The Republic of the Union of Myanmar health system review

Overview

The Myanmar HiT reports of positive indications that, along with the changes in the country’s political system and administrative structures following the 2010 national elections, the new government is undertaking important reforms in the health sector. 

Although resources for health sector have been limited until recently, life expectancy at birth increased for both males and females between 1980 and 2011, along with an increase in the child immunization coverage, and declines in infant and under-five mortality rates, including maternal mortality ratio. Myanmar has made some progress towards achieving its Millennium Development Goals (MDG), but further improvement is needed to reach the 2015 targets.

The Ministry of Health (MOH) is the major player in the health sector as a governing agency, as well as a provider of comprehensive health care. However, many key players are changing roles with the evolving political and administrative circumstances. The government used to be the main source of financing, with provision of services virtually free until user charges were introduced in the form of cost-sharing in 1993; since then household out-of-pocket (OOP) payment has become the main source of finance. 

Human resources for health are constrained. Even as the recruitment of doctors, nurses and midwives have been increasing since the early 1990s, it has not yet reached the benchmark of 2.28 doctor, nurse and midwife positions per 1,000 population. 

The National Health Plan (NHP) remains an integral part of the comprehensive national development plan. The government has started to take the initiative to introduce formal social protection in the country, and the (MOH is in the process of piloting and introducing some community-based and demand-side approaches as interim measures, while the Social Protection System is in the developmental stage. Universal access to free essential generic medicines is a recent step taken to move closer to universal health coverage (UHC). 

The challenges of the Myanmar health sector are not only to overcome the supply-side limitations of the past (for example, low investment in rural health services, inadequate funding for expansion of UHC, health workforce shortage), but also to effectively utilize new resources (for example, possible use for health of the funds generated from revenue on extracting natural resources and huge influx of official development assistance (ODA) from several international development partners).