Universal health coverage (UHC) means that all people can access needed, quality health services without suffering from financial hardship as a result. UHC has three dimensions - population (who to cover), services (what to cover) and affordability (how to reduce direct cost). The direct cost refers to how much the patient has to pay themselves and is sometimes called out of pocket expenditure (OOPE).
You can find more information on the different dimensions of UHC and lessons learned from eleven countries that are in the process of reforming the health care system to provide universal health coverage to their people. This study of 22 countries on the path to UHC highlights the importance of a bottom-up approach. It provides knowledge and tools for countries working towards UHC to meet the challenges they face.
Why UHC?
Due to limited financial means and availability of services, many people, particularly the poor and marginalized, delay getting the care that they need. Evidence from Myanmar shows that there are many barriers to quality health services. For example, some families live in remote areas and face geographic challenges; others lack financial resources to pay for costs associated with seeking care.
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New centres improve access to health in hard-to-reach areas Accessing health services in rural and remote areas can be challenging, and as a result, people in these areas can experience lower health status than those people who live in cities. To help close this gap, 3MDG is financing the construction of 82 rural and sub-rural health centres across Myanmar under the leadership of the Ministry of Health and Sports. To find the best locations for the centres, factors including population coverage, availability of staff and supplies, accessibility, local needs and lack of existing services were considered. But just building the centres is not enough – it is critical that there is light, water, medicine and staff there when needed. 3MDG has helped to ensure this with solar panels, rainwater tanks, drug storage rooms and onsite staff accommodation. The Ministry of Health and Sports is working to ensure the centres, and others like them across the country, are manned at all times. Midwife Daw Rosy Tin, who works in a new centre in Magway, has delivered six healthy babies since the centre opened in February. “Before, I had to look after pregnant women in their own houses which can be unclean and cause infections. Now it’s better, and I am available for them 24 hours a day, as I live here as well,” she says. |
So how can UHC help?
UHC helps to protect people from poverty. Every year, almost one in five people are pushed further into poverty in low-income countries due to health-related costs. A recent study shows that health expenses are the second greatest cause of catastrophic expense (after natural disasters). Of households that reported to have visited a health facility (public or private) in the last 12 months, nearly one-third took loans and more than 15 percent sold assets to cover their medical expenses [Source: Myanmar Poverty and Living Conditions Survey 2014-15].
As part of the process to ensure that services are available, governments often provide substantial investments to improve infrastructure, deploy trained health workers in remote areas, and ensure medicines and commodities are available. These investments in health help to reduce some of the barriers and encourage families to seek care in a timely manner.
Countries that are implementing UHC, such as Thailand and China, are already seeing the benefits – improved economies, better health outcomes, and stronger communities.
The Government of Myanmar is committed to improving access to health by providing a package of essential health services (EPHS). This means Basic EPHS by 2020, Intermediate EPHS by 2025 and a Comprehensive EPHS by 2030. In addition, the Government is developing strategies to reduce catastrophic expenditure so that when someone gets sick, health services can be accessed without undue financial burden. Read more about the Essential Package of Health Services here.
What does UHC mean for Myanmar?
Myanmar is on the road to universal health coverage, with a commitment to provide families with access to a package of essential quality health services by 2030.
Guiding Myanmar’s path to UHC is the National Health Plan 2017-2021 for the next five years. Subsequent National Health Plans (2021-2026) and (2026-2031) will build on the current National Health Plan to reach the long-term goal of UHC. It is the result of an inclusive and collaborative process that sought to include all stakeholders. Providing a package of essential health services and improving access for all is the cornerstone of this plan.
Important first steps are already being taken. This includes strengthening the primary health care system; developing strategies to improve financing; and strengthening communities, who have an important role to play in ensuring health access. They can generate demand for services and hold services and finances accountable. To implement the NHP, annual operational plans will be developed including concrete steps needed to make universal health coverage a reality.
You can access the National Health Plan (Myanmar | English) or the Executive Summary of the Plan (Myanmar | English) or check out the Facebook page for more.