Health Care as a Social Enterprise: “You can see a doctor for less than a dollar.”

Against the backdrop of conflict, political turmoil, and economic crisis in Myanmar, a social enterprise supported by Community Partners International (CPI) is piloting a new approach to health care, bringing sustainable, affordable, high-quality primary health services within reach of low-income households.

“Our concept is based on an affordable solution.”

Less than three percent of Myanmar’s population has health insurance, national or private, and three-quarters of health expenditure is out-of-pocket, one of the highest levels in the world. In 2018, 16% of households in Myanmar faced catastrophic health costs. In the aftermath of the 2021 coup and an ongoing civil war, Myanmar’s health system is on the brink of collapse. The economy is also in freefall, with poverty doubling and 40% of the population falling below the national poverty line in 2022. Within this multidimensional crisis, more and more households in Myanmar are struggling to access affordable, quality health care.

Nae Thit Kyan Mar (NTKM), or “New Day Health,” is a Myanmar social enterprise supported by Community Partners International (CPI) that is seeking to develop a sustainable and affordable model of primary health care for low and middle-income households in Yangon. NTKM currently operates two clinics in South Okkalapa and Dagon Seikkan townships that offer subsidized, subscription, or installment-based and, in some cases, free health care services and medicines.

“Our concept is based on an affordable solution,” General Manager Dr. Kaung Myat explains. “Most people in Myanmar cannot afford high medical costs. Government hospitals face limitations in the current situation. Private clinics and hospitals are out of reach of most people. Charity clinics often lack funding and have to close or limit their services. We think the social enterprise model can help solve some of these problems.”

“When we make profits, they are fully reinvested to further our social mission.”

Launched in late 2022, NTKM’s two clinics offer primary health care services, including prenatal care and diagnosis and treatment for infectious and non-communicable diseases. They run on a cost-share model, with grants, donations, and income from service and pharmacy fees.

“We aim to create positive social impact and prioritize community wellbeing over profits,” explains Dr. Kaung Myat. “When we make profits, they are fully reinvested to further our social mission. We position ourselves to be as affordable as possible. You can see a doctor for less than a dollar. We don’t claim to be the cheapest for all services, but we aim for mass affordability of quality health care, especially for low and middle-income families.”

NTKM is seeking to develop new revenue lines to help keep the cost of medical consultations, laboratory tests, and pharmacy products as low as possible. “We run an online pharmacy through social media,” reveals Kaung Myat, “and we provide medical check-ups and vaccination services to businesses and organizations.”

NTKM has also launched a pilot telehealth service providing online medical consultations to migrants from Myanmar in Thailand, Japan, and other countries in the region. “They are working away from home and often struggle to pay health costs,” explains Dr. Kaung Myat. “They also face language barriers. Our telehealth service helps solve some of these problems.”

“We have some funding for people who cannot afford to pay anything.”

NTKM’s clinics offer affordable care for some of Myanmar’s most common infectious and non-communicable diseases. “We focus on hepatitis B and C and work with the Myanmar Liver Foundation to provide diagnosis and treatment,” clarifies Dr. Kaung Myat. “We also provide diagnosis and care for diabetes and hypertension.”

For chronic diseases such as diabetes and hypertension, NTKM’s subscription model helps make long-term care affordable. “If a diabetes patient needs treatment for a long period, it can be costly,” confirms Dr. Kaung Myat. “Under our subscription model, they pay just 11,800 kyats per month (around $5.60 at the time of writing) for treatment and monitoring.”

NTKM’s payment installment plans help low-income households cope with short-term health costs. “Treatment for hepatitis C can cost between 800,000 and 1,000,000 kyats (around $380 to $476 at the time of writing),” reveals Dr. Kaung Myat. “We offer payment plans of up to 12 months to help low-income families afford it.”

In cases where service users cannot afford to pay, the clinics hold limited funds to provide health care free of charge. “We have some funding for people who cannot afford to pay anything,” confirms Dr. Kaung Myat. “So, we can still provide them with health care.”

“As a social enterprise, we can justify a lower profit margin.”

NTKM uses a cost-share model to subsidize medicines sold through their pharmacies and fees for medical consultations. “We survey the market and sell medicines below the market price,” confirms Dr. Kaung Myat. “As a social enterprise, we can justify a lower profit margin. Our medical consultation fees are two or three times less than at private clinics.”

NTKM’s clinics have seen rapid growth in service users since they opened in September 2022. “Patient volumes grew by 90% in the first quarter of 2023,” reveals Dr. Kaung Myat. “After conducting a market survey, we also extended our opening hours in the evening to nine pm as many patients can only visit the clinic after work.”

This rapid growth is helping NTKM to become more financially sustainable. “Our revenue in the first nine months of operation covered about 20% of our operating costs,” reveals Dr. Kaung Myat. “We hope to increase that by the end of this year to 40 or 50%. If we expand our laboratory services, we can triple or even quadruple our revenue. And once our telehealth service is fully up and running, it can also help us grow our revenue stream.”

Looking to the future, NTKM plans to continue growing its range of services and clinic network. “We plan to add new clinics to our network in the Yangon region and open a new diagnostic center,” confirms Dr. Kaung Myat. “We’re also looking to open additional pharmacies in Yangon, Ayeyarwady Region, Kachin State, and Rakhine State, and to move into pharmacy wholesaling.”