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Objectives To evaluate healthcare for children with DS after insertion of adapted PCHR (personal-child-health-record) Burmese version to overcome the barriers, less access to health services, knowledge of caregivers about schedule of health checks, identified in the previous study conducted in 2020 (study-2020).Methods Data extracted from CDC registry (21/03/2024-21/03/2025) were analyzed in comparison with the results of the study-2020 and CDC annual reports (2022, 2023)Results A total of 106 DS children (0-18 years old) with 71% aged 0-5 and 52.83% male, were included in this study. Annual total number reached 184 in 2024-2025 from 30 in 2023 and 16 in 2022 with 97 follow-up cases in 2024-2025 from 15 in 2023 and 4 in 2022. Parental characteristics were mean maternal age at conception (35.55 years) and education (40.22% tertiary). More health checks were conducted: cardiac (71.69% vs. 72.89% study-2020), thyroid (69.81% vs. 40.96% study-2020), eye (16.98% vs. 25.3% study-2020), hearing (15.09% vs. 26.51% study-2020), 28.30% dental, 85.84-100% assessment of growth and development. More co-occurring medical conditions were detected: cardiac (73% vs. 53.01% study-2020), thyroid (36% vs. 13.25% study-2020), eye (33.33% vs. 13.25% study-2020), hearing (37.5% vs. 8.43% study-2020) and 80% dental. The leading cause of mortality was cardiac complications (61.11%), and neonatal deaths were 55.55% of total 18 cases.Conclusions Recommended health checks for treatable medical conditions are crucial for Myanmar children with DS based on the clinical profile of both studies, previous multi-center (study-2020) and this one-center. Further assessment of growth and development is also essential for future DS studies.