In 2008, Myanmar proposed the development of a Health System Strengthening (HSS) programme to the Global Alliance for Vaccines and Immunization (GAVI) and thus received funding and support for its initiative. The HSS framework aimed to shore up three main gaps which were identified: service delivery, programme coordination, and human resources. Service delivery gaps were to be improved upon via the distribution of MCH, EPI, and Nutrition and Environmental Services to communities, particularly for hard-to-reach areas. Programme coordination would be strengthened by capacity building focusing on management and organization at the township level. This would include the development of the Coordinated Township Health Plan guidelines, conducting health financing research, and developing the community health initiative scheme. As for human resources management and development, the framework aimed at improving the distribution, skill, number, and mix of health workers, once again placing an emphasis on rural, hard-to-reach areas. These service packages are to be provided by BHS in order to improve the accessibility of service to the people. In turn, these staffs are compensated with per-diems and transportation expenses for the whole year. As a result, this promoted the supply-side by improving financial incentives for BHS to increase accessibility of service.

According to the HSS proposal, a community health initiative scheme was recommended for implementation in a pilot township in order to enhance accessibility to hospital-based services for poor mothers and their children. The specified scheme – also known as the Maternal Child and Health Voucher Scheme (MCHVS) – aimed to synergise with the Hospital Equity Fund (HEF) by covering medical allowances for emergency transport and life-saving procedures at the township level. However, in terms of scaling up, there is a requirement in financing under the GAVI HSS especially on the demand side. Thus, the Health Intervention and Technology Assessment Program (HITAP), the research arm of Thailand’s Ministry of Public Health, was requested to provide technical support for the financing component as well as to conduct a feasibility study to design a program which would introduce attractive demand-side financing initiatives to be implemented by the MoH, Myanmar. A team of HITAP researchers travelled to Myanmar three times between 2010 and 2011 to conduct the feasibility study of the community health initiative for MCH.

A concise review report with clear analysis of the situations on the success and bottlenecks of the scheme, and suggested recommendations on how to improve such a program