Opinion: The Road to 2030: Keeping Reproductive Health Supplies in Myanmar’s Universal Health Coverage Scheme
7th January 2016
Preparations for universal health coverage are progressing steadily in Myanmar. Reproductive health supplies, including contraceptives, are already a priority for the government.
In February 2015, the World Bank and the government of Myanmar entered into a historical agreement to prioritize maternal, newborn, and child healthcare with the Essential Health Services Access Project. This US$100M project supports Myanmar’s ongoing efforts toward universal health coverage and is expected to accelerate achievement of the unfinished Millennium Development Goal 4 and 5 targets.
In an interview conducted in December 2015, H.E. Deputy Minister of Health Dr. Thein Thein Htay explained two challenges confronting Myanmar: “The first is the need to increase expenditures to deliver supplies to the whole country; another challenge is to turn incoming donor support and our increasing public health budget into [high] quality commodities with appropriate pricing. Myanmar has been increasing its reproductive health supplies budget by US$1M a year, but it is still far from enough. The knowledge and skills of health staff working to deliver family planning services also need improvement, especially for long-acting methods.” Under World Bank financing, commodity expenses are not covered directly, but as the Ministry of Health allocates financial support to hospitals and districts, those funds could be spent purchasing commodities more locally to fill gaps.
Maintaining an effective supply chain also presents a huge challenge, given the rough terrain and sparsely populated areas far from main roads. The situation is improving, however, with the Logistics Management and Information Systems (LMIS) training supported by the United Nations Population Fund, John Snow Inc. (JSI), and other partners. RHSC members Pathfinder International and JSI are currently planning with UNFPA to expand training to additional townships in southern Shan State to improve forecasting and move more towards a “pull” system.
Currently there are two extremes: stockouts on the one hand, and stockpile of expiring contraceptives on the other.
“Currently there are two extremes: stockouts on the one hand, and stockpile of expiring contraceptives on the other. We need to accelerate harmonization of different commodity management systems that exist in the country, and an effective monitoring system is critical to that effort,” added the Deputy Minister. As is the case in many low-income countries, manpower is very limited in the Ministry of Health, and without nationwide cellular phone access to compile information, real-time data collection is still a huge challenge. Fortunately, the technology revolution is taking place rapidly in Myanmar, with Facebook now being used in many townships to communicate information about supplies.
The stakeholders working towards universal health coverage are at the initial stage of developing a service package. The maternal, newborn, and child health package will continue to be defined and expanded. Equity for the rural poor will be a key consideration for Myanmar’s future plans. “We will continue to learn from the mistakes of other countries so we can leapfrog forward,” Dr. Thein Thein Htay concluded. We look forward to following Myanmar’s continued prioritization of reproductive supplies as its new government administration comes into power in April 2016.
Sono Aibe, Senior Advisor for Strategic Initiatives, Pathfinder International
This post is part of an occasional series of articles written by members of the RHSC’s universal health coverage (UHC) steering team. The series explores different perspective and topics on the role of supplies in UHC policies.
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