What Works for Myanmar’s UHC Scheme
Myanmar has taken some important steps toward UHC. The National Health Plan (2017–2021) laid out a clear policy to expand access to a Basic Essential Package of Health Services and strengthen health system foundations such as workforce, infrastructure, and financing strategies. This plan reflects stakeholder engagement, including government, civil society (CSOs), and ethnic health organizations (EHOs), which helps make health policy more inclusive and responsive. Prioritizing primary health care (PHC) has also been recognized as essential because it focuses on prevention and early treatment, which are cost-effective and improve equity. Community-level approaches and partnerships with civil society have helped to engage local voices in planning and monitoring health services. These policy commitments and collaborative structures provide a foundation on which to build further progress.

What Needs to Be Done for Myanmar’s UHC Scheme
Despite these positive steps, Myanmar still faces major barriers on the path to UHC. Financial protection remains weak. Many people pay large out-of-pocket costs for care, risking poverty when they get sick. Reducing these financial barriers through stronger public financing, social protection mechanisms, and health insurance will be crucial. There are also deep inequities in access to services, with poorer and rural regions having much lower coverage of essential care compared with wealthier/urban areas. This is driven by shortages of trained health workers, limited infrastructure, Civil Disobidient Movement (CDM) after the military coup, and limited health facilities, which are the problems that need targeted investment and workforce planning. Strengthening health system capacity and security, especially in remote, underserved, and conflict affected areas, will be essential to provide equitable services across the country. Moreover, continued engagement with communities, civil society, EHOs, and local/international partners can support accountability, ensure services meet the country needs.

References
1. Nikoloski, Z., McGuire, A., & Mossialos, E. (2021). Evaluation of progress toward universal health coverage in Myanmar: A national and subnational analysis. PLoS Medicine, 18(10), e1003811. https://doi.org/10.1371/journal.pmed.1003811
2. Ministry of Health, Myanmar. (2021). Universal health coverage. Retrieved from https://moh.nugmyanmar.org/universal-health-coverage/
3. Universal health coverage in Myanmar: The way forward. (n.d.). Community Partners International. Retrieved from https://cpintl.org/type/impact-story/universal-health-coverage-in-myanmar-the-way-forward
4. Strengthening financial protection and advancing UHC in Myanmar. (2025, December 12). Myanmar Digital News. Retrieved from https://www.mdn.gov.mm/en/strengthening-financial-protection-and-advancing-uhc-myanmar

In Myanmar, National Health Plan (NHP) 2016 to 2021 set the goal that to extend access to a Basic Essential Package of Health Services ( EPHS) to entire population by 2020 while increasing financial protection. The strategy is extending the Basic EPHS to the entire population will require substantial investments by the Ministry of Health and Sports (MoHS) in supply-side readiness at Township level and below and in strengthening the health system at all levels. It will also require active engagements of health providers outside the public sector, including private-for-profit GP clinics, EHOs and NGOs. Services and interventions will need to meet the same minimum standards of care, irrespective of who provides them. But the pursuit of Universal Health Coverage (UHC) has been severely disrupted following the February 2021 coup, shifting from a structured national policy phase into a fragmented, crisis-driven environment.
As Current Strengths: What Working is
Localized Care: After the 2021 coup, formal health systems collapsed. Local resistance networks now provide primary care in many areas.
Ethnic Health Organizations (EHOs): These groups have long experience running parallel health systems and continue to fill gaps in service delivery.
New Partnerships: Former government staff and ethnic providers are working together to build more equitable healthcare models.
Humanitarian Outreach: Local and international health clusters reached over 4 million people by late 2024, improving access to care.
Major Weaknesses: Current Challenges are

System Fragmentation: The national health system is broken, and tools like DHIS2 are often unusable.
Violence in Health: Attacks on health facilities and staff are common. Air strikes on hospitals nearly doubled in 2024.
Worker Shortage: Many doctors and nurses have left their jobs or the country, creating a severe human resource crisis.
Declining Indicators: Routine immunization has dropped sharply, leaving over a million zero-dose children. Malaria cases rose by 700% in some regions.
Financial Hardship: Inflation pushed medicine prices up by 148%, forcing families into high out-of-pocket spending.

Action Plan: What Needs to be Done

Increase Funding: The 2025 health plan is mostly unfunded. Immediate money is needed to reach more people.
Support Community Leaders: Aid should go directly to community-based organizations and ethnic groups trusted by local people.
Protect the Workforce: International actors must push to stop arrests of healthcare workers so they can treat patients safely.
Restore Basic Services: Urgent catch-up vaccination campaigns and stronger supply chains for TB and HIV drugs are needed.
Help Vulnerable Groups: More support is required for IDPs and people with disabilities who lack rehabilitation or medical equipment.

Reference List;

Community Partners International. (2020). Synthesis report: Keeping universal health coverage in Myanmar on track..

Ghebreyesus, T. A. (2017, October 19). A great step forward for access to healthcare in Myanmar [Opinion]. Frontier Myanmar..

Jongdeepaisal, M. (2023). Prospects for primary care interventions to improve quality of care and strengthen linkages with community health workers in Thailand: A case study of Ubon Ratchathani and Chiang Rai [Presentation slides]. Mahidol Oxford Tropical Medicine Research Unit (MORU)..

Ministry of Health and Sports. (2016). Myanmar National Health Plan (2017-2021)..

Ministry of Health and Sports. (2018). Myanmar human resources for health strategy 2018-2021..

NLD Health Network. (2016b). NLD program of health reforms: A roadmap towards UHC in Myanmar (2016-2030)..

World Health Organization. (2015). Tracking universal health coverage: First global monitoring report..

World Health Organization. (2019). Primary health care on the road to universal health coverage: 2019 global monitoring report [Executive Summary].

Since 2021, Myanmar has scaled up its efforts to achieve UHC and adopted the National Health Plan (NHP) (2017-2021). The aim of the NHP is to extend access through the basic EPHS (Essential Package of Health Services) to the entire population while increasing financial protection.
One study found that there is a robust link between socioeconomic development and UHC at subnational level in Myanmar. There is a significant heterogeneity in UHC progress in Myanmar reflecting socioeconomic disparities across states and regions.
Myanmar’s UHC index is about 65.4 (out of 100), but progress varies across regions — for example: in large city like Yangon has ~71.7, whereas in Rakhine State ~54.5.

Myanmar’s UHC Efforts
Myanmar has taken important steps to advance UHC, particularly through policy reforms, PHC strengthening and strategic health planning.
-The National Health Plan (2017-2021)
-Implementation of EPHS
-Strengthening PHC and community based approach
-Strengthening the Health System – including strengthening in
 Health workforce capacity
 Essential health infrastruc¬ture
 Service delivery networks
 Health financing mechanisms
-Gradual expansion of financial protection schemes (eg. MCH voucher scheme)
-Multi-stakeholders service delivery (including NGO, EHO)

Weaknesses
-Underfunding (only 1% of GDP)
-High out-of-pocket spending (~76%)
-Shortage of workforce
-Insufficient infrastructure
-Fragmented public-private sectors
-Limited insurance scheme

What needs to be done
-Strengthen public-private partnerships (including NGO, CSO, EHO) to make sure balanced EPHS implementation
-multi sectoral collaboration
-forming robust and more coverage of insurance scheme
-investment for health workforce and infrastructure
-Strength data systems and governance
-Community participation for people-centered PHC

Achieving UHC in Myanmar require strong and sustained investment, public-private-EHO partnerships, and prioritization of primary health care and financial protection.

References:
https://www.mdn.gov.mm/en/strengthening-financial-protection-and-advancing-uhc-myanmar?utm_source=chatgpt.com
https://pmc.ncbi.nlm.nih.gov/articles/PMC8519424/?utm_source=chatgpt.com#sec016

Republic Act No. 11223, otherwise known as the Universal Health Care Act, was enacted in the Philippines in 2019. It has two general objectives: (1) to progressively realize universal health care in the country through a systemic approach and clear delineation of roles of key agencies and stakeholders towards better performance in the health system; and (2) to ensure that all Filipinos are guaranteed equitable access to quality and affordable health care goods and services, and protected against financial risk.

In 2024, the Department of Health (DOH) commissioned IDinsight Philippines, Inc. to design and conduct the first Universal Health care (UHC) survey to all 70 active UHC integration sites (UHC-IS). Respondents in the survey included 7,824 households, 1,135 Facility Heads (medical chiefs, directors, etc.), and 11,377 healthcare workers.

Below is a summary of the results, including recommendations:
What Works
– Increase in facility Konsulta accreditation (71.3% of facilities being accredited). Konsulta (Konsultasyong Sulit at Tama) refers to the comprehensive primary care benefit package offering free outpatient consultations, laboratory tests, and medicines for all Filipinos.
– Referral pathways and e-referrals are becoming established
– PhilHealth registrations are increasing (15.2% of patients report registering within the last year interviewed, up from under 6% in previous years)

What Needs Improvement
– Low awareness of UHC and Konsulta among Filipinos, especially on benefits. Of those aware of UHC, 30.4% cannot name any benefit.
– Usage of referral pathways and e-referrals among patients is lagging
– Lack of lab and radiological services (46.1%), and human resources (44.2%), especially in primary care facilities
– High catastrophic health expenditure and out-of-pocket expenses among private inpatients (45.9%, compare to 7.9% in public facilities)
– Almost half of all healthcare workers interviewed (48.3%) consider leaving their facility in the next 12 months, with most common plan after resigning is to emigrate to another country (48.2%)

Recommendations
– Health Promotion Bureau (HPB) should implement a revised UHC communications plan, using both 1) mass media for the public, and 2) targeted campaigns at the local-level through facilities and local governments
– PhilHealth should simplify policies, processes and systems involving the service delivery of the Konsulta package, and ensure timely capitation.
– Reestablish a Primary Care Technical Working Group to help delineate roles and responsibilities for Konsulta package implementation
– Establish clearer guidelines for patients/healthcare workers on conditions that should be seen by the Konsulta providers, and when and how referrals to specialist care should take place.
– Strengthen support for primary care facilities to improve availability of different services in the Konsulta package and evaluate if Memorandum of Agreement/Understanding with nearby facilities are actually working
– Expand package services and target increasing insurance coverage in private facilities
– The Health Human Resource Development Bureau (HHRDB) of the Department of Health should implement a Human Resource for Health (HRH) master plan to coordinate policies and interventions targeted towards healthcare workers, such as training, distribution, task shifting, etc.

References:
DOH Universal Health Care Survey. (n.d.). National Evaluation Portal. https://nep.depdev.gov.ph/storage/document/1761205159_DOH%20Universal%20Health%20Care%20Survey.pdf

Implementing Rules and Regulations of the Universal Health Care Act (Republic Act No. 11223). (n.d.). PhilHealth. https://www.philhealth.gov.ph/about_us/UHC-IRR_Signed.pdf

Myanmar’s political leadership has expressed a strong commitment to accelerating progress towards UHC through the National Health Plan (2017-2021) to extend access to a Basic Essential Package of Health Services (EPHS) to the entire population. The strategy includes geographical prioritization, service prioritization, planning at the township level, systems building, a supportive environment, and community engagement.

Strengths
The approaches towards the UHC worked at the following points:
• There is a clear policy commitment to UHC
• Strong focus on primary health care
• Inclusive and multisectoral design
• Systematic framework for strengthening health systems

Areas for improvement
• Increase the health financing
• Strengthening the health workforce
• Improve infrastructure and service readiness
• Strengthening governance, quality and accountability
• Improve coordination with partners and NGOs

Universal Health Coverage (UHC) in Myanmar
UHC means that all people have access to needed health services without suffering financial hardship. In Myanmar, efforts toward UHC have been ongoing, although progress has been challenging due to political instability, economic limitations and weaknesses in the health system.

Current Efforts Toward UHC
Myanmar introduced the National Health Plan (2017–2021) as a key step toward achieving UHC. The plan aimed to expand access to a basic Essential Package of Health Services (EPHS), especially at the township level. The government has worked to strengthen primary health care services, improve maternal and child health programs, expand immunization coverage and reduce the burden of communicable diseases such as malaria, tuberculosis and HIV/AIDS.
Myanmar has also collaborated with international organizations such as the World Health Organization to improve health financing and service delivery. Community health workers and midwives play an important role in providing basic services in rural and hard-to-reach areas.

What Is Working Well (Strengths)
Strong Primary Health Care Approach – Myanmar focuses on township-level health systems, which helps bring services closer to communities.
Immunization and Disease Control Programs – Expanded immunization programs have improved child health outcomes in many areas.
Community Health Workforce – Midwives and community health volunteers are essential in delivering maternal and child health services, especially in rural regions.
International Support – Technical and financial support from global partners has strengthened some health programs.

Weaknesses and Challenges
Limited Health Financing – Government spending on health remains relatively low, and many people still pay high out-of-pocket costs.
Urban–Rural Inequality – Rural and conflict-affected areas have limited access to quality services.
Shortage of Health Workers – There is an uneven distribution of doctors and nurses, especially in remote areas.
Political Instability – Recent political and economic challenges have disrupted health services and slowed UHC progress.
Weak Health Infrastructure – Some facilities lack essential medicines, equipment and adequate buildings.

What Needs to Be Done
To make UHC work effectively in Myanmar, several actions are needed:
Increase Government Health Spending to reduce out-of-pocket payments and financial hardship.
Strengthen Primary Health Care Services and ensure all townships can provide the Essential Package of Health Services.
Improve Health Workforce Distribution by providing incentives for staff to work in rural and conflict areas.
Enhance Health Financing Systems, such as developing social health insurance mechanisms.
Ensure Political Stability and Good Governance, which are crucial for rebuilding and sustaining health services.
Strengthen Partnerships with international organizations and local NGOs to maintain service delivery.

Conclusion
In conclusion, Myanmar has made efforts toward achieving Universal Health Coverage through national health planning and strengthening primary health care. However, financial constraints, workforce shortages, inequality, and political instability remain major challenges. With increased investment, stronger governance, and improved health system management, Myanmar can make further progress toward achieving UHC and ensuring equitable health services for all its people.

Reference
https://www.moh.gov.mm/wp-content/uploads/2025/11/NHP-2017-2021_ENG.pdf
https://www.mdn.gov.mm/en/strengthening-financial-protection-and-advancing-uhc-myanmar

1. The strengths

Thailand’s UHC is a well-known success because it covers the majority of the population, effectively ending medical bankruptcy to its people. The scheme has expanded to cover high-cost investigations and long-term treatments for NCDs, such as dialysis and cancer care. The latest 30-Baht Treatment Anywhere policy, launched in 2025, has further improved access by allowing patients to use their ID cards at any facility. Supporting all of this is a strong primary care infrastructure by a network of community health volunteers that are available in every sub-district in the country.

2. The weaknesses

The system currently faces a major financial crisis because the government’s per-head reimbursement rates have not kept pace with actual medical expenses. This has led to public hospitals losing billions, including subsidies for its health workers. On top of the financial strain, there is a severe maldistribution of the workforce. Health professionals are being drained toward the private sectors, attracted by better pay and working environments, which leaves the public sector struggling more with critical staff shortages and worsening service quality.

3. What needs to be done

To make the system sustainable, they must first fix the funding model by redistributing payments to match the actual spending of each hospital and balancing treatment costs with the national budget. The workforce drain must be addressed by limiting work hours to reduce burnout and introducing better salary structures, pension plans, or immediate welfare benefits during service. Providing more flexible hiring power to hospital directors could be essential, allowing them to hire support staff locally to meet their specific needs rather than being held back by rigid civil service regulations.

Myanmar’s journey toward UHC was primarily guided by the National Health Plan (NHP) 2017–2021. The goal was to extend access to a Basic Essential Package of Health Services (EPHS) to the entire population while increasing financial protection. While significant progress was made in prioritizing Primary Health Care (PHC) and engaging multi-stakeholder partnerships, the pursuit of UHC was severely disrupted by the February 2021 military coup, shifting the landscape from a structured national policy into a fragmented, crisis-driven environment.

What is Working Well
Localized Care and Community Networks: Local resistance networks and community-based organizations have stepped up to provide primary care in many areas where formal systems have failed.
Ethnic Health Organizations (EHOs): EHOs have decades of experience running parallel health systems in border and conflict areas. They continue to play a crucial role in filling massive service delivery gaps.
New Collaborative Partnerships: Former government healthcare staff (who joined the Civil Disobedience Movement) and ethnic providers are collaborating to build more equitable, decentralized healthcare models.
Community Health Workforce: Midwives and community health volunteers remain essential in delivering maternal and child health services, especially in rural and hard-to-reach regions.
Humanitarian Outreach: Local and international health clusters successfully reached over 4 million people by late 2024, improving access to life-saving care.

Major Weaknesses and Challenges
Violence Against Healthcare: Attacks on health facilities and staff are frequent, with airstrikes on hospitals nearly doubling in 2024.
Severe Workforce Shortages: A massive exodus of doctors and nurses—either leaving their jobs due to the coup or fleeing the country—has created a critical human resource crisis.
Financial Hardship: Government health spending is extremely low (around 1% of GDP). Consequently, out-of-pocket (OOP) spending is incredibly high (~76%). Combined with inflation that pushed medicine prices up by 148%, families face severe financial ruin when seeking care.
Declining Health Indicators: Routine immunizations have dropped sharply, resulting in over a million zero-dose children, and diseases like malaria have surged by up to 700% in some regions.
Deep Inequities: There is a stark divide between urban and rural/conflict-affected areas, which suffer from limited infrastructure and lack of essential medicines.

Action Plan
To get UHC back on track and ensure equitable health services for all people in Myanmar, several urgent actions are required:
Direct Funding to Trusted Local Actors: Because the 2025 health plan is largely unfunded, international aid and investments must be channeled directly to community-based organizations, civil society, and EHOs that are trusted by local populations.
Protect the Health Workforce: International actors must advocate strongly to stop the arrests of and violence against healthcare workers so they can treat patients safely.
Restore Basic Services and Supply Chains: Urgent catch-up vaccination campaigns are needed, along with the restoration of supply chains for essential medicines, including TB and HIV drugs.
Strengthen Financial Protection: There must be a concerted effort to develop social protection mechanisms and health insurance schemes to reduce the crippling out-of-pocket costs for patients.
Support Vulnerable Populations: Targeted support is urgently needed for Internally Displaced Persons (IDPs) and people with disabilities who currently lack access to rehabilitation and medical equipment.
Foster Public-Private-EHO Partnerships: Long-term success will require robust, multi-sectoral collaboration to ensure that the Essential Package of Health Services (EPHS) meets minimum standards of care, regardless of who provides it.

For population coverage
Myanmar has 14 State and Division, 5 Self-administered Zone, 330 townships in which 52 million of people are residing. Moreover, disparities in service availability, quality of care, and health outcomes exist across conflict-affected areas, and socioeconomic groups. Current conflict situation causes ongoing tensions and restricted movement of people and providers to cover the intended population. To give health services for those populations, the Ministry of Health cannot implement solely, so in collaboration with Ministry of Immigration and Population, they collect the data of vulnerable groups and demographic data to prepare the national health plan in align with UHC. It is important to combine with Ethnic Health Organizations (EHOs), INGO, NGOs, local CBO and CSO because not all areas are accessible by Ministry and to get standardized system is still challenging.
Need to do; conduct a situation analysis, review existing preparedness capacities, identify stakeholders, strengthen a framework for governance and institutional arrangements

For service coverage
There are 1134 public hospitals and 1796 rural health centers around the country. This only covers 12 % of rural population and only 23 % of doctors are working under government health system. So, many new infrastructures and human resources are required for service coverage under UHC. Even those are fulfilled, supply side readiness, Minimum Essential Health Package, provider and customer satisfaction and proper financial management for Universal Health Coverage are challenges to implement. Especially, retention of health workers remains a challenge, resulting in coverage gaps. So, Myanmar National Health Plan sets forth many service delivery reforms. It endorsed the Community based Health Worker (CBHW) Policy in November 2020 to formally incorporate CBHWs into Myanmar’s national health system. It intends to cover a wide range of interventions for reproductive, maternal, newborn, child, and adolescent health (RMNCAH), nutrition, communicable diseases and emergency conditions. The quality of care is till bottleneck of health service, only private sector can provide primary and ambulatory care, the level of pandemic preparedness is very low according to IHR standard.
Need to do; provide technical support for capacity building in national and regional institutions,

For financial coverage
The following UHC financial indicators, proportion of out-of-pocket expenditure, total health expenditure percentage, prepayment and risk pooling scheme, social assistance and social safety net program must be established. But Myanmar has focused only on Ministry’s budget not from risk sharing system. Total health spending per capita in 2014 was estimated to be US$20, about 2% of GDP (WHO Global Health Expenditure Database—GHED, 2017). Out-ofpocket (OOP) spending is the dominant source of health financing, comprising 51% of the total in 2014 (GHED, 2017). No comprehensive health insurance system; health coverage remains extremely low.
The established security system covers less than 2% of Myanmar’s population, and social health insurance spending amounted to just 1% of government health spending in 2014 (WHO GHED, 2017).
The EPHS (Essential Package of Health Services) were planned to introduce progressively in three phases over the next fifteen years (a basic package accessible to all by 2021, an intermediate package by 2025, and a comprehensive package by 2030). This package will also define cost-sharing ratios, providing clarity on expected costs and reducing uncertainty about out-of-pocket fees.
Need to do; develop a financing plan to address financing gaps

References
122045-BRI-Moving-Toward-UHC-series-PUBLIC-WorldBank-UHC-Myanmar-FINAL-Nov30.pdf
2020-12_cpi_synthesis_report_keeping_uhc_in_myanmar_on_track_web.pdf

UHC in Myanmar
Myanmar developed the National Health Plan (2017–2021) to guide the country toward UHC. The plan focused on:
Strengthening Primary Health Care (PHC)
Expanding basic health services
Working with civil society organizations (CSOs) and ethnic health organizations (EHOs)
Improving health services for poor and rural communities
Primary health care is a strong point because it focuses on prevention, maternal and child health, immunization, and early treatment. Community-based health workers also help reach remote and conflict-affected areas.
Initially, the NIMU (National Health Plan Implementation Monitoring Unit) had 2 more 5-year-plans expanding services and coverage population from 2021 to 2030 but military coup happened and the plan was halted.

However, many challenges remain at large.
High out-of-pocket payment: Many people still pay directly for treatment and medicines. This can push families into poverty.
Inequality between urban and rural areas: Cities have better hospitals and more doctors. Rural and conflict areas often lack staff, medicines, and facilities.
Health workforce shortage: After the 2021 political crisis and Civil Disobedience Movement (CDM), many health workers left public facilities. This weakened the already insufficient healthcare workforce.
Political instability and conflict: Ongoing conflict affects health service delivery, supply chains, and access in many areas.

To make UHC work in Myanmar:
Increase public health funding
Reduce out-of-pocket costs
Develop stronger health financing or insurance systems
Invest in training and retaining health workers
Strengthen primary health care in rural and conflict areas
Continue working with EHOs, CSOs, and communities