A reproductive health needs assessment in Myanmar

A Reproductive Health Needs Assessment in Myanmar
From this assessment and previous studies, it is known that it is necessary to provide services
that are accessible and provide non-judgmental care to young people. The model such
services should follow is less clear and requires further study.
Several pilot projects to test models for providing youth-friendly services should be
developed based on local needs assessments.
Costs and financing
Guidelines for cost sharing within public sector health services exist as a result of recent
policy decisions regarding health care financing. The team observed that the cost sharing
schemes at government health facilities differed widely and was left with the impression that
the implementation of current health financing policy varies tremendously depending on local
interpretation. Clients also seem confused by the current policy and are often uncertain about
the costs that may pertain to services they need, including birth spacing. As a consequence,
cost (and in some cases perceived cost) present an important barrier to service access.
There is a need to determine the effect of current cost sharing policies for birth
spacing. If it is found that the associated user fees discourage women from seeking
appropriate reproductive health care there will be a need to review and revise these
guidelines.
At present, throughout Myanmar individuals personally purchase the bulk of reproductive
health services and commodities with little subsidy from the state. The cost of such services
is often a barrier to seeking appropriate health care and, consequently, significant delays in
care seeking sometimes result. There is often a trade off between cost and quality. Yet
current international best practices recommend that interventions to improve reproductive
health status should be a part of an essential package of health services and studies have
shown that investments in reproductive health are extremely cost-effective and provide
significant public health externalities, justifying significant public sector subsidy. (World
Bank, 1996, pp. 106,112)
The current situation regarding the financing of reproductive health services in
Myanmar should be reviewed, with serious consideration given to expanding the
public subsidy of critical services, such as emergency obstetrical and STD care.
Given that cost is often a barrier to appropriate health service utilization, there is a
need to review and refine cost sharing schemes, especially for the poor. More formal
research should be conducted on reproductive health care costs and financing options
in Myanmar.
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