The main objective of this study is to review the health sector of Myanmar and to develop and suggest future cooperation programs between Korea and Myanmar. In recent years, the importance of cooperation in the health sector became more visible. Three out of eight Millennium Development Goals (MDGs) are health-related. Many people in developing countries in Africa and Southeast Asia have lower health status and face significant risk of disease. Because of the shortage of health care workers and insufficient facilities and financing, people in those countries also have difficulty obtaining necessary health services.
 With a population of over 50 million, Myanmar is a country with very low economic status, not to mention having weak social security and health care systems. Since overall assistance to Myanmar have hitherto been very low, it is expected that many Western donors will actively try to provide assistance to Myanmar. Recently, Korea also has included Myanmar as a special target country for assistance. However, there appear to be no specific plans about ways to cooperate with the country in the near future. Therefore, this study assesses Myanmar’s health sector, reviews other donors’ experience in collaborating with the country, and evaluates Korea’s comparative advantages in terms of development assistance, to formulate how to work with the country.
In terms of the study methods, a review of the literature on the health sector of Myanmar and recent trends of assistance to the country by major donors was done. Also, in-depth interviews with key stakeholders in Myanmar, such as government officials and researchers, were conducted to identify major problems in the health sector in Myanmar and to suggest future collaboration programs.
The results of this study are as follows. In terms of overall health status, Myanmar needs to make significant improvements. Although Myanmar has seen a dramatic improvement in average life expectancy during the past 20 years, disability adjusted life expectancy(DALE) is still very low: 51.4 years for men and 51.9 years for women, respectively. Myanmar continues to have higher mortality from infectious diseases, such as tuberculosis and diarrheal diseases, and HIV/AIDS; there is also growing prevalence of and mortality from chronic, non-communicable diseases including malignant neoplasms, respiratory diseases, and cardiovascular diseases. At the same time, maternal and child health needs to be improved as well.
 Myanmar’s health expenditure per capita has increased steadily. Specifically, it went up from $2.43 in 2001 to $19.79 in 2012. However, total health expenditure as a percentage of the gross domestic product (GDP) increased only about 2.0%. This figure is the lowest among the countries of WHO’s Western Pacific and Southeast Asia region. In addition, the proportion of households falling into poverty due to health care utilization is very high because the percentage of out-of-pocket payment is almost 71.3%. This may be due to the Myanmar government’s overall low spending in health.
 The low level of investment in health is related to insufficient health care resources in Myanmar. Shortages of health care workers in Myanmar remains an important issue. Compared to the average number of physicians per 1,000 population in OECD countries (3.1) and 22 Asian countries (1.3), Myanmar has only 0.6. In addition, the OECD average of nurses per 1,000 population is 8.7, and the average for 22 Asian countries is 2.8, but the number in Myanmar is only 0.6. Insufficient health care facilities are also problematic. The average number of beds per 1,000 population among OECD countries is 4.9, and that of 22 Asian countries is 2.5, but, the number in Myanmar is only 0.6.
Most health care spending in Myanmar is financed by out-of-pocket payments by individuals, and the public financing system is still in the early stages of development. Governance structure for the health care system has so far remained centralized, but the necessity for decentralizing it to some extent has arisen recently, and thus, capacity building for local government officials in health planning should be needed.
Overall level of assistance to Myanmar by major donors has been very low compared to other developing countries in the neighborhood. However, since the new government began working together with major donor countries and resuming development cooperation, it is expected that cooperation with the Myanmar government continues to grow. Aid to the health sector in Myanmar by major donors has been focused on infectious disease control. Japan has been the leading country in assisting Myanmar in terms of developing the health sector. USA and other Western countries have primarily relied on developing 3 MDG funds to assist Myanmar. Although such a vertical approach has led to some success, the Myanmar government has also recognized the importance of using the horizontal approach, where strengthening the overall health system is pursued while also continuing project-based collaboration programs.
Based on the analysis of the current situation of the Myanmar health sector and the assessment of comparative advantage of Korea in terms of development assistance, a total of four specific areas for cooperation are suggested: 1) developing a system to improve the overall quality of health care service, such as by reforming the health care system and by developing a more efficient governance system of health care institutions, 2) strengthening the role of public health centers, particularly in areas of non-communicable disease management and health promotion, maternal and child health, and vaccinations, 3) enhancing the capacity of health care workforce by providing a variety of education and training programs tailored to policy makers, clinicians, and primary level health care personnels, and 4) assisting the government in building public health care financing system, such as introducing a pilot program for health insurance and launching a health information system.
Given that Myanmar has many underdeveloped areas, particularly in the health sector, Korea needs to formulate viable development programs to cooperate with the Myanmar government. During the process, however, it is essential to work together with multiple development partners and allowing them to participate when developing plans for assistance programs related to the health sector in Myanmar.