Qualitative analysis of household economic burden of illness in Myanmar

Abstract

Household level economic burden of illness prevails much of low and middle-income countries. Myanmar, one of the least developed countries, has a challenge of health care financing which is still characterized by the dominance of catastrophic health care payment and the relative lack of prepayment mechanisms. The study was carried out in selected two rural communities of the Yangon Region (low poverty region) and the Northern Shan State (high poverty region) of Myanmar. These mixes of two extremities are purposely selected to capture the diversities of geographical, cultural and socioeconomic contexts influencing the household behavior and social institution to interact with the illness cost. Based on the household interviews, key informant interviews and focus group discussions the study attempt to explore the economic burden of illness in the context of the complex and dynamic nature of illness costs, household behaviors and illness consequences. Because of financial barriers to access health care services, the households are at the risk of deteriorating their socioeconomic status and livelihood by a series of event such as income loss, indebtedness, and asset depletion. People use haphazard coping mechanisms such as payment in labor and putting school aged children to workforce. These are the factors weakening the physical, social and human capital of the households in the long run. Strengthening social network and institutions, promoting the household economic resilience to endure the illness shock and implementing demand-side financing schemes are the important dimensions of formulating policy to prevent households from a vicious cycle of illness and impoverishment.