A reproductive health needs assessment in Myanmar

A Reproductive Health Needs Assessment in Myanmar
United Nations High Commission for Refugees (UNHCR)
UNHCR are currently active in the Northern Rakhine State in Myanmar, and as part of their
activities are working with MMCWA in the area of reproductive health. Their activities
include: training sessions; promotion of community-based contraceptive distribution
systems; and, health education projects to improve maternal health and address STD/HIV
issues.
International NGOs
A number of international non-governmental organizations have been working on
reproductive health issues in Myanmar. Family Planning International Assistance, Care,
Medicins du Monde, World Vision International, Population Services International, Marie
Stoppes International, Medicins Sans Frontiers, the Population Council and ICOMP have
been working very closely with local non-governmental organizations in awareness raising
campaigns, out-reach activities, development of IEC materials, research activities and in the
social marketing of condoms.
National NGOs
There are a number of national non-governmental organizations working in the field of
reproductive health in Myanmar. The most active is the Myanmar Maternal and Child
Welfare Association which works through its country-wide network to disseminate
information on the prevention of HIV/AIDS, provision of maternity homes, and the provision
of some child care and birth spacing to the village level. The Myanmar Medical Association
works primarily with the private sector, and plays an active role in a number of United
Nations sponsored reproductive health projects, particularly in the area of HIV/AIDS. Some
township level Red Cross groups have been involved in UNICEF’s HIV/AIDS projects, and
blood donation programmes.
Health sector expenditure and financing
It is difficult to analyse the financing of the health sector in Myanmar as no careful study of
expenditure on health services has been carried out. Two major observations can be made,
however. First a large proportion of health expenditure is in the private sector. A consumer
expenditure study, estimated that 2 to 3 per cent of total household expenditure was on
health. In 1994 to 1995, the government budget on health totalled approximately 2,000
million kyats, which has been estimated to be about 0.5 per cent of GDP (UNICEF 1998b).
Thus the total health sector expenditure could be estimated to be approximately 3 per cent of
GDP. However, in the “Health for All” strategy, the health expenditure is targeted to have a
5 per cent share of GDP by the year 2000 (Ministry of health 1996).
Second, it appears that the public health sector is significantly under financed. The World
Bank (1993) has estimated that low income countries would need to spend US$8 per person
per year on an essential clinical services package and US$4 per person per year on public
health, resulting in a total cost of US$12 per person per year. In 1995, the per capita income
in Myanmar was estimated to be approximately US$300 (UNDP 1995). If we use the figure
above (i.e. 3 per cent of GDP for health sector expenditure), then we can estimate that
approximately US$9 per person per year is spent on all health care. Even if this was all spent
on public health and essential clinical services, it would still represent only 75% of the World
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