Social Protection Assessment Based National Dialogue in Myanmar September 3 rd -5 th, 2014 Nay Pyi Taw Workshop on evaluating the cost of social protection policy options

Session 6: Wrap-up

Strategy drafting process Assessments and technical inputs Social protection delivery workshop Social protection strategy work plan December 2014 Sector working group meeting and NTWG launch NTWG training workshop NTWG policy workshop Draft strategy National dialogue no.1 Social protection assessment matrix National dialogue no.2 From recommenda tions to scenarios National dialogue no.3 scenario costing and fiscal space Social protection inventory Assessment of delivery mechanisms January 2014 February 2014 March 2014 April 2014 June 2014 Sept 2014 October 2014 Sept 2014 National dialogue no.3 scenario costing and fiscal space

1. Inventory of schemes (November 2013) 2. Draft Assessment Matrix 3.Dialogue # 1 on assessment matrix (March 2014) 4. Translation of policy recommendations into practical scenarios 5. Dialogue # 2 on proposed scenarios (May-June 2014) 6. Data collection for the RAP protocol and costing of the scenarios (June- August 2014) 7. Dialogue # 3 on costing (August - September 2014) 9. Endorsement by the government and inclusion of some recommendations in the national strategy (Oct Feb. 2015) 8. Finalization of Costing, Fiscal space, Writing ABND report (Sept. – Oct. 2014) Step 1 Step 3 The process in Myanmar Steps of ABND

Social protection inventory October 2013 – February 2014: inventory of social protection programmes in Myanmar conducted by the World Bank. Main observations: – Government social protection programmes are small and scattered. – A very large number of social assistance programmes are run by NGOs on a temporary basis at the moment. Many are still part of emergency relief programmes.

Expectations of a SP strategy March 2014: First national dialogue workshop, identification of existing government programmes on social protection, policy gaps and implementation issues. Creation of new social protection schemes (education, health, nutrition, maternity, disability, unemployment, and old age) Integration of regional and state priorities Inclusiveness of vulnerable groups and minorities Alignment of line ministries towards common priorities Resource mobilization of implementation of the social protection schemes Fair redistribution of income Poverty and vulnerability reduction Access to education and reduction of child labour Building human resources Extend social protection coverage and avoid duplication

Social protection assessment matrix March 2014: first national dialogue workshop, identification of existing government programmes on social protection, policy gaps and implementation issues.

Main existing programmes March 2014: first national dialogue workshop, identification of existing government programmes on social protection, policy gaps and implementation issues. Contributory - one main social protection programme : – Social Security Schemes – Social Security Law and rules, 2012 – partially implemented (free medical care in limited facilities, sickness, maternity, work injury). Over 700,000 workers covered (mainly from the formal private sector). Non-contributory - A number of scattered programmes which aim at providing some social assistance: – Civil servants, military and political personnel pension scheme – Civil Service law and rules, old age, disability, survivors. Over 700,000 pensioners. – Free programmes run by the Ministry of Health, mixing both supply-side and demand-side interventions (free medicine programme, free delivery and care until 5 years old, free immunization, hospital trust funds, maternal health voucher scheme, …). – Assistance mechanisms run by the Ministry of Social Welfare, Relief and Resettlement directed at special vulnerable groups with very limited coverage. – School grants and stipends programmes run by the Ministry of Education with high coverage but limited benefit amount.

Civil servants have access to a pension scheme. Main existing programmes Rest of theFormal sector Level of protection Population Poor Some formal private sector workers have access to the Social Security Schemes (medical care, sickness, maternity, work injury). Some programmes target some vulnerable categories of the population. Some emergency relief programmes run by development partners target the poor. Some community solidarity. Free basic public health and education programmes for all.

Main policy gaps Absence of a general framework for social protection schemes design and coordination. Limited coordination across line ministries in charge of existing programmes (currently being formulated). Most programmes are not yet embedded in the law and do not constitute sustainable entitlements. The existing laws do not provide for long-term income security of the intended beneficiaries (benefits not indexed on salaries or inflation, no regular actuarial valuation, partially defined benefit packages, qualifying conditions often very restrictive). The rights to health and education are mentioned in the Constitution, but the detailed content of those rights in terms of individual entitlements is not yet available. This makes it difficult to develop both supply and demand side interventions.

Main implementation issues Many programmes are not monitored in a consolidated manner yet with regular public publication of key coverage indicators. Accordingly, the central statistical organization does not produce yet consolidated social protection indicators for Myanmar. Supply-side shortages and geographical inequity (especially in the health and vocational training sectors). Lack of enforcement of existing social protection laws and programmes. Low awareness of intended beneficiaries and difficulties to access scattered schemes (geographical distance, opportunity cost, etc.). Limited delivery capacity of line ministries (presence on the ground is limited and capacities at States and regions level needs to be built).

Special vulnerable groups March 2014: first national dialogue workshop, identification of existing government programmes on social protection, policy gaps and implementation issues. The elderly Internally displaced people Female household heads Landless casual workers Women and children Poor rural population Persons with disabilities Persons living in urban slums Orphans Persons living in conflict areas

Main design constraints for social protection schemes June 2014: second national dialogue workshop on identifying policy options to close the social protection coverage gaps. Lack of institutional capacity Weak financial commitment Lack of shared information systems and registration systems for beneficiaries No official poverty line and no official minimum wage yet (in formulation). Issues with identification (ID cards and birth registration issues) Accessibility issues Supply-side readiness (health) Lack of multi-sector collaboration Lack of public awareness on social protection Lack of participatory planning processes

Summary of recommendations Improved operationsAdditional provisionsStructural reforms Health Develop a detailed package for the Social Security Medical Care Scheme, extend access to more health care facilities. Financial protection for the population not covered by the Social Security Medical Care Scheme. Extend Social Security Medical Care Scheme to the workers’ families. Strengthen the Health System in order to ensure supply-side readiness. Children Ensure that free primary education is enforced. Create social protection mechanisms to support families with children. Put in place a social protection scheme for children with disabilities. Put in place a nutrition-sensitive social protection scheme to prevent malnutrition in the first 1000 days of the new born. Ensure coordination with interventions directed at children (i.e. child protection, nutrition, fight against child labour, reintegration of child soldiers, etc.).

Summary of recommendations Improved operationsAdditional provisionsStructural reforms Active Age Extend provisions for access to vocational training. Review workmen compensation in case of work injury. Revise the new voluntary social security scheme. Raise awareness on workers right to social security. Develop social protection mechanisms for the rural informal population. Create linkages with vocational training opportunities. Extend maternity protection to all pregnant women. Create a social protection scheme for adults with permanent disabilities. Apply the same social protection schemes to civil servants and formal private sector workers. Move towards unified and enforced labour legislation. Include social protection in the legislation framework for oversea migrants. Old Age Ensure current pension schemes are indexed on inflation and wages. Create a social pension. Establish a mechanism for long- term care. Create a coordination mechanism and portability of benefit across the different pension schemes. Coordination and delivery Improve the delivery of social protection schemes through the establishment of a single entry point for the identification, registration and benefit delivery to beneficiaries. Coordination and monitoring mechanism at both central level and States and regions level.

Goals and Objectives GoalsObjectives Improve social well-being and social cohesion through poverty and inequality reduction as well as human development. Contribute to fulfilling human rights. Improve resilience against shocks and disasters. For all Myanmar citizens, especially those experiencing socio-economic difficulties, to live better and safer lives. Ensure equitable access to basic services Improve the well-being of families. Health Ensuring all people from Myanmar, free from catastrophic health care expenditure by universal health care coverage by Children Increase capacity of families to provide for children (with disabilities). Decrease malnutrition rate of women and children. Increase enrolment, completion and transition rates. Active Age Improve health and nutrition of mothers Ensure economic security, in particular but not exclusively in the case of disability, under- employment/seasonal casual work, and unemployment Old Age Income security for all elderly, especially the poor and disabled, through either a contributory old age pension or non- contributory old age pension. Access to health care services/ facilities for all elderly, especially the poor and disabled, through a financial risk protection mechanism.

Formulating scenarios Rest of theFormal sector Level of protection Population Poor Health Children Active Age Old Age Over 60 scenarios were formulated during the last workshop

Main social protection packages PackageDescription Low package Health package of 30,000 kyats per year free for the poor and partly subsidized for the non-poor. Scale-up existing free ARV treatment to all HIV/AIDS patients. Scale-up the existing school stipend programme to all poor students. Create a Public Employment Programme for 60 days a year at 70% of the future minimum wage per day in all rural areas, years old. Create a social pension of 25,000 kyats per month for poor elderly people. Medium package Health package of 30,000 kyats per year free for all people not covered by the SSB, including transportation costs for pregnant and lactating women. Scale-up existing free ARV treatment to all HIV/AIDS patients and include mother-to-child anti-contamination kit. Create a cash transfer of 15,000 kyats a month for pregnant women and new born until 2 years old. Create a universal child allowance for families of 8,000 kyats per month for all children 2-15 years old. Scale-up the existing school stipend programme to all poor students. Create a Public Employment Programme for 60 days a year at 3,000 kyats per day in all rural areas, years old. Create a universal allowance for people living with disabilities, Create a social pension of 30,000 kyats per month for all elderly people not covered by the existing pension schemes, over 65 years old. Scale-up the home care programme for dependent elderly persons.

Main social protection packages PackageDescription High packageHealth package of 53,000 kyats per year free for all people not covered by the SSB. Scale-up existing free ARV treatment to all HIV/AIDS patients and include mother-to-child anti-contamination kit. Create a cash transfer of 15,000 kyats a month for pregnant women and new born until 2 years old. Create a universal child allowance for families of 8,000 kyats per month for all children 2-15 years old. Create a universal allowance of 16,000 kyats per month for all children with disabilities, 0-18 years old. Create a school feeding programme for all schools. Create a Public Employment Programme for 60 days a year at 3,000 kyats per day in all rural areas, years old. Create a universal allowance for people living with disabilities, Create a social pension of 30,000 kyats per month for all elderly people not covered by the existing pension schemes, over 65 years old. Create an additional pension for old people living with disabilities. Scale-up the home care programme for dependent elderly persons.

Evaluated cost of the main packages

Estimated need for fiscal space

Suggestions for mobilizing fiscal space Budget reallocations => From infrastructure, defense… Budget reallocations => From infrastructure, defense… Raise new taxes => high income, sin taxes, luxury taxes, taxes on extractive industries Renegotiation of debt Low interest loans Renegotiation of debt Low interest loans Donor funding CSR

Jan Mar Inputs World Bank: Inventory World Bank: in-depth assessments on social assistance and delivery mechanisms ABND costing & fiscal space ABND finalization & endorse- ment ABND matrix: SP gaps/issues, policy options NSPS VisionObjectives Flagship programmes Costing NSPS Inputs to the NSPS

Take out messages and pending issues for the formulation of the NSPS If there is one main message => need to drastically increase social protection coverage: Need to scale-up and improve the quality of a number of existing schemes => specific recommendations by scheme provided by the assessment matrix. Need to create some new programmes, especially non-contributory ones => specific policy options proposed by the ABND. Issues not addressed by the ABND: Coordination mechanism, involving States and Regions => what are the next steps for the participatory process? Some regional consultations are already happening, how to scale it up? Discuss the delimitations of formal – informal economy in the future and the consequences on the social protection system (contributory – non-contributory => until where do we extend existing provisions?). Geographical access, geographical equity and the progressive integration of conflict-affected areas following the peace process. Final choice of new flagship programmes, sequencing and implementation arrangements.

Next steps Compilation of the social protection assessment- based national dialogue report. Hand over of the report to the national working group on social protection and its technical support group in order to support the national social protection strategy drafting process. Follow-up advocacy activities for the endorsement and effective implementation of some of the recommendations of the national dialogue.

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