Evaluation of progress toward universal health coverage in Myanmar: A national and subnational analysis

Universal health coverage (UHC) encompasses 2 main components: access to essential healthcare services and protection from financial hardship when using healthcare. This study examines Myanmar's efforts to achieve UHC on a national and subnational level. It is a primer of studying the concept o...

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Bibliographic Details
Published in:PLoS medicine Vol. 18; no. 10; p. e1003811
Main Authors: Nikoloski, Zlatko, McGuire, Alistair, Mossialos, Elias
Format: Journal Article
Language:English
Published: United States Public Library of Science 15.10.2021
Public Library of Science (PLoS)
Subjects:
Cervical cancer
Confidence Intervals
Economic reform
Evaluation
GDP
Gross Domestic Product
Health aspects
Health care
Health care expenditures
Health care industry
Health care policy
Health Expenditures
Health facilities
Humans
Medical screening
Medicine and Health Sciences
Myanmar
National health insurance
People and Places
Poor
Population
Poverty
Poverty - economics
Purchasing power parity
Quality management
Regions
Social Sciences
Socialized medicine
Universal Health Insurance - economics
Myanmar
East Asia
Southeast Asia
Vietnam
Myanmar (Burma)
ISSN:1549-1676, 1549-1277, 1549-1676
Online Access:Get full text
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Summary:Universal health coverage (UHC) encompasses 2 main components: access to essential healthcare services and protection from financial hardship when using healthcare. This study examines Myanmar's efforts to achieve UHC on a national and subnational level. It is a primer of studying the concept of UHC on a subnational level, and it also establishes a baseline for assessing future progress toward reaching UHC in Myanmar. The study uses the Demographic and Health Survey (2015) and the Myanmar Living Conditions Survey (MLCS; 2017) and adapts a previously developed UHC index to provide insights into the main barriers preventing the country's progress toward UHC. We find a negative correlation between the UHC index and the state/region poverty levels. The equity of access analysis reveals significant pro-rich inequity in access to all essential healthcare services. Socioeconomic status and limited availability of healthcare infrastructure are the main driving forces behind the unequal access to interventions that are crucial to achieving UHC by 2030. Finally, financial risk protection analysis shows that the poor are less likely to use healthcare services, and, once they do, they are at a greater risk of suffering financial catastrophe. Limitations of this study revolve around its correlational, rather than causal, nature. We suggest a 2-pronged approach to help Myanmar achieve UHC: Government and state authorities should reduce the financial burden of seeking healthcare, and, coupled with this, significant investment in and expansion of health infrastructure and the health workforce should be made, particularly in the poorer and more remote states.
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The authors have declared that no competing interests exist.
ISSN:1549-1676
1549-1277
1549-1676
DOI:10.1371/journal.pmed.1003811