The Republic of the Union of Myanmar (Burma) has a long and complex history characterized by internal
conflict and tense international relations. Post-independence, the health sector has gradually evolved,
but with health service development and indicators lagging well behind regional expectations. In recent
years, the country has initiated political reforms and a reorientation of development policy towards
social sector investment. In this study, from a systems and historical perspective, we used publicly
available data sources and grey literature to describe and analyze links between health policy and history
from the post-independence period up until 2012. Three major periods are discernable in post war health
system development and political history in Myanmar. The first post-independence period was associated
with the development of the primary health care system extending up to the 1988 political events.
The second period is from 1988 to 2005, when the country launched a free market economic model and
was arguably experiencing its highest levels of international isolation as well as very low levels of national
health investment. The third period (2005e2012) represents the first attempts at health reform
and recovery, linked to emerging trends in national political reform and international politics. Based on
the most recent period of macro-political reform, the central state is set to transition from a direct
implementer of a command and control management system, towards stewardship of a significantly
more complex and decentralized administrative order. Historical analysis demonstrates the extent to
which these periodic shifts in the macro-political and economic order acts to reset the parameters for
health policy making. This case demonstrates important lessons for other countries in transition by
highlighting the extent to which analysis of political history can be instructive for determination of more
feasible boundaries for future health policy action.