RAISING AWARENESS OF SOCIAL SECURITY SCHEME AND WILLINGNESS TO PAY FOR SOCIAL HEALTH INSURANCE AMONG BASIC HEALTH STAFF IN YANGON REGION, MYANMAR

Background: In many low- and middle-income countries, including Myanmar, out-of-pocket spending continues to be a primary method of financing healthcare, often placing households at risk of financial strain. The limited information is available regarding the level of financial protection among basic health staff. Aim: The study was conducted to raise awareness of Social Security Scheme and to identify willingness to pay for social health insurance among basic health staff at township health departments in Yangon Region, Myanmar. Methods: A cross-sectional institution-based study was carried out among basic health staff using structured questionnaires for data collection. Descriptive statistics and logistic regression analyses were applied to explore factors associated with awareness, perception and willingness to pay for social health insurance. Catastrophic health expenditure was assessed using the standard 40% threshold of household capacity to pay. Ethical approval was obtained, and informed consent was secured from all participants. Findings: The findings reveal that most participants financed healthcare through out-of-pocket payments (86.3%). Using the standard threshold of 40% of non-food expenditure, only 4.1% of households experienced catastrophic health expenditure. To cope with healthcare costs, respondents mostly relied on withdrawing savings, borrowing money, and, in some cases, selling assets. The awareness-raising procedure provided by the investigator was the most common source of information (99.5%). Only 26% of the study population had good awareness and 23.5% of them had a positive perception toward SSS by SSB. The study found that 81.6% of the study participants were willing to contribute 2% of their monthly salary to SHI. Econometric analysis using a logit model estimated the mean WTP at 22,544 MMK (10.74 USD). Higher income levels were significantly associated with better awareness of social health insurance, while the participants with higher educational attainment were more likely to have a positive perception of social health insurance. Furthermore, a positive perception of social health insurance was significantly associated with willingness to pay, whereas respondents who experienced catastrophic health expenditure were less likely to be willing to pay. Conclusion: These results highlight the importance of strengthening awareness programs. Expanding social health insurance coverage and improving the quality of public health services could help lessen the financial burden and support progress toward universal health coverage in Myanmar.