study.

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 evaluating 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.

Hydrogel-Templated Solid Base Catalysts for Transesterification of Soybean Oil.

A new method for utilization of hydrogel is proposed here for the preparation of solid base catalysts for the transesterification of vegetable oil. When a solution of KF is mixed with a solution of Ca(NO3)2, CaF2 is obtained and inactive as a catalyst in the transesterification of vegetable oils. The catalysts were synthesized by the sequential incorporation of KF and/or Ca(NO3)2 solutions into the hydrogel upon microwave irradiation and then the as-obtained hydrogel was calcined at 800°C for 5 hours to eliminate the template and yield catalysts for the biodiesel productions. The prepared catalysts obtained by the different ways in the incorporation of ions into the hydrogel showed different physical properties and catalytic activities in the transesterification of soybean oil. All catalysts, except the low concentration of Ca(NO3)2, exhibiting the high activity yielding more than 90% FAME after 1 hour at 65°C, using oil to methanol molar ratio of 1:15 and 10 wt% of catalyst amounts.

Esterification of fatty acid catalyzed by hydrothermally stable propylsulfonic acid-functionalized mesoporous silica SBA-15.

Propylsulfonic acid-functionalized mesoporous silica SBA-15 has been synthesized via one-step strategy at 130°C based on the co-condensation of TEOS and MPTMS in the presence of Pluronic 123 polymer and H2O2 in HCl aqueous solution. The synthesized solid exhibited hydrothermal stability in boiling water without significant change in textural properties. The catalytic performance of the synthesized solid was studied in the esterification of oleic acid with methanol. The experimental results revealed that the large mesopore structures of SBA-15-PrSO3H solid synthesized at 130°C could favor a facile access of oleic acid to the acid sites, making the comparable activity to that of phenyl ethyl sulfonic acid functionalized silica and higher than that of dry amberlyst-15.