Policy Note #4: Myanmar Health Systems in Transition Policy Notes Series
Protecting people from financial hardship when they fall ill is one of the two key elements of universal health coverage (UHC). In practice, this means that the majority of health care costs have to be met from government ...revenues so that services are provided free or with a small affordable co-payment. The alternative is to rely on pre-payment through some form of insurance, where risks are pooled across all contributors.
The challenge in Myanmar is that at present neither approach is functioning. Government spending is too low to meet people’s health needs and the proportion of the population covered by insurance is negligible. As a result, families face a stark choice in the event of serious illness: either defer treatment and face the consequences, or incur what can amount to catastrophic expenses and a downward spiral of disinvestment and poverty.
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Policy Note #3: Myanmar Health Systems in Transition Policy Notes Series
A network of basic health facilities has been established in each of the 330 townships, covering both rural and urban areas. For the vast majority of Myanmar’s people, particularly the 70% who reside in rural areas, the ...township health system (THS) is the only government-funded source of preventive, promotive and curative services.
To achieve the national policy objective of progressing towards universal health coverage (UHC) through a primary health-care approach by 2030, the THS is critical to success. It is responsible for the bulk of health care delivery – particularly in rural areas – and is at the heart of national health development in Myanmar. However, if the THS is to be the backbone of health care provision, it currently suffers from a severe case of osteoporosis.
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Operational Updates
Emergency Relief & Nutrition Rakhine: A significant increase in internal displacements due to continued armed conflict between the Myanmar military (Tatmadaw) and Arakan Army was reported in northern and central Rakhine State increasing from 6,000 people in February to 20,000 i...n March. WFP delivered a one-month ration of food to 2,220 newly displaced people in central Rakhine State, with plans to extend support to additional displaced populations based on coordination with other actors meeting current needs, including the Government and ICRC. WFP continued providing emergency relief assistance to 96,050 conflict-affected people from 173 Muslim, Buddhist and Hindu villages in Buthidaung and Maungdaw townships of northern Rakhine State. In addition, WFP reached over 16,300 children under 5 years through nutrition interventions. In central Rakhine, 4,740 pregnant and lactating women (PLWs) and 24,160 children under 5 years were reached with nutrition interventions, and over 128,040 food-insecure people received relief assistance.
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Myanmar has made significant progress in its disaster management policies, plans, and procedures since 2008, when Cyclone Nargis impacted the country leaving devastation in its aftermath. The Government of Myanmar (GoM) has modified the government structure and created new authorities and plans to i...mprove the effectiveness of disaster management at all levels. While this progress is encouraging and shows the determination of the government to make necessary adjustments, the resources to implement the policy changes have been slower to develop. Myanmar has made significant progress in its disaster management policies, plans, and procedures since 2008, when Cyclone Nargis impacted the country leaving devastation in its aftermath. The Government of Myanmar (GoM) has modified the government structure and created new authorities and plans to improve the effectiveness of disaster management at all levels. While this progress is encouraging and shows the determination of the government to make necessary adjustments, the resources to implement the policy changes have been slower to develop.
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It aims to minimize damage to property, reduce injury and lives lost, and normalize the lives of those affected in a timely manner in the case of a damaging earthquake in the country.
It also seeks to contribute to the achievements of Myanmar Sustainable Development Goals as well as respond to Gl...obal and Regional Frameworks which Myanmar has endorsed.
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The purpose of this Strategy is to set out the way to meet the needs of the rural populations for improved domestic water supply services, access to and use of improved sanitation with elimination of open defecation, and improved hygiene behaviour by the Year 2030. It also addresses water, sanitatio...n and hygiene in schools up to high school level and health facilities up to township hospital level. The Strategy is supported by Investment Plans covering a financing period 2015 to 2030 in order to ensure sufficient funding for development and operation of services in accordance with the Strategy.
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The changes occurring in Myanmar highlight the need to have a robust DRR network that can support the Government as well as the communities in their efforts to build a resilient Myanmar. To this end, the DRR WG devised and facilitated a multi-stakeholder process aiming to develop its Strategic Frame...work 2013-2018. This document is the outcome of a series of internal workshops and external consultations, in particular with the relevant departments of the Government of Myanmar. This Strategic Framework will guide the collective efforts of the DRR WG over the next five years.
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March - December 2018
The Government of Bangladesh has kept its borders open to Rohingya refugees and leads the humanitarian response. The people of Bangladesh continue to show tremendous generosity and hospitality in the face of a massive influx. In keeping with its policies, the Government of Ban...gladesh refers to the Rohingya as “Forcibly Displaced Myanmar Nationals”, in the present context. The UN system refers to this population as refugees, in line with the applicable international framework for protection and solutions, and the resulting accountabilities for the country of origin and asylum as well as the international community as a whole. In support of these efforts, the humanitarian community has rapidly scaled up its operations as well. Over a two-month period, the refugee population in Cox’s Bazar more than quadrupled.
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JOINT RESPONSE PLAN (JRP)
The Strategic Executive Group has developed a Joint Response Plan (JRP) for 2019 regarding the displaced people from Myanmar and who are affected specially by this influx The JRP has included different issues in terms of measuring people who are in need, of support interve...ntions and assistance, types of aid, a emphasizing on a coordinated approach among all NGOs and concerned government sectors pointing the below topics:
• Overview of the crisis and needs
• Protection framework for humanitarian response
• Response strategy of 2019
• Coordination and monitoring
• The new way of working
• Cross-cutting issues
• People targeted by sector
Through developing this Plan, the SEG attempted to depicting shared understanding of the crisis, including the most pressing humanitarian needs. It represents a consolidated evidence-base and will helps this joint strategic response plan who are working at the same ground.
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Recommendations and Summary
This report explores the impact of COVID-19 on humanitarian access in the initial months of the crisis, including both the delivery of assistance and performance of protection activities. It examines the varying crisis responses, including the shift to a more localized a...pproach in certain cases. The analysis draws on case research from Colombia, Myanmar, Nigeria, South Sudan and Yemen, as well as on wide-ranging interviews with humanitarian practitioners and experts from around the world. The research was conducted between August – November 2020. It does not make claims about the legitimacy of government decisions to restrict access – indeed, in many instances, there appeared to be a clear objective of limiting the spread of COVID-19 – but instead focuses on how access limitations have affected the delivery of aid.
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The purpose of this document is to provide a comprehensive overview of existing institutional arrangement for disaster management in Myanmar at all levels with an aim to make information available to all stakeholders involved in disaster risk management in Myanmar.
Joint data assessment by the Central Statistical Organization and UNDP
The report shows that the National Statistical System of Myanmar has some work ahead of it in terms of preparing for the monitoring of the SDG indicators. Only 44 of the SDG indicators are currently produced and readily avai...lable at the national level. However, the good news is that many (97) of the missing indicators can be computed from existing data sources – often with little effort - and don’t require any additional data collection. The report concludes that Myanmar is in a decent position to start monitoring the SDGs, and should start as soon as possible in putting its existing data to full use for the SDGs.
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Census Report Volume 4-F (Thematic report on Population Projections for the Union of Myanmar, States/Regions, Rural and Urban Areas, 2014-2050)
Key findings
- The total population of Myanmar is estimated to be 65 million by 2050. The projection is based on steadily declining population grow...th rate over the projection period: from 0.9 per cent in 2015 to 0.3 per cent in 2050.
- The proportion of the urban population rises from 29.3 per cent in 2015 to 34.7 in 2050. The rural and urban crude birth rates both decline between 2015 and 2050, but the difference between them narrows to almost zero by the end of the period.
- The population of Yangon grows more rapidly than any other area, by 39 per cent between 2015 and 2031. Other rapidly growing areas include Kayah (37 per cent), Kachin (32 per cent), Nay Pyi Taw (27 per cent), and Shan (26 per cent). Ayeyawady, Magway and Mon lose population, mostly due to migration.
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Based on the Vulnerability Index developed in this review, an estimated 22.7 million persons in Myanmar, or 44% of the population, were found to have some form of vulnerability related to human development and/or exposure to active conflict/violence. These people experience varying combinations of p...oor housing, lack of education, poor educational attainment, lack of access to safe sanitation and improved drinking water, and direct exposure to conflict.
Shan and Ayeyarwady have the largest populations of vulnerable persons, a function of both their size and relative vulnerability in comparison to other States and Regions. Yangon and Shan show the widest variation in vulnerability across townships (in terms of the number of vulnerable persons and their level of vulnerability), followed by Mandalay, Chin and Rakhine.
Original file: 15 MB
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Technical Assistance Report
The study collected data on the impact of HIV-related diseases on income, revenues, economic dependency, consumption, education, health, food security, stigma, discrimination, quality of life, and migration. The study also assessed people living with chronic diseases in order to compare the impact o...f living with HIV/AIDS with the impact of living with a chronic disease.
Stigma, discrimination, and socio-economic exclusion continue to affect the rights and socio-economic opportunities of people living with HIV in Myanmar. Households with a family member who has HIV, have lower incomes, fewer assets and lower home-ownership, compared to households that are not affected by HIV. They also have more household debt, and their families pay a higher rate of interest compared to families not affected by HIV.
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The study analyses the current situation of children with disabilities in relation to realizing their rights and accessing basic services, as well as their life experiences in their communities. It also focuses on identifying the barriers created by society that prevent children with disabilities fr...om enjoying their human rights. This includes identifying negative attitudes; environmental and communication barriers; gaps in policies or their effective implementation.
The report reveals that children with disabilities in Myanmar are less likely to access services in health or education; rarely have their voices heard in society; and face daily discrimination as objects of pity. It also highlights how inadequate policies and legislation contribute to the challenges these children face.
The information available in this publication should be useful for policy makers, development partners and Disabled Persons Organisations to promote the realization of the rights of all children with disabilities.
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This study aims to analyze national and international stakeholders and their initiatives in Early Warning Systems in Myanmar, to identify priority gaps that need to be addressed by all stakeholders. It is presented as a first step towards supporting GoUM in information-gathering under the Myanmar Ac...tion Plan for Disaster Risk Reduction (MAPDRR), in particular under Components (2) Risk Assessment, (3) Multi-hazard Early Warning System and (4) Preparedness at all levels, and especially in implementing Sub-Component (3.4) Enhanced Flood Monitoring and Forecasting Capacities at Township Levels.
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Report on Main Findings
The review encompasses three complementary components: 1) a review of published literature 2000-2015 on NCDs and their risk factors; 2) qualitative interviews with key actors engaged in NCD research in Myanmar; and 3) additional reviews of Myanmar ethical committee inqui...ries and postgraduate research on NCDs in Myanmar. This report outlines the key findings from the three components including a synthesis of the key outcomes from the literature review and qualitative interviews, and an assessment of the gaps in the evidence against a framework of evidence needs.
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