Myanmar Improving Public Financial Management for Health Services : Challenges and Opportunities for Improving Service Delivery in the Wake of COVID
Myanmar exhibits poor health outcomes and lags regional peers. Myanmar’s Human Capital Index (HCI) score is 0.47, compared to a regional average of 0.60. Every year, 2,000 pregnant women and 50,000 children die from preventable causes, and 29 perce...
| Main Author: | |
|---|---|
| Format: | Report |
| Language: | English |
| Published: |
World Bank, Washington, DC
2021
|
| Subjects: | |
| Online Access: | http://documents.worldbank.org/curated/en/439921613542231195/PFM-in-Health-assessment http://hdl.handle.net/10986/36133 |
| Summary: | Myanmar exhibits poor health outcomes
and lags regional peers. Myanmar’s Human Capital Index (HCI)
score is 0.47, compared to a regional average of 0.60. Every
year, 2,000 pregnant women and 50,000 children die from
preventable causes, and 29 percent of children under age 5
are stunted. While there are many reasons for these poor
outcomes, the effective coverage (access, utilization, and
quality) of service delivery in the health sector plays a
fundamental role. Budget execution remains prominent among
PFM challenges in the health sector, demonstrated by several
roadblocks to spending on time and on target. There is an
urgent need to better understand the PFM bottlenecks that
affect frontline service delivery. Budgeted expenditure for
the Ministry of Health and Sports (MoHS) has been
increasing, but actual spending has been declining. Budgeted
expenditure increased for the MoHS from 0.86 percent of
gross domestic product (GDP) in 2014-15 to 1.15 percent of
GDP in 2017-18. However, actual expenditure by MoHS has
declined from 1.0 percent to 0.8 percent of GDP in the same
period. The increase in resources available through the
budget allocation process had helped expand access and
availability of health services to some extent, but it has
not been able to address significantly the major health
challenges and achieve better outcomes at population level.
This is partly due to weaknesses at several points along the
chain of financial management within MoHS and at the point
of service delivery. The main objective of this report on
PFM in the health sector is to improve service delivery and
the efficiency of health financing at all levels of health
care in Myanmar. This will be achieved by identifying and
analyzing relevant PFM bottlenecks and providing
recommendations to address them. Secondary objectives are to
deepen the understanding of PFM arrangements in Myanmar’s
health sector, including the PFM reforms required under the
health financing reforms for UHC, and strengthen the
communication and coordination between MoHS and MOPFI to
ensure sustainability of reforms going forward. |
|---|