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 #1: Myanmar Health Systems in Transition Policy Notes Series
The Government of the Republic of the Union of Myanmar is committed to achieving universal health coverage (UHC) by 2030. In practice, this means that over the next 15 years the aim is to progressively ensure that all peop...le in all parts of the country have access to the health-care services they need – both preventive and curative – without suffering financial hardship when paying for them.
This policy note is the first in a set of four. It provides an overview of the challenges to be overcome in making progress toward UHC and sets out recommendations for how they can be tackled. The other notes look in more detail at three specific issues: how UHC can improve equity, and how strengthening the township health system and expanding financial risk protection contribute to UHC.
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Bonchial asthma is the most common chronic respiratory disease in the world. In Kenya, it has been estimated that about 7.5% of the Kenyan population, nearly 4 million people, are currently living with asthma. Many cases tend to be underdiagnosed and undertreated which leads to high levels of morbid...ity and avoidable deaths. The consequences of poorly controlled asthma, including physical, mental, social, and economic impacts, are magnified in the poor on account of poor access to asthma services and sub-optimal quality of those services. With these guidelines, Kenya's Ministry of Health aims to work towards embedding asthma care in Universal Health Care (UHC) to ensure that quality asthma services are available in primary care settings with
referral networks strengthened for those who may require secondary and tertiary care. These national asthma guidelines will also ensure that treatment for asthma is standardized in both the public and the non-state health care sector.
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Annual and medium-term budget preparation processes are the platforms through which specific plans are transformed into actual resource allocation decisions. The aim of this Process Guide is to support key stakeholders involved in these processes (such as the Cabinet, Ministries of Finance and Healt...h, the Parliament, citizens, media, and civil society organizations) to reorient budgetary arrangements in order to facilitate the ability of national governments to respond to the COVID-19 pandemic by delivering, therapeutics, diagnostics, and vaccine services to their populations. Reorienting budgetary arrangements positions governments to sustain the capacity to mitigate and respond to COVID-19 while concurrently delivering other essential health services and working towards Universal Health Coverage (UHC). The reorientation process is an opportunity to better align budgetary arrangements to sustain systemic capacity to prevent emerging health threats over the short, medium, and long terms.
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The evaluation covers the period January 2020 to August 2023. The geographical scope of the evaluation has involved the three levels of WHO (global, regional and country levels) and external key partners. The programmatic evaluation scope was concerned with assessing the SP-PHC in the following area...s/evaluation criteria: relevance, coherence, effectiveness, efficiency, added value, sustainability and equity, gender and human rights considerations. The evaluation did not assess the Universal Health Coverage Partnership (UHC-P) as it has its own separate governing body and reviews/evaluations, but instead considered how the SP-PHC had enhanced the value of the UHC-P and vice versa. The resilience and essential public health functions (REPHF) team and Systems’ Governance and Stewardship (SGS) were also not within the scope of this evaluation. However, these workstreams were considered in the wider conclusions and recommendations for the SP-PHC, as appropriate. Finally, the evaluation was focused on the SP-PHC; its scope did not include assessing the configuration and capacity of WHO’s departments and functions as they relate to UHC and health systems.
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The 2021 Report examines country health spending patterns and trends over the past 20 years, before the COVID-19 pandemic, with greater focus on public spending on health. The report also presents spending on primary health care, preliminary health expenditure in 2020 for a small set of countries (i...ncluding their health spending on COVID-19) and an analysis of high-income countries spending patterns, in particular during the global financial crisis. The report also points out the need for more public investment in health to get progress towards UHC back on track and strong health security.
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This document presents the World Health Organization Operational framework for building climate resilient and low carbon health systems*. ***The framework's goal is to increase the climate resilience of health systems to protect and improve the health of communities in an unstable and changing clima...te, while optimizing the use of resources and implementing strategies to reduce GHG emissions. It aims to contribute to the design of transformative health systems that can provide safe and quality care in a changing climate.
Implementation of the framework's ten components would help health organizations, authorities, and programmes to be better able to anticipate, prevent, prepare for, and manage climate-related health risks and therefore decrease the burden of associated climate-sensitive health outcomes. Implementing low carbon health practices would contribute to climate change mitigation while also improving health outcomes. Achieving these aims is an important contribution to universal health coverage (UHC), global health security, and specific targets within the Sustainable Development Goals (SDGs). The document is a useful resource for decision-makers in health systems, including public health agencies, and other specialized institutions, and for decision-makers in health-determining sectors.
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This paper outlines the background to and design of the Health Financing Progress Matrix (HFPM), WHO’s standardized qualitative approach to assessing country health financing systems. Primarily qualitative in nature, the HFPM assesses a country’s health financing institutions, processes, policie...s and their implementation, benchmarked against good practice in the context of universal health coverage (UHC). The paper also details processes which ensure that country assessments are credible. While health financing is only one of the core functions of a health system, it significantly influences both the extent to which the population accesses health services, and the extent to which they face financial hardship in the process. Through a forward-looking assessment process the HFPM contributes to building resilience within health systems, which also contributes directly to improved emergency preparedness and response.
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This regional summary draws on the WHO Global oral health status report (2), published in 2022, which provides a comprehensive overview of the global oral disease burden, the global health importance of oral health and the impact of oral diseases over the life course.
The summary focuses on the ...oral health status in the Western Pacific Region and is split into four sections: (a) oral diseases are global and regional health problems; (b) the burden of the main oral diseases; (c) key challenges and opportunities towards oral health for all in the Western Pacific Region; and (d) road map towards UHC for oral health 2030. This regional summary is based on the 27 Member States in the Region.
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The World Health Organization's fourth Country Cooperation Strategy 2022-2026 is an outcome of a consultative process with inputs from the Ministry of Health, various agencies in the health sector, and other relevant stakeholders. It has been developed to provide strategic direction and support towa...rd achieving the priorities of the Government of the Kingdom of Eswatini.
It is designed to support the strengthening of health systems and services toward the attainment of Universal Health
Coverage (UHC) and the Sustainable Development Goals targets. The CCS 2022-2026 also presents the collaborative
agenda between the Kingdom of Eswatini and the three levels of WHO, aligns with the strategic priorities of WHO’s
13th General Programme of Work (2019 – 2025), as well as Eswatini’s United Nations Sustainable Development Cooperation Framework (UNSDCF) 2021-2025
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In this report, we present the findings from this study, discuss the issues as
understood through interactions with the Finance and Health Department Officials, and provide some short-, medium- and long-term recommendations that could help the Union Territory in its journey toward achieving UHC.
n 2015, Member States of the United Nations adopted the 2030 Agenda for Sustainable Development and its accompanying Sustainable Development Goals (SDGs), with the third goal of the agenda focusing on health – good health and well-being. This has the attainment of universal health coverage (UHC) a...s its umbrella target. Since then, the WHO Regional Office for Africa has been supporting countries plan, and monitor progress towards this goal. This report represents an analysis of the evidence so far countries are making towards this goal, and includes the effect COVID-19 has had on its attainment so far. It also makes recommendations on how countries can prioritize their health actions post COVID-19, in a manner that allows acceleration of progress towards UHC.
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A systematic analysis for the Global Burden of Disease Study 2019. The Lancet Vol.399 Issue 10341 p.2129-2154
Human resources for health (HRH) include a range of occupations that aim to promote or improve human health. The UN Sustainable Development Goals (SDGs) and the WHO Health Workforce 2030 s...trategy have drawn attention to the importance of HRH for achieving policy priorities such as universal health coverage (UHC). Although previous research has found substantial global disparities in HRH, the absence of comparable cross-national estimates of existing workforces has hindered efforts to quantify workforce requirements to meet health system goals. We aimed to use comparable and standardised data sources to estimate HRH densities globally, and to examine the relationship between a subset of HRH cadres and UHC effective coverage performance.
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This updated step by step guide aims to assist the ministries of health (MoHs) in developing the national action plans for noma prevention and control, with a view to sustainably reducing the incidence of noma as a public health problem through programmes that are fully integrated with national heal...th planning, strengthening of primary health care (PHC) and attainment of universal health coverage (UHC).
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Noma (cancrum oris) is a severe gangrenous disease of the mouth and face. It mostly affects children between the ages of 2 and 6 years living in extreme poverty. In addition to the known factors such as malnutrition, lack of vaccination in children and poor oral hygiene, several social and environme...ntal factors such as maternal malnutrition and close spacing of pregnancies that result in offspring with increasingly weakened immune systems are potentially related to the onset of the disease.
The aim of this guide is to assist the ministries of health (MoHs) to identify a general goal to be attained by the end of five years, with a view to sustainably reducing the incidence of noma as a public health problem through programmes that are fully integrated with national health planning, strengthening of primary health care (PHC) and attainment of UHC.
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Health sector reforms not only require attention to specific components but also a supportive environment. In low- and middle-income countries (LMICs), there is still much to be done on ensuring that people receive prioritized healthcare services. Despite LIMCs spending an average of 6% of their GDP... on health, there have been minimal impacts compared to high-income countries. Health sector reform is a gradual process with complex systems; hence, the need for a vision and long-term strategies to realize the desired goals. In this chapter, we present our proposal to advance universal health coverage (UHC) in LMICs. Overall, our main aim is to provide strategies for achieving actual UHC and not aspirational UHC in LMICs by strengthening health systems, improving health insurance coverage and financial protection, and reducing disparities in healthcare coverage especially on prioritized health problems, and enhancing a primary care-oriented healthcare system.
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22nd edition
The purpose of the SAHR has always been to analyse and assess progress and challenges in key areas of the health system, and to propose recommendations for improvement. We are pleased to continue this tradition in the 2019 edition, which presents a unique collection of perspectives on ...the key challenges in implementing universal health coverage (UHC) in South Africa, as analysed by experts in various fields.
Each of the 20 chapters deals with aspects of the UHC journey, dedicated towards an equitable and inclusive national health system that leaves no-one behind. While some authors describe the fundamental changes and practical considerations required to reconfigure the country's health system, others have reflected on specific programmatic areas and have made recommendations from a National Health Insurance (NHI)/UHC lens.
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One billion people around the world live with disabilities. This report makes the case that they are being “left behind” in the global community’s work on health. This lack of access not only violates the rights of people with disabilities under international law, but UHC and SDG 3 cannot be a...ttained without better health services for the one billion people with disabilities.
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Rwanda’s fourth health sector strategic plan (HSSP4) is meant to provide the health sector with a Strategic Plan that will highlight its commitments and priorities for the coming 6 years. It will be fully integrated in the overall economic development plan of the Government. HSSP4 will fulfill the... country’s commitment expressed in the national constitution, National Strategy for Transformation (NST) and the aspirations of the Health Sector Policy 2015. The strategies herein adhere to the Universal Health Coverage (UHC) principles towards realisation of the Sustainable Development Goals (SDGs). HSSP4 therefore lays a foundation for Vision 2050 (“The Rwanda We Want”), which will transform Rwanda into a high-income country by 2050. HSSP4 anticipates the epidemiological transition of the country, the increase in population and life expectancy and the expected increase of the health needs of the elderly, notably in Non Communicable Diseases (NCDs). HSSP4 also anticipates a decrease in external financial inflows, hence it is imperative to build secure / resilient health systems.
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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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