A RECENT policy conference on health and
education has reignited debate on the country’s struggling public health
system.
While
the proposed nine-fold budget increase for the Ministry of Health in 2012-13
has been widely welcomed, experts say further increases are needed along with
changes to the ministry’s operating procedures.
Speaking
at the Conference on Development Policy Options in Myanmar in Nay Pyi Taw on
February 13, Myanmar Medical Association vice president Dr Khin Maung Aye said
the cost-sharing policy for public healthcare placed too much financial burden
on the public.
He said
the public’s out of pocket expenses should not exceed 30 or 40 percent of
overall health spending, well below the 2008 World Health Organisation estimate
of 89pc.
He said
that while there were no “detailed” statistics on public health expenditure, it
was clear the public was paying the majority of health expenses.
Dr
Nilar Tin, director of planning at the Department of Health, said government
spending on health was just 10pc of total spending – the lowest in the WHO’s
Southeast Asia region.
She
said lack of funding was one of many weaknesses of the country’s public health
system, including lack of staff and infrastructure, poor monitoring and
supervision of staff, lack of reporting and harmonisation of data, and
geographical coverage gaps.
Amyotha
Hluttaw representative Dr Myat Nyarna Soe said last week that the government’s
proposal to increase its health budget from K40 billion to K367 billion, or
from 1.1pc to 3pc of the total budget, in the 2012-13 financial year was a good
first step. However, he said that it was not only the amount of money that
needed to change but also the way in which it was spent.
“The
Ministry of Health needs to change many systems, such as removing the rule that
50pc of earnings from the cost-sharing system go back into the overall
government budget. The ministry also shouldn’t have limitations placed on
hiring staff and needs to make sure that all this money is spent on public
needs,” he said.
Despite
the cost-sharing system, treatment at state-run health facilities is still
cheaper than at private hospitals and clinics. However, patients are forced to
wait much longer to be seen by staff.
In some
urgent cases the long waiting times mean patients have little choice but to
turn to the private health sector.
Ma
Thida, a 26-year-old accountant from Pabedan township, said her mother’s heart
condition would have cost K1.8 million to treat at Yangon General Hospital –
after waiting six months.
“At a
private hospital, she can get the operation in time but we will have to spend
between K2.5 million and K10 million – and that’s only for the operation, we
also have to pay a lot of extra money. Right now I am trying to choose the
hospital,” Ma Thida said.
Dr
Myint Oo, a general practitioner at the privately run clinic Win in Ahlone
township, said it was common for people to buy medicine from a pharmacy rather
than seek professional medical advice because they couldn’t afford it.
“Most
patients are unlikely to come to the clinic to receive treatment for illnesses
because they cannot afford to pay the fees, which are at least K2000,” he said.
“They also try to save money on medicine, so if we tell them to take a
three-day course of antibiotics they demand a treatment that can cure them in a
single day.”
Shwe
Yee Saw Myint
mmtimes.com
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