Dr Ye Moe Myint, Hospital Administrator, Pun Hlaing Hospital: Interview

Interview: Dr Ye Moe Myint

What impact are the under-penetration of health services and the low number of hospital beds having? What can be done to ease overcrowding?

DR YE MOE MYINT: Maternal and child care, especially in remote rural districts, is an example of how below-par health infrastructure is affecting services. Childbirth remains the number one cause of death for women, which speaks to the depth of logistical and infrastructural constraints. Only 57% of births are attended by skilled personnel, and maternal mortality ratios remain higher than the regional average, despite remarkable improvements in the past 20 years. Neonatal mortality rates and stillbirths also remain relatively high, at 3.3% and 2%, respectively. Since the start of the political and economic reform process the government has prioritised the provision of better health care. The Myanmar Health Systems in Transition series held by the Ministry of Health (MoH), for example, reflects a step forward in health care reform. For 2014-15 the government allocated a budget to increase the number of beds, and open 12 additional rural health centres and 33 sub-centres. Moreover, multilateral donors have committed up to $1bn by 2020 to tackle AIDS, tuberculosis and malaria, as well as strengthen the nationwide care system, particularly maternal and child health care. This should lead to big improvements. We are also working with the government to reduce the amount of red tape involved in private provision so that qualified personnel can better meet rising demand. The private network has been growing steadily, with the number of private hospitals in Myanmar rising from 165 in 2013 to 174 in 2014.

What opportunities are there in the market for multinational corporations (MNCs)?

MYINT: MNCs can play a leading role in capacity building and providing know-how for the sector, but the most important market for MNCs will be private consumers in the short- to medium term. The government only accounts for around 12% of Myanmar’s health expenditure. MNCs will be able to enter the market successfully if they can cost-effectively enhance quality and diversity. The biggest challenge is determining whether the country’s infrastructure and population is ready. If the government’s health budget does not rise substantially, expenditure will remain largely driven by private practice, and the market will be dependent on domestic consumers’ disposable income.

How can private investment be incentivised? What scope exists for public private-partnerships (PPPs)?

MYINT: The industry is lagging behind rising demand, with many people seeking treatment in countries such as Singapore, Thailand and India. Services sought overseas range from check ups to transplants and cardiac procedures. Growing unmet demand and pockets of underserved patients should be a big incentive for private investment. We are making an effort to set up PPPs, learning from successful Indonesian hospital PPPs, and we plan to operate three PPP hospitals in Myanmar by 2020. The government, too, is encouraging PPPs, and many opportunities are coming up.

How will the rise in non-communicable diseases (NCDs) impact future investment in the sector?

MYINT: The number of annual deaths from NCDs has risen steadily in the last decade. The probability of dying from one of four main NCDs ( cardiovascular, chronic respiratory, cancer or diabetes) is 24% for Myanmar aged 30-70. World Health Organisation global NCD strategies have been incorporated in the national multi-sector action plan, including strategies to reduce alcohol and tobacco consumption, promote physical exercise, and encourage healthy diets. Yet the country has no NCD operational unit within the MoH, and no monitoring system, making it hard to track NCDs or follow through with action plans. Myanmar also lacks a national cancer registry. The rising incidence of NCDs creates an increasing need for infrastructure to monitor and treat NCDs. Future investment opportunities may include PPP projects that seek to bridge this gap.