Newly emerged resistance healthcare systems in northwest Myanmar’s Sagaing Region post-military coup: qualitative insights from anti-junta healthcare workers and community members

Introduction The 2021 military coup and the accompanying armed conflicts in Myanmar have disrupted the country’s health systems, particularly in conflict-affected rural areas. Anti-junta healthcare providers innovated alternative systems to address the needs. This study aims to provide insights into the experiences and perspectives of the anti-junta healthcare providers and community members regarding the prevailing health issues in conflict settings of Sagaing Region, how the anti-junta healthcare providers have established alternative care systems in the region, and the challenges the providers and community members encounter in healthcare provision and access. Methods We conducted qualitative, semi-structured, in-depth online interviews with 26 healthcare workers providing, managing or supporting healthcare services and six community members receiving these services from the Sagaing Region, Myanmar. We analysed the data thematically. Results Prevailing health issues included conflict-related injuries, infectious diseases, chronic non-communicable diseases and mental health concerns. In resistance force-controlled rural areas, junta-controlled rural health centres have stopped functioning, and anti-junta healthcare workers and local communities have established new systems to provide primary care to the local communities, although secondary care was still limited. However, limited workforce, supplies, funding and infrastructure, restricted travel and communication and safety concerns impeded their efforts. Moreover, the politicisation of healthcare, targeted attacks and interference by the junta further hindered effective responses to these challenges. Conclusion The post-coup conflict has severely devastated Sagaing Region’s healthcare systems and health status, disproportionately affecting rural areas, demanding immediate action. Failure to address these issues promptly could worsen the region’s health outcomes and deepen the humanitarian crisis. Improving healthcare in the region will require effective interventions from international stakeholders to stop junta attacks on healthcare and civilians and innovative ways to support new local healthcare initiatives technically, financially and logistically.