Extending social protection in the ASEAN and Myanmar Lou Tessier Technical Officer ILO November 22nd, 2014 Nay Pyi Taw

Outline Social protection in the ASEAN Social protection in Myanmar

Social protection is…. … at least a minimum guarantee; and then progressive extension to higher levels of social security Level of protection Nationally defined SPF Poor Rest of informal sector Formal sector Population

Social protection floors Four basic guarantees:  All residents have access to essential health care, including maternity care  All children enjoy basic income security, providing access to nutrition, education, care, and any other necessary goods and services  All persons in active age who cannot earn sufficient income, enjoy basic income security, particularly in cases of sickness, unemployment, maternity, disability  All older persons have basic income security

SPF endorsed globally ILO’s Recommendation on Social Protection Floors, 2012 (No. 202) was endorsed by 185 member States in June 2012 with 456 ‘yes’ votes and 1 ‘not present’ Recommendation No. 202 guides member States on establishing and maintaining nationally defined SPFs http://www.ilo.org/wcmsp5/groups/public/---ed_norm/---relconf/documents/meetingdocument/wcms_183326.pdf

SPF adopted in Asia The 15th Asia Pacific Regional Meeting, Dec 2011, prioritizes “reducing poverty and wide inequalities in income and wealth” and “building effective social protection floors in line with national circumstances” ASEAN member States adopted the Declaration on strengthening social protection, Sep 2013

Social protection: a priority for ASEAN leaders Declaration on strengthening social protection adopted by ASEAN leaders on 9 October 2013 Towards the development of a common social protection denominator: ABNDs, recommendations for the design of SPFs, development of national social protection strategy, support to the design and implementation of social security, south-south cooperation, knowledge development & knowledge sharing Towards a specific protection for migrant workers: Ensure non discrimination in national SS laws, and facilitate portability through bilateral agreements

Upcoming ASEAN community Single regional common market and production base In 2015 for the 600 million women and men of the ten ASEAN Member States Impact the structure of economies, drive innovation and could double productivity higher incomes for some, such as the high-skilled exacerbate inequality for some, such as for lower skilled and migrant workers Common demographic challenges: Ageing Migration Rural-Urban shift Towards an action plan and a monitoring framework on social protection in the ASEAN

Social security schemes in the ASEAN Branch of social security provided overall Country Medical care Sickness Unemploy ment Old age Work injury Family Maternity Invalidity Survivors Brunei Darussalam ●   Cambodia ●* Indonesia Lao PDR Malaysia Myanmar Philippines Thailand Singapore Viet Nam NOTES: *Social security laws have been adopted though the implementing legal texts are still in draft form.

Social protection in the ASEAN Where are we now? Spending on social protection: Social protection expenditure represent in average 3.09% of GDP in ASEAN countries

Social protection in the ASEAN Where are we now? Coverage of social protection => little consolidated data available… HEALTH What remains to be financed by households? How many people are covered?

Additional cost to achieve a SPF Cambodia; 0.4 – 2.4% GDP by 2020 Indonesia; 0.7 to 2.4% GDP by 2020 Thailand; 0.5 – 1.2% GDP by 2020 Viet Nam; 2% to 6% GDP by 2020

Outline Social protection in the ASEAN Social protection in Myanmar

How to make the social protection floor a reality in ASEAN?

How do we achieve the SPF and make it a reality for the whole population of a country? The United Nations developed a methodology, the social protection assessment based national dialogue, which: Identifies the existing situation and gaps in the social protection system Develops recommendations for achieving the SPF It was conducted in a number of ASEAN countries, including in Myanmar in 2014, which is meant to feed the elaboration of a national social protection strategy.

Assessment based national dialogue in ASEAN to be started on-going completed

Steps of the ABND ABND FACTSHEET Step 1 – Building the assessment matrix including the identification of priority recommendations ABND FACTSHEET Step 2 – Rapid Assessment Protocol to estimate the cost of implementing the social protection provisions Step 3 – Finalisation of the assessment report for endorsement and further action by the higher levels of government

A participatory process ABND Line ministries (Labour, Health, Social Welfare, Planning, Interior, Education, Finance, Rural Development, Women’s Affairs, etc.), social security institutions Local governments Workers’ and employers’ organizations National Statistics Office, academicians UN agencies involved in SPF (ILO, UNICEF, WHO, UNESCAP, UNFPA, UNAIDS, UNESCO, UNWOMEN, UNDP, WFP), World Bank, ADB, other development partners Civil society

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

Main existing programmes 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), i.e. over 1% of the total population. 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, 2013 - old age, disability, survivors. Over 800,000 pensioners, i.e. 10% of the population aged 55+ 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.

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).

Summary of recommendations   TYPE 1 – Additional or extended SPF provisions TYPE 2 – Structural reforms TYPE 3 – Improved operations Health Reduce OOP through financial protection Scale-up the HIV/AIDS treatment and counselling programme Strengthen the Health System Develop a detailed package for the Social Security Medical Care Scheme Children Introduce a maternity and new- born nutrition-sensitive social protection scheme Ensure that families with children are provided with support, including through the reinforcement of existing mechanisms (i.e. school stipends) Pay special attention to children with disabilities Ensure coordination among interventions directed at children Ensure that free primary education is enforced

Summary of recommendations   TYPE 1 – Additional or extended SPF provisions TYPE 2 – Structural reforms TYPE 3 – Improved operations Working Age Develop social protection mechanisms against seasonal under-employment Extend maternity protection Create a social protection scheme for adults with permanent disabilities Apply the same social protection schemes to the whole formal sector Move towards a unified and enforced labour legislation. Include social protection in the legislation framework for oversea migrants Enforce all social security schemes mentioned under the Social Security Law, 2012. Extend provisions for access to vocational training. Review the level of workmen compensation in case of work injury. Revise the new voluntary social security scheme to ensure financial access to informal economy workers. Raise awareness on workers’ right to social security.

Summary of recommendations   TYPE 1 – Additional or extended SPF provisions TYPE 2 – Structural reforms TYPE 3 – Improved operations Elderly Create a social pension Address the special needs of elderly dependent persons Create a coordination mechanism and portability of benefit across the different pension schemes Ensure current pension schemes are indexed on inflation and wages Cross-cutting Establish a sustainable coordination and monitoring mechanism at both central level and States and Regions level. Improve the delivery of social protection schemes through the establishment of a single entry point for the identification, registration and benefit delivery to beneficiaries, especially in hard-to reach areas with limited administrative presence.

Proposed social protection packages   Low Medium High Health Scenario 1: Ensure supply side readiness through health system strengthening by progressively increasing public spending on health infrastructure, facilities, human resources, etc. to 4% of GDP.   Scenario 2: Expanding the coverage of SSS (civil servants and family–based). Scenario 3: Ensure out-of pocket spending on health is kept at a minimum, on the basis of providing a package of 30,000 Kyat per person per year, for the entire population not covered by SSB. Scenario 5: Ensure out-of pocket spending on health is kept at a minimum, on the basis of providing a package of 30,000 Kyat per person per year, for 30% of the population (ie. the poorest) and 15,000 Kyat per person per year for 50% of the population. Scenario 6: Ensure out-of pocket spending on health is kept at a minimum, on the basis of providing a package of 54 USD per person per year, for the entire population not covered by SSB. Scenario 7: Coverage of transportation costs for maternal and new born. Scenario 9: Scaling up the existing HIV/AIDS comprehensive care and treatment programme and HIV Testing and Counselling.

Proposed social protection packages   Low Medium High Children Scenario 1: Conditional cash transfer of 15,000 Kyat per month for all pregnant women in the last 6 months of pregnancy and children until 2 years old.  Scenario 5: Universal child allowance of 8,000 Kyat per child per month for all children aged 2-15. Scenario 7: Scale-up of the school stipends programme to all children in school from poor households. Scenario 10: School feeding in all schools. Scenario 12: Unconditional cash transfer of 16,000 Kyat per child per month for all families with children with disabilities aged 0-18. Working age Scenario 2: A Public Employment Programme with 60 days of work in all rural areas for ages 16-64, at 3,000 kyats per day. Scenario 4: A Public Employment Programme with 60 days of work in all rural areas for ages 16-64, at 3,000 kyats per day, with Technical Vocational Educational Training (TVET) every year for 5 days. Scenario 7: Universal allowance for people aged 18-59 living with disabilities of 40,000 kyats a month. Scenario 9: Universal allowance for people aged 18-59 living with disabilities of 30,000 kyats a month. Old age Scenario 1: Universal social pension of 30,000 kyats per month for people 65 years old and over. Scenario 2: Universal social pension of 30,000 kyats per month for people 70 years old and over. Scenario 4: Social pension of 25,000 kyats per month for people 65 years old and over that are poor. Scenario 10: Additional pension for older persons (65 years old and over) living with disabilities and all dependent older persons (80 years old and over) of 30,000 Kyats per month. Scenario 11: Scale-up of the home care programme.

Proposed social protection packages   Low Medium High Old age Scenario 1: Universal social pension of 30,000 kyats per month for people 65 years old and over.  Scenario 2: Universal social pension of 30,000 kyats per month for people 70 years old and over. Scenario 4: Social pension of 25,000 kyats per month for people 65 years old and over that are poor. Scenario 10: Additional pension for older persons (65 years old and over) living with disabilities and all dependent older persons (80 years old and over) of 30,000 Kyats per month. Scenario 11: Scale-up of the home care programme.

Evaluated cost of the main packages

Estimated need for fiscal space

Inputs to the national social protection strategy 2014 2015 Jan Mar 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 Inputs NSPS Vision Objectives Flagship programmes Costing NSPS

Thank you for your attention Lou Tessier, ILO tessier@ilo.org