Healthcare Policy in Myanmar: Development, Issues, Challenges

This report examines the healthcare policy landscape for older adults in Myanmar, a nation undergoing significant demographic and economic shifts. It begins with an introduction to Myanmar's aging population and its position within Southeast Asia, highlighting the increasing need for healthcare services for the elderly. A literature review explores the economic and social conditions of older adults, including their material wealth, access to essential services like electricity and running water, and sources of income. The report then delves into health-related issues, such as the prevalence of non-communicable diseases, limited access to healthcare, and the challenges posed by an underfunded and understaffed healthcare system. It discusses the government's efforts, including social welfare programs and international collaborations, to address these challenges. The report also highlights the disparities in healthcare access and outcomes based on factors like gender and financial status, and concludes by emphasizing the need for policy interventions to improve the quality of life for older adults in Myanmar.

Healthcare policy for
older adults in Myanmar:
development, issues and
challenges

Contents
INTRODUCTION.........................................................................................................................3
Literature Review..........................................................................................................................4
Methodology...................................................................................................................................8
Results.............................................................................................................................................9
Discussion.....................................................................................................................................12
REFERENCES............................................................................................................................14

INTRODUCTION
Myanmar was seen as one of the most remote countries until political and fundamental change
began in 2015 (The Lancet, 2015). It is the biggest land drafting nation in Southeast Asia with a
complete populace of 51.5 million as per the 2014 registration. On the western edge of Myanmar
on the Andaman Sea, the Bay of Bengal, Bangladesh and India, a north of China and east of
Laos and Thailand. Populace development and a critical expansion in the quantity of occasional
populaces happen all through Southeast Asia, including Myanmar, regardless of changing
patterns. As of the 2015 UN Department of Population gases, Singapore is the most progressive
regarding populace development with 17.9% of the populace developing 60 years and all the
more occasionally, trailed by Thailand with 15.8% . At the opposite end is Laos with just 6%
beyond 60 years old. Myanmar is at the focal point of the street with 8.9% being 60 and all the
more quarterly (United Nations, Department of Economic and Social Affairs, Department of
Population, 2015). Related nations' projections foresee that the populace development
circumstance among Southeast Asian nations will continue as before until 2050, notwithstanding
the way that there will be incredible populace development in all nations.
The circumstance of more settled individuals in Myanmar is especially solid due to the degree of
need. In overall ten nations of ASEAN (Association of Southeast Asian Countries), just
Cambodia's situations under Myanmar, assessed as far as GDP (Gross Domestic Product), have
changed because of buying power equality (International Monetary Fund). - public [IMF], 2015).
Moreover the absolute most disturbing indications of prosperity and prosperity are weak (The
Lancet, 2012). High mortality with future section into the world for 2015-2020 is assessed by the
United Nations at simply 65.6, 5 years lower than Southeast Asia overall (United Nations,
Department of Affairs Economic and parties, Department of the People, 2015). Besides, for the
period 2015-2020, the future at age 60 is stretched out to 16.7 years, right around 2 years not
only 18.4 for Southeast Asia all in all and underneath than the overall standard for all nations
assigned as low-wage (United Nations, Department of Economic and Social Affairs, Department
of Population, 2015).

Literature Review
Since the advancement of changes was exhibited in 2010, Myanmar's economy has grown
quickly with a GDP development pace of 7.2% in 2015 and is relied upon to arrive at its quickest
movement in the Southeast Asian in the United States. a couple of years after the fact (Asian
Development Bank [ABD], 2016). Notwithstanding a basic new development, 70% of the all out
populace lives in local zones and destitution stays for quite a while (Population, 2015). This is
clear in MAS 2012, which shows that the most settled individuals in Myanmar are extremely
poor in material riches. A lot more occasional grown-ups live in houses made of durable
materials (for example bamboo). 33% (34%) need admittance to power and the greater part
(56%) need running water. These conditions are especially steady in local regions where 44% of
perpetual inhabitants have no power and 63% have no running water. In general, family units
have practically no occasional possession in pretty much every case, as long as they incorporate
components that have a spot with others in the family unit. . Just 40% of Myanmar's old live in
family units with TVs and not exactly a 10th in phone families in 2012. The 2014 record notes
upgrades in the material abundance of everybody. For instance, half of families have a TV and
33% have a cell phone. Better material wealth tends to lead to better lifestyles. Extended
telephone permission, for example, can be especially important for older people to keep in touch
with adult children on the go and to provide it in an emergency.
As identified by the MAS, a lion's share of Myanmar's most experienced adults, especially those
at the bottom of 60% circulatory abundance, live in desperate need as assessed by household
funding and the nature of housing (Teerawichitchainan and Knodel, 2015a). The last two
quintiles live in specially rejected families, and even the middle (third) puppy does not monitor
material conditions much better. Only in the top two fifths is housing assets and common
housing utilities in Southeast Asian countries becoming clearer.
The vast majority living in Myanmar consistently live in low paid families. A MAS study shows
that practically 10% report that the family unit's regularly scheduled installment is near 25,000
kyat, or short of what US $ 1 every day, and that simply over 60% apply to families with

installment near US $ 3 every day. Just 55% accept that their compensation is sufficient to meet
their day by day needs consistently. Moreover, one out of five has venture cash or gold.
Work is the expected source of support for more successful people. Most of Myanmar's most
experienced people (94%) have been financially dynamic throughout their lives. Of these, 60%
were heavily involved in agricultural food, with 10% engaged in non-agricultural work and 11%
in formal area occupations. Ironically, unlike nearby Thailand, Myanmar’s more settled adults
are significantly more likely to work in the first year (30% vs. 43%) (Knodel, 2014b). The split
could reflect a more unfortunate mood among the more settled people in Myanmar than in
Thailand, where the legislature offers complete medical coverage and the economy is further
developed (Sasat and Bowers, 2013).
In Myanmar, adult adolescents are the most recognized source of material support for older
people. More than 80% of quarterly people say they accept some form of child support, as
evidenced by the MAS. Furthermore, 59% say that young people are their basic form of income
and only 24% say they work (excluding anyone else or a life partner). As wages from work
decline with age, there appears to be a growing crisis among young people.
There are huge benefits as a form of income for Myanmar's more seasonal mature population. In
general, 8% report any payment from an annuity and only 3% report benefits as a basic form of
income. Likewise, the benefits are largely limited to the most settled people in metropolitan
areas. Only 3% of the most stable adults in rural areas report an annuity payment and only 1%
show it as their main source. Virtually no studies in the MAS report received government
support from governmental or non-governmental offices.
Due to the vulnerabilities of mature age payment and limited and accessible social insurance
tools in Myanmar, the Department of Social Welfare started as a team with HelpAge
International in 2015 by leading a mature age annuity program in two cities in Kachin state and
Ayeyarwady Region. Under this pilot program, more established individuals will receive a cash
transfer of 10,000 Kyat (USD 8) paid on a quarterly basis for a period of one year. In any case,
no assessment or recognition of the program was provided at the time of appointment. It should
be noted that there was a plan with the support of government pioneers to provide one-time
money transfers to Myanmar's centenarians. In addition, the plan was expanded to include
seniors aged 90 and over and established with the support of the legislator.

Health
After a period of political turmoil, financial hardship and unhelpful everyday environments, it
seems that many more successful people in Myanmar are facing poor age-old welfare
achievements. The connection with Thailand’s medieval income country makes it surprising.
Only 33% of the most experienced people in MAS said their well-being was adequate or special
compared to 43% of their Thai participants (Knodel, 2014a; Knodel, Teerawichitchainan,
Prachuabmoh, and Pothisiri, 2015 ). The percentage indicating poor or very poor well-being
among Myanmar's more experienced adults is gradually increasing as they grow from 17%
between the ages of 60-64 to 31 % among people older than 80. In addition, 28% of the most
knowledgeable people in Myanmar detailed visually impaired problems, compared to 18% in
Thailand. When it comes to work, more experienced people in Myanmar scored worse on all
exercise limitations and ability to perform daily life exercises (ADL) than more Thai-based
adults. Real challenges increase with age in Myanmar. Compared to those in their 60s, people in
their 70s showed 2.5 times the same number of practical limitations in general and four times the
number of ADL challenges. In practice, 90% of people aged 80 and over reported a problem in
real work and faced almost six specific regularity challenges. Patterns and examples of prevalent
challenges in Myanmar indicate that stringent requirements for long-term care (LTC) will
increase later in Myanmar as the numbers of more experienced adults at advanced age continue
to increase.
Further evidence shows sexual orientation and financial shifts in well-being among the more
experienced people in Myanmar. Women are almost more adept than their male partners at
reporting problems with different parts of well-being. According to the MAS, about a quarter of
women were more seasonal than 19% of men who described their well-being as poor or very
poor. Similarly, 57% of women versus 40% of men described any form as a barrier to use and
19% of women versus 13% of men reported being an ADL problem at any level. Further studies
show that more established people who are fortunate enough to have a better self-reported
wellness experience, less tactile dissatisfaction, and lower utilitarian boundaries than participants
who are financially burdened (Teerawichitchainan and Knodel, 2015a). It is essential that the
differences in well-being between the most established people in the base and the second quintile

of abundance are evident, suggesting that the overall financial imbalance is important even
among the poorest.
Myanmar faces the growing problems of a developing geriatric population (WHO, 2014). The
country is facing a double whammy of communicable and non-communicable diseases. The
incidence of stroke, coronary heart disease, diabetes, and kidney disease increased in 1990-2010.
About 40% of follow-up pathways in Myanmar are due to non communicable diseases (WHO,
2011). A follow-up report shows that 34% of the adult population surveyed in Yangon Province
had a high risk of hypertension, with 32% of the high-tolerance respondents now taking
medication and only 11% have their tolerance checked. at the hip (Zaw, Latt, Aung, Thwin and
Myint, 2011). Given the continuing nature of non communicable diseases, the increase in the
proportion and total number of established people at risk of chronic disease and LTC needs could
put significant pressure on Myanmar's welfare framework and the families caring for them.
Myanmar's government assistance structure has been vigorously financed (Grundy, Annear,
Ahmed and Biggs, 2014). As per the World Bank's World Development Indicators Information
Center, the Myanmar government will burn-through 2.3% of GDP on benefits in 2014,
contrasted with 6.5% among nations in the East Asian locale and 5.7% among other low-wage
countries (World Bank, 2016). This looks at to a worldwide utilization of $ 103 for each
inhabitant for advantage. Staff insufficiencies and a prosperity establishment are likewise clear.
There are just 100 clinical colleagues/birth specialists (2014) and 60 beds (2006) per 100,000
occupants. The extent of remittances for government assistance organizations situated in
Myanmar is viewed as moderately high, representing 51% of the all out utilization of clinical
administrations influenced and 25% in the East Asia and Pacific area and 37% among low paid
nations. In spite of the way that overall government assistance workplaces have free doctor
organization and gear, contingent upon the zone and treatment, patients have some an ideal
opportunity to offer blessings to clinical authorities who treat them and pay for medications and
supplies utilized in the treatment of Rajan and Sreerupa, 2016; Shobert, 2013). Regardless of the
significant level of private subsidizing of clinical administrations, various obstructions
incorporate lower access because of topographical and key reasons. The absence of cleared
expressways in Myanmar and security worries in certain zones block admittance to government
assistance organizations (Perlez, 2014).

The late development of the country's monetary currency contributes to poverty reduction and
the development of jobs and expectations for daily comforts in some segments of the population
(Myanmar World Bank, 2016). This shift made a difference in terms of strong mitigation, as
evidenced by research findings on neglected needs in LTC (Teerawichitchainan and Knodel,
2016). Myanmar has more seasonal people from more fortunate families who are more likely to
meet the other requirements for assistance and at least, when they receive assistance, they usually
do not take it into consideration. Holes in LTC decrease in the vertical slope with greater family
wealth.
Major changes since 2010 have led the Myanmar government to increase public welfare
spending. To date, there is a strong government role in allocating more funds for regional
essential medical care, unavoidable infectious prevention, and maternal and child well-being
(WHO, 2014). Myanmar's 2014-2018 welfare system tends to be important in controlling the
development of non communicable disease problems, but does not specifically target more
established medical services or long-term care. Although one or two welfare strategies have
entered the mature population over a period of time, many limited funds and restrictions have
reduced their wealth (Han, 2012). For example, the Healthy Aging project initiated by the
Ministry of Health since the mid-1990s achieved 161 urban areas or only about a proportion of
330 cross-country areas by 2014 (Tin, 2014).
Methodology
Significant information sources not explicitly meeting more established people are the censuses.
The 1973 and 1983 censuses were utilized by specialists as a purpose behind the development of
populace information (Department of the Population and UNFPA, 2005, 2012). The most recent
Myanmar populace figures delivered in 2014 blueprint the purpose behind an impending phony
populace report. Regardless of the data contained in the figurings, the first and second Integrated
Household Living Assessment (IHLCA) (2004-2005 and 2009-2010), the 1991 Population and
Outcome Change Primary data collection and Outcome Studies and Reconstructive Health 1997,
2001, and 2007 led by the Department of the Population are also valuable for trials identified by
more established people. This is because these overviews contain informative documents at the
household level and in each case contain the basic data of each person in the household,

including the more familiar mature people. Access to the information menus listed above is
limited but is available on request from the associations that conducted / supported the studies.
Results
Historical process of Elderly health policy in Myanmar
The government of Union of Myanmar recognizes the fact that in order to age
successfully, it is important for the older people to be economically and socially be balanced. As
a result, elderly care programs were structured by taking into account the healthcare as well as
social care provision in Myanmar’s Social Protection Strategic Plan. The responsibility of taking
care of the elderly is considered as the responsibility of their family members, the community as
well as the state on the whole. The national health policy was formulated in the year 1993 and
states that health is equitable and those who are in the need should have access to basic health
services. Elderly healthcare was initially introduced in the second National Health Plan. Prior to
this, little policy attention was given to the health of elderly people at national level. However, in
the year 2001, there were rapid changes in the demographic, economic trends both at the
international as well as national level.
The long term-plan comprises of the various political, social as well as economic status
of the country.The primary goals and objectives of the plan include reducing the public health
impact on various communicable diseases, ensuring that everyone in the entire nation has an
access to health care services as well as ensuring that sufficient quantity of high-quality essential
medicine is available. The constitution of the respective country was revised in the year 2008 by
the last military government. Also, since the year 2010, the government of Myanmar has
undergone various changes, both politically as well as structurally. This has led the government
to allocate a greater number of resources to the health sector. One of the areas that require
immediate attention and action include priority of the new government as well as the social
factors including education as well as health.
Policy Mapping and Ageing
The National Social Protection Strategic Plan of Myanmar was launched in the year 2014
under the responsibility of Ministry of Social Welfare. In the respective country, culture as well
as religion play an important role in the care of elderly. Also, family care systems are very

popular in the country with homes for the aged people. As far as rural development on ageing is
concerned, REVEAL projects are the ones that are provide support with household to the older
people. From the outlook of populace aspect, the Department of Population has conducted
national Population Census in 1973 and 1983 and the series of Fertility and Reproductive Health
Surveys on account that 1991. “the Elderly Population in Myanmar: Trends, Living Conditions,
and Characteristics and Prospects” is carried out in 2004 and “Ageing Transition in Myanmar” in
2009 by means of Ministry of Population and UNFPA. It observed out the functions of the
ageing in Myanmar are a shift in the distribution of the elderly, with an growing share of the
aged being determined inside the oldest of the antique age organizations; an growing proportion
of the elderly that the population of older humans will exceed the population of youngsters
around 2040 (Ageing Transition in Myanmar, 2012). According to the Myanmar National
Census figures, out of the country’s total population of fifty-two million or so, Seventy-five
million (nine.06%) are elderly 60 and above in 2015-2016.
The Myanmar elderly People community is responsible for establishing care, day care
and recreation centers for the elderly people within the country. Due to changes in the family
systems, elderly people feel lonely. To fulfil the overall objective, the Elderly Health Care
program pursuits to provide at the least 20% of the ambulatory aged with geriatric medical
services through the primary fitness-care technique in the assignment townships. It additionally
encourages home-based geriatric care through families, fitness volunteers and nongovernmental
agencies. Training packages for fitness workforce, voluntary medical experts, family individuals
and community volunteers are also covered inside the application. Also, in order to create a
convenient environment for the elderly people, it is very important to take into account their
special requirements. These can be related to their housing, transportation, public places etc.
Actors in Policy Process
It is stated in the National Health Policy that in order to ensure successful conduct of the
elderly people, their needs should be taken into account. The Health Workforce Strategic Plan
(2012-2017) also acknowledges that engagement and partnership with health experts outside of
the general public zone, the non-public fitness zone, NGOs, CSOs, EHOs, and DPs should be
reinforced to tackle issues round planning and control of the fitness workforce. MoHS has these
days shown interest to apprehend non-authorities health workers in ethnic areas and anticipated

to collaborate with Ethnic Health Organizations to offer fitness services to hard-to-reach ethnic
areas.
Context
Holed up behind the nationwide midpoints are broad geographic, ethnic and socio-money related
abberations. For instance, the maternal mortality value (MMR) in Chin State is 357, in contrast
with 213 in Yangon, and the U5MR levels from 108 in Magwe Region to 48 in Mon State.
Youngsters from more unfortunate families are more than twice bound to be undernourished than
those from higher-off family units. Country factors, the Government of the Republic of the
Union of Myanmar are focused on achieving ordinary wellness protection (UHC) by 2030.
Notwithstanding being the National League for Democracy birthday celebration's vision, UHC is
in like manner part of the Sustainable Development Goals, to which Myanmar has bought in.
The Program of Health Reforms proposes a guide toward UHC.
Elderly care in Myanmar
To sell the wellbeing of the more seasoned people and increment the openness of geriatric
consideration administrations for them, Elderly Health Care Project has been figured. Old Health
Care Program is underneath the Improving Health for Mothers, Neonates, Children, Adolescent
and Elderly as a Life Cycle Approach Program Area of National Health Plan.
Older people in Myanmar are usually surrounded by family at home. The MAS provides
extensive data on material craftsmanship, passionate and social support just as there are inter-age
administrations within such a family. The average family size of 60 people and the most
established procedures are five and 86% live in families with at least two ages, of which 77%
basic with one of their children. Such multigenerational plans encourage intergenerational
craftsmanship. Among those living with a young married person, living with a married child is
more common than with a married child. This mirrors a flexible two-sided bonding frame but
with a tendency for developed girls to take on more visible tasks within the family than boys.
With a moderate reversal of monetary progress in Myanmar coupled with a gradual withdrawal,
past turnover of incoming labor has been modest. In this way, not only do adult children's centers
agree with them, but they also live nearby, encouraging intergenerational exchange of material
support and individual administrations. Regulating support for obedient pledges to mature

defenders is wide-ranging. By far, most acquaintances agree that young people should offer
financial help and individual consideration to their mature parents. Gradually, it seems,
according to everyone, that this is the situation. It is estimated that 66% of more experienced
adult learners provided drug help to defenders, and just over a quarter provided what could be
compared to US $ 60 in the year before MAS. From a custodian’s perspective, this translates to
over 90% receiving substantial help from at least one of their children, including just about 66%
who received $ 60 or more in a setting any.
Discussion
Until this point, not many investigators are explicitly centered around developed examination in
Myanmar. There are halfway individuals from universities in Myanmar (for example Yangon
University of Public Health, Yangon Institute of Economics, particularly its segment office),
government workplaces (for example Division of Population, Ministry of Immigration and
Population; Department of Social Welfare, Ministry of Social Security, Relief and Resettlement;
Ministry of Health) and worldwide affiliations (for example UNFPA, WHO, HelpAge
International). A little gathering of developing researchers are leading Myanmar out with a
mastery of the social gerontology of the Myanmar population.
The maturation of the population and its effects are among the few problems currently faced in
the face of poverty affecting Myanmar. After a long period of political turmoil and social
change, Myanmar is restoring harmony and nationalism. The country is powerless in the face of
catastrophic events, including tropical storms, floods, and even earthquakes that typically
transform the financial and social events of events. With this, financial development is
accelerated by political and fundamental change. Myanmar faces great difficulties in accepting
racial pressures, altering financial development, eliminating need, promising social value and
equality, and providing social security to its people in more established people. Rapid financial
reversal of events, extensive urbanization and movement, and small family size could support
family dispersion for older people and, therefore, negative effects on personal satisfaction.
An examination of the current circumstances reveals that there has been little government
welfare settlement for Myanmar's more established mature population, leaving individuals and
families alone fighting for the goodness and success of the most experienced. Be that as it may,
Myanmar received worldwide rules for social and financial insurance of the most experienced

population in its action plan on aging in 2014 during Myanmar’s previous legislature
(Williamson, 2015). The agreement supports the creation of a National Aging Steering
Committee (comprising a majority of key line service representatives and led by the Minister for
Social Welfare, Relief and Resettlement) and National Aging Advisory Committee (including
Line Service Agents, World Offices, United Nations Offices and Neighborhood NGOs). A law
on the most experienced was drafted and ratified in August 2016 by the Myanmar high house of
parliament. Under the new government, the Ministry of Social Security, Support and
Resettlement is as of now looking for gatherings on Myanmar's public deal understanding which
is relied upon to be finished in mid-2017. A business activity plan is probably going to proceed.
updated. These group would then prepare their arrangements to implement agreements and
projects for more established people.
Looking ahead, key investigations for Myanmar include whether the country will age before
wealth becomes sufficient to provide satisfactory social insurance for the more established
mature population and what the right and practical actions are. the role of the state, networks and
families in analyzing the needs of more seasonal people. So far, need and imbalance are
inevitable in Myanmar, as evidenced by the inconsistencies in material wealth, well-being and
personal satisfaction among more seasonal people. While intergenerational support remains
strong and broad because relative wealth includes older people, changes in support can cause
significant difficulties in maintaining normal mature age types. In the short term, Myanmar
needs a public system that covers all aspects of maturity to ensure that it is possible to work and
coordinate projects for more established people. In order to regulate the public system, it is
necessary to develop mature research in Myanmar from biochemical, financial and socio-
behavioral perspectives, to enhance the experimental assessment of more established human
conditions and to use detailed evidence to clarify strategic information and program plans. for a
more seasonal population.

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