Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Oct 1;34(Supplement_1):i38-i46.
doi: 10.1093/heapol/czy110.

A new hope: from neglect of the health sector to aspirations for Universal Health Coverage in Myanmar

Alex Ergo  1 , Thant Sin Htoo  2 , Reena Badiani-Magnusson  3 , Rivandra Royono  4
Affiliations

A new hope: from neglect of the health sector to aspirations for Universal Health Coverage in Myanmar

Alex Ergo et al. Health Policy Plan. .

Abstract

Myanmar's health sector has received low levels of public spending since 1975. Combined with the country's historic political and economic isolation, poor economic management and multiple internal armed conflicts, these limited resources have translated into low coverage of even the most basic services and into poor health outcomes with wide disparities. They have also resulted in out-of-pocket payments for health as a proportion of total health spending being among the highest in the world. The Government of Myanmar has now affirmed its commitment to moving toward Universal Health Coverage. This commitment is reflected in the National Health Plan 2017-2021. Drawing upon analysis of data from the Myanmar Poverty and Living Conditions Survey 2015 and using the country's revised methodology to estimate poverty, this paper explores some of the consequences of Myanmar's excessive reliance on out-of-pocket funding as the main source of health financing. Around 481 000 households in Myanmar experienced catastrophic health spending in 2015. Of this group, 185 000 households lived below the national poverty line. Households that experienced catastrophic health spending spent, on average, 54.7% of their total capacity to pay on health. Of all Myanmar households that went to a health facility in 2015, ∼28% took loans and ∼13% sold their assets to cover health spending. In that same year, ∼1.7 million people fell below the national poverty line due to health spending. The paper then discusses how ongoing reforms could help alleviate the financial hardship associated with care-seeking. With current political will to reform the health system, a conducive macro-economic environment, and the relatively limited vested interests, Myanmar has a window of opportunity to achieve significant progress towards UHC. Continued high-level political support and strong leadership will be needed to keep reforms on track.

Keywords: Myanmar; catastrophic health expenditure; equity; health financing; health reforms; impoverishing health expenditure.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Pen’s Parade of Myanmar’s households, before and after out-of-pocket health spending. Source: analysis of MPLCS 2015 data
Figure 2.
Figure 2.
Share of households that took a loan or sold an asset to cover health care expenses*. Source: analysis of MPLCS 2015 data; *Of households who made spending on health care in the last 12 months
See this image and copyright information in PMC

References

    1. ADB, UNDP, UNFPA and UN Women. 2016. Gender Equality and Women’s Rights in Myanmar: A Situational Analysis. Mandaluyong City: Asian Development Bank.
    1. Bitran R. 2014. Universal Health Coverage and the Challenge of Informal Employment: Lessons from Developing Countries. Health, Nutrition, and Population (HNP) Discussion Paper. Washington, DC: The World Bank.
    1. Bump J, Cashin C, Chalkidou K. et al. 2016. Implementing pro-poor universal health coverage. The Lancet. Global Health 4: e14–6. - PubMed
    1. Cotlear D, Nagpal S, Smith O, Tandon A, Cortez R.. 2015. Going Universal: How 24 Developing Countries Are Implementing Universal Health Coverage Reforms from the Bottom Up. Washington, DC: World Bank.
    1. Crapper D, Htat HW, Ergo A, Aung PM.. 2017. Package of Services Myanmar Strategic Purchasing Brief Series 1. Yangon: Population Services International.

MeSH terms