Myanmar, formerly known as Burma, achieved independence from Great Britain in 1948. It was then a military dictatorship until 2011 when it transitioned to a civilian government. Since then, the democratic process has accelerated. It changed governments again in 2015. The healthcare system in Myanmar has been ranked among the worst in the world and the new governments have made reforming it a priority. It has fallen way behind other countries in the region in regards to healthcare. It has extremely high maternal and infant mortality rates, despite some decreases in the last decade. Malaria is among the leading causes of death. Myanmar healthcare systems have drastically evolved with recent changes of the political and administrative systems.
Healthcare systems in Myanmar are a mixture of public and private sectors. The Ministry of Health (MoH) is the official government healthcare provider in Myanmar. There are 6 departments within the MoH that facilitate all aspects of health for the entire population. The Department of Public Health is mainly responsible for primary healthcare and basic health services. The Disease Control Division covers prevention and control of infectious diseases. The Department of Medical Services provides effective treatments and rehabilitation services. The Department of Health Professional Resource Development and Management is mainly responsible for training of all categories of health personnel. The Department of Medical Research conducts national surveys and research for evidence-based medicine and policy making. The Department of Food and Drug Administration ensures safe food, drugs and medical equipment and cosmetics. The Department of Traditional Medicine is responsible for the provision of healthcare with traditional medicine, as well as training of traditional medicine personnel.
Most major specialist hospitals like children’s hospitals and women’s hospitals, are located in the Yangon and Mandalay regions. Second tier cities in other regions may have one or two specialist hospitals located in the region. Most of these regions will have general hospitals with some specialist services available. Townships have hospital sizes according to their size with rural areas having station hospitals. Patients are referred up the healthcare system when necessary. The Myanmar health system also offers traditional herbal medicine along with modern day medical practices. There are 14 traditional medicine hospitals operated by the Myanmar government. In the last decade, multiple insurance plans have started to be offered in the private sector. There are also private hospitals and clinics available for those who can afford them. The private facilities are of a higher quality and better equipped than their public counterparts. Many NGOs provide healthcare in Myanmar, especially in regions that are underserved.
In 2017, the reformed government spent 5.2% of GDP on healthcare expenditures which is up from 1% in 2010. Health indicators have begun to improve as spending continues to increase. Patients continue to pay the majority of healthcare costs out-of-pocket. Although, out-of-pocket costs were reduced from 85% to 62% from 2014 to 2015. They continue to drop annually. In Myanmar, health insurance was only provided for government employees by the government and for employees of international organizations by private health insurance. In 2015, they began to offer other insurance plans. The Myanmar Insurance and 11 private domestic companies offer identical policies. Customers are able to buy between one to five units of coverage, one unit costs around 50 USD, with a single unit providing the most basic level of coverage. Citizens and foreigners aged 6 to 65 years who are in good health can buy the insurance. Insurers will pay approximately 15 USD per day of hospitalization per unit. A policy holder may receive 30 days worth of hospitalization costs per year. If a policy holder dies in hospital, their designated beneficiary will receive around 1,000 USD per unit of insurance in compensation.
While Myanmar is making great strides to improve their healthcare system, there are still many issues. The quality in public facilities is extremely poor. There is a shortage of quality doctors and healthcare workers. Many regions with unrest have little to no access to care. Those who can afford to travel out of the country for more serious health issues. Myanmar has not yet reached the Millenium Development Goals and is unlikely to reach the global universal health coverage goal of 2030. There is a large disparity of care between the urban centers and the large rural population. As well as between ethnic groups. There is still higher than average maternal, infant and child mortality rates and lower than average life expectancy, with some ethnic groups worse than others. Malaria, HIV/AIDS, TB and measles remain a cause for concern. Although, immunization rates among children has increased. Despite all the issues with the healthcare system in Myanmar, it has made more improvements in the last decade than it did in the 50 years before that. Myanmar hopes to continue that trend.