October 21, 2020.

Myanmar is undergoing a transition from military to civilian rule since 2011 and government expenditure on health has increased from 1% in 2010 to 3.4% in 2015, still one of the lowest in the Asia-Pacific region. Though health sector decentralization is said to be put in place, the progress so far has not been assessed. There is limited information on how resources are managed and how well is decentralization progressing. The current system favors top-down decision-making, creating vast gaps of expectations between decision-makers and communities in states/regions, townships and villages/wards. In ethnic states, the delivery of health service remains unequal and insufficient due to poor governance, limited budgets, outdated facilities, and lack of supplies and health staff. Moreover, in such resource-poor setting, the gap between community expectations and what service providers can actually offer remains enormous, and needs to be closed.

As Myanmar aims to decentralize, there is limited information about how decentralization is really working on the ground. A coordinated mechanism between national and sub-national governments with technical guidelines could help. Also, health services could be better if local governments had greater autonomy for governing their own human resources, infrastructure, service delivery and budgeting. Understanding service providers’ perspectives and communities’ voices can help reaching the government’s ultimate commitment of delivering Universal Health Coverage.

The talk relies on a survey conducted with 2,800 households by University of Toronto under the K4DM Initiative with local partners in Myanmar’s ethnic states of Chin, Kachin, and Kayin to understand the voices of the communities and the perspectives of the health service providers.


Dr. Myat (Crystal) Pan Hmone, founder of M&PH Research Consult and Technical Advisor for the IDRC Public Service Delivery Project, University of Toronto – Myanmar Institute of Peace & Security.


Prof. Jacques Bertrand, Professor of Political Science, University of Toronto, focuses on ethnic conflict, nationalism, and democratic politics in Southeast Asia.