DETERMINANTS OF HEALTH CARE UTILIZATION HEALTH AND SOCIAL CARE 

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The NHIP weaknesses are it has a limited benefit package, created negative pressure on the health system, and is not financially stable (Alhassan et al., 2016).  The NHIP has weaknesses and has created and has systemic barriers such as accessibility and culture.  These systemic barriers impact the older adults, the poor, and women. 

In many developing countries, the financial source for health care is dominated by private sector as house-hold out of pocket payment. However health insurance schemes are becoming an increasingly recognized tool in recent decades to finance low and middle income countries. As one of the poorest countries in South-East Asia, Myanmar health care financing mainly relies on private financing source in a form of out-of pocket payment. According to (NHA 2008-2009), 85% of total health expenditure comes from private household.

In Myanmar, there are some financial schemes initiated by the government in order to protect the financial lost and impoverishment of the people. Among those health financing schemes, Social Security Scheme (SSS) plays a role to pool the risk of financial burden among insured workers. Myanmar government started the social health insurance in 1956 to provide social assistances and health care services to the insured workers. Regardless of the long period of implementation, the coverage of social health insurance is only 0.97% of total population and 1.96% of working population. There are 93 clinics in 110 townships to provide health care services to insured workers (Social Security Board 2012). The clinic time is from 8:00 am to 4:00pm which is during working hours of insured workers (Social Security Board 2012). The social security clinic’s locations are mostly not closed with the work places. The director of Social Security Board (SSB) mentioned about health care services in the news interview that, “The current health care system is not enough for workers as the social security clinics cannot provide 24-hour service. Social security clinics cannot be found all over the country so workers in areas where there are no social security clinics can face difficulties.”(The Myanmar Times, April 16-22, 2012).

Apart from the difficulty in accessibility, th