Publication:
Myanmar Health Financing System Assessment

Loading...
Thumbnail Image
Files in English
English PDF (2.51 MB)
1,829 downloads
English Text (222.03 KB)
62 downloads
Date
2018-10
ISSN
Published
2018-10
Editor(s)
Abstract
Myanmar’s National Health Plan (NHP) for 2017-2021 has laid out the vision of achieving Universal Health Coverage (UHC) by 2030. The NHP aims to improve the delivery of health services and financial protection for Myanmar people through substantial investments in frontline service delivery units and through a range of reforms in the health system, including on health financing. This report assesses Myanmar’s health financing system. The analysis is structured around three main sets of questions: (i) Who pays for health in Myanmar? Given that the government needs to invest more in the health sector, where could (or should) the money come from; (ii) Are prepaid and pooled funds for health sufficient and equitable? What additional pooling arrangements could Myanmar consider; and (iii) What key steps and reforms are needed for Myanmar to develop the capabilities of a strategic purchaser in the medium term? This Health Financing System Assessment aims to inform health financing policy choices that the Government of Myanmar will need to make as part of the development and implementation of its Health Financing Strategy.
Link to Data Set
Citation
Teo, Hui Sin; Cain, Jewelwayne Salcedo. 2018. Myanmar Health Financing System Assessment. Health, Nutrition and Population Discussion Paper;. © World Bank. http://hdl.handle.net/10986/31007 License: CC BY 3.0 IGO.
Associated URLs
Associated content
Report Series
Other publications in this report series
Journal
Journal Volume
Journal Issue

Related items

Showing items related by metadata.

  • Publication
    The Future of Health Financing in Vietnam
    (World Bank, Washington, DC, 2019-06) Teo, Hui Sin; Bales, Sarah; Bredenkamp, Caryn; Cain, Jewelwayne Salcedo
    Vietnam is changing rapidly economically, with parallel shifts in epidemiology and demographics. There have also been significant policy shifts in recent years, including in the health sector. The combined effects of these transitions pose some risks to the sustainability of essential public health services, and will continue to put upward pressure on health spending. This report analyzes how Vietnam can maintain a sufficient level of public spending on health to sustain and further good health outcomes and respond to new health challenges.
  • Publication
    Intertemporal Dynamics of Public Financing for Universal Health Coverage
    (World Bank, Washington, DC, 2018-12) Tandon, Ajay; Cain, Jewelwayne; Kurowski, Christoph; Postolovska, Iryna
    As countries undergo their health financing transitions, moving away from external and out-of-pocket (OOP) financing toward domestically sourced public financing, the issue of fiscal space – that is, of finding ways to increase public financing in an efficient, equitable, and sustainable manner -- is front and center in the policy dialogue around universal health coverage (UHC). Although how money is expended is just as critical as the overall resource envelope, we analyze changes in per capita public financing for health in real terms, a proxy for realized fiscal space, within and across 151 countries over time. This allows for an assessment not just of trends in public financing for health but also of contributions from three macro-fiscal drivers -- economic growth, changes in aggregate public spending, and reprioritization for health -- exploiting a macroeconomic identity that captures the relationship between these factors. Analysis of data from 2000 to 2015 shows per capita public financing for health in low- and middle-income countries increased by 5.0 percent per year on average: up from US$60 (2.2 percent of GDP) in 2000 to US$117 (2.8 percent of gross domestic product [GDP]) in 2015. Some of the largest increases were in countries in the Europe and Central Asia (ECA) and East Asia and Pacific (EAP) regions. At 3.1 percent per year, annual growth in public financing for health was lower among high-income countries, albeit from a much higher baseline in 2000. Increases in on-budget external financing comprised most of the changes among low-income countries, whereas domestic government revenues dominated changes in composition of public financing among lower- and upper-middle-income countries. Public financing increased at a faster rate than OOP sources for health in most regions except for South Asia. Although there are important country-specific differences, it is notable that more than half of the increase in public financing for health was due to economic growth alone. For the remainder of the increase, aggregate public spending contributed more than reprioritization across low and lower-middle-income countries, whereas the reverse was true in high-income countries. One key point of note from the landscaping exercise summarized in the paper is the diversity of growth trajectories across countries and, especially, the volatility in trends over time. The implications are clear: capturing public financing with a single growth rate is not the best metric to characterize country experiences, many of which are punctuated by episodes wherein trends are flat or have varying degrees of growth rates (positive or negative). Although country context matters, the importance of economic growth for public financing for health underscores the critical need to situate, integrate, leverage, and proactively manage health financing reforms within a country’s overall macro-fiscal context and to assess different pillars of fiscal space holistically.
  • Publication
    Government Health Spending Outlook - Projections Through 2029
    (Washington, DC: World Bank, 2024-11-08) Kurowski, Christoph; Schmidt, Martin; Evans, David B.; Tandon, Ajay; Eozenou, Patrick Hoang-Vu; Cain, Jewelwayne Salcedo; Pambudi, Eko Setyo
    This paper examines the implications of the IMF’s April 2024 macro-fiscal forecast updates on government health expenditure (GHE) across 170 economies through 2029, covering nearly all years remaining to achieve the Sustainable Development Goals (SDGs). The findings reveal wide disparities in governments' capacities to increase health spending, with differences not only observed across income groups but also within them. Primary concerns focus to two groups of low- and lower middle-income countries: the first group is projected to experience a contraction in real per capita GHE from 2019 and 2029, threatening to reverse progress toward the health SDG targets, while the other group faces stagnation in real per capita GHE, greatly limiting advancement. The insights presented are crucial for health policymakers and their external partners to respond to evolving macro-fiscal circumstances and stabilize investment growth in health. While increasing the priority of health in spending is a key policy option, it will not be sufficient on its own. Effective responses also require improving spending efficiency and addressing broader fiscal challenges. Without decisive action, many countries have little chance of achieving the health SDGs. 
  • Publication
    From Double Shock to Double Recovery
    (World Bank, Washington, DC, 2021-03) Kurowski, Christoph; Evans, David B; Tandon, Ajay; Eozenou, Patrick Hoang-Vu; Schmidt, Martin; Irwin, Alec; Salcedo Cain, Jewelwayne; Pambudi, Eko Setyo; Postolovska, Iryna
    “From Double Shock to Double Recovery (DSDR) – Implications and Options for Health Financing in the Time of COVID-19,” a discussion paper published in March 2021. The original paper used macroeconomic projections released by the International Monetary Fund in October 2020 to project the possible time path of health spending per capita in 178 countries and territories from 2020 to 2025 under different scenarios. They suggested that few countries had been spared by the global recession of 2020 and that in many countries, government spending, after initial increases in response to the crisis, was likely to fall in at least one, often multiple years. The paper showed that despite a projected return to global economic growth from 2021, low- and lower-middle-income countries (LICs and LMICs) would, with few exceptions, struggle to maintain health spending at levels sufficient to continue combating the pandemic. The paper discussed a range of policy options that countries could use to increase the available domestic resources for health in times of economic crisis. DSDR first technical update, “From Double Shock to Double Recovery – Widening Rifts,” published in September 2021, updated the analysis presented in the original discussion paper. This edition explored the implications of the new IMF projections for governments’ capacities to spend on health. It identified a group of 52 countries of special concern. It found that to change this dynamic, governments in these countries would need to take bold steps to substantially increase the share of their available resources allocated to health. The paper also showed that many LICs and LMICs would struggle to find the domestic resources to roll out COVID-19 vaccines to their populations and to strengthen pandemic preparedness and response, putting the economic recovery at risk. DSDR second technical update, “From Double Shock to Double Recovery – Old Scars, New Wounds,” published in September 2022, describes the new IMF macroeconomic projections. It explores the extent to which the need to pay interest on debt might reduce governments’ capacity to spend; and the implications for country health spending.
  • Publication
    Revealing the Missing Link
    (World Bank, Washington, DC, 2017-06-21) Yap, Wei Aun; Pambudi, Eko Setyo; Marzoeki, Puti; Salcedo Cain, Jewelwayne; Tandon, Ajay
    Every six hours, the death of a woman from the complications of pregnancy serves as the most vexing reminder of Indonesia’s challenges with maternal health (MH). This is incommensurate with Indonesia’s strong economic development and stature compared with regional peers, especially as MH is a marker of overall health system performance and affects economic opportunities especially for the poor. The maternal mortality ratio (MMR) is high and progress on improving MH outcomes has been slow, such that the MH Millennium Development Goal (MDG) has already been missed. This policy paper analyzes new data on the ‘missing link’ of primary MH service provision, i.e., private providers, which is critical given that 54 percent of all deliveries in Indonesia occurred in the private sector, compared with 22 percent in the public sector, although overall rates of institutional deliveries remain below target. Key findings from the analysis elucidate the potential value of the private sector in expanding access to MH services covered by the financial purchasing and strategic purchasing umbrella of JKN, the effectiveness of these private MH services, and patient satisfaction. The remainder of the policy paper is structured as follows: The next section provides some background on Indonesia, including general health-related outcomes and an overview of the country’s health system and financing. Section III focuses on MH outcomes and context, including comparisons with global peers, and provides an overview of provision, utilization, and financing of MH services in the country, underscoring the importance of private providers. Section IV summarizes the distributional context and service readiness of private MH providers across the 64 high-priority districts, including a comparison with public providers for context. Section V concludes with a summary of key findings and their policy implications.

Users also downloaded

Showing related downloaded files

  • Publication
    Global Economic Prospects, June 2023
    (Washington, DC: World Bank, 2023-06-06) World Bank
    Global growth is projected to slow significantly in the second half of this year, with weakness continuing in 2024. Inflation pressures persist, and tight monetary policy is expected to weigh substantially on activity. The possibility of more widespread bank turmoil and tighter monetary policy could result in even weaker global growth. Rising borrowing costs in advanced economies could lead to financial dislocations in the more vulnerable emerging market and developing economies (EMDEs). In low-income countries, in particular, fiscal positions are increasingly precarious. Comprehensive policy action is needed at the global and national levels to foster macroeconomic and financial stability. Among many EMDEs, and especially in low-income countries, bolstering fiscal sustainability will require generating higher revenues, making spending more efficient, and improving debt management practices. Continued international cooperation is also necessary to tackle climate change, support populations affected by crises and hunger, and provide debt relief where needed. In the longer term, reversing a projected decline in EMDE potential growth will require reforms to bolster physical and human capital and labor-supply growth.
  • Publication
    Classroom Assessment to Support Foundational Literacy
    (Washington, DC: World Bank, 2025-03-21) Luna-Bazaldua, Diego; Levin, Victoria; Liberman, Julia; Gala, Priyal Mukesh
    This document focuses primarily on how classroom assessment activities can measure students’ literacy skills as they progress along a learning trajectory towards reading fluently and with comprehension by the end of primary school grades. The document addresses considerations regarding the design and implementation of early grade reading classroom assessment, provides examples of assessment activities from a variety of countries and contexts, and discusses the importance of incorporating classroom assessment practices into teacher training and professional development opportunities for teachers. The structure of the document is as follows. The first section presents definitions and addresses basic questions on classroom assessment. Section 2 covers the intersection between assessment and early grade reading by discussing how learning assessment can measure early grade reading skills following the reading learning trajectory. Section 3 compares some of the most common early grade literacy assessment tools with respect to the early grade reading skills and developmental phases. Section 4 of the document addresses teacher training considerations in developing, scoring, and using early grade reading assessment. Additional issues in assessing reading skills in the classroom and using assessment results to improve teaching and learning are reviewed in section 5. Throughout the document, country cases are presented to demonstrate how assessment activities can be implemented in the classroom in different contexts.
  • Publication
    Commodity Markets Outlook, October 2023
    (Washington, DC: World Bank, 2023-10-30) World Bank
    The conflict in the Middle East—the latest of an extraordinary series of shocks in recent years—has heightened geopolitical risks for commodity markets, in an already uncertain global environment. Before the conflict began, voluntary oil supply withdrawals by OPEC+ producers pushed energy prices up 9 percent in the third quarter. As a result, the World Bank’s commodity price index rose 5 percent over that period and is now 45 percent above its 2015-19 average. For now, the war’s impact on commodity prices have been muted. Prices of oil and gold have risen moderately, but most other commodity prices have remained relatively stable. Nevertheless, history suggests that an escalation of the conflict represents a major risk that could lead to surging prices of oil and other commodities. A Special Focus section provides a preliminary assessment of the potential impact of the conflict on commodity prices. It finds that the effects of the conflict are likely to be limited, assuming the conflict does not widen. Under that assumption, the baseline forecast calls for commodity prices to decline slightly over the next two years. If the conflict does escalate, the assessment also includes what might happen under three risk scenarios, relying upon historical precedents to estimate the effects of small, moderate, and large disruptions to the global oil supply. The magnitude of the effects will depend on the duration and scale of the supply disruptions.
  • Publication
    Global Economic Prospects, June 2024
    (Washington, DC: World Bank, 2024-06-11) World Bank
    After several years of negative shocks, global growth is expected to hold steady in 2024 and then edge up in the next couple of years, in part aided by cautious monetary policy easing as inflation gradually declines. However, economic prospects are envisaged to remain tepid, especially in the most vulnerable countries. Risks to the outlook, while more balanced, are still tilted to the downside, including the possibility of escalating geopolitical tensions, further trade fragmentation, and higher-for-longer interest rates. Natural disasters related to climate change could also hinder activity. Subdued growth prospects across many emerging market and developing economies and continued risks underscore the need for decisive policy action at the global and national levels. Global Economic Prospects is a World Bank Group Flagship Report that examines global economic developments and prospects, with a special focus on emerging market and developing economies, on a semiannual basis (in January and June). Each edition includes analytical pieces on topical policy challenges faced by these economies.
  • Publication
    G20 Policy Recommendations for Advancing Financial Inclusion and Productivity Gains through Digital Public Infrastructure
    (Washington, DC, 2023-10-03) World Bank
    This report was developed by the Global Partnership for Financial Inclusion (GPFI) under the G20 India Presidency. Powered by digital financial services (DFS), there has been progress globally on financial inclusion, but several challenges remain. In the rapidly evolving DFS landscape and against the backdrop of widespread digital transformation across sectors, digital public infrastructure (DPI) has the potential to help countries leapfrog their digital transformation. DPI, generally understood as interoperable, open, and inclusive systems supported by technology to provide essential, society-wide, public, and private services, can play a critical role in accelerating this digital transformation in an inclusive way. DPIs can have a multiplier effect on the gains achievable through DFS by accelerating financial inclusion and closing the existing gaps. DPIs are similar to other digital and financial infrastructures but, depending on country context, can differ on account of DPIs being foundational and cross-cutting while also having an emphasis on serving key public policy objectives. DPIs can be combined to unlock even more innovation and extend further benefits to users and the market. The policy recommendations presented in this report are indicative, voluntary, and nonbinding and seek to complement the existing guidance. The policy recommendations are grouped around five key dimensions that collectively seek to ensure that DPIs adhere to a basic set of principles for achieving the following: (i) enabling and fostering the use of DPIs in accelerating financial inclusion; (ii) fostering well-designed DPIs and the enabling environment; (iii) implementing appropriate regulation, supervision, and oversight; (iv) ensuring sound and effective institutional and governance arrangements by DPIs; and (v) protecting customers and leaving no one behind.