"Abstract: The quality of health care available to a population is considered a robust measure of the effectiveness or otherwise of a nation?s governance. In transitional states with a legacy of authoritarian governance, the provision of health care may be hostage to other priorities, leading to sub-optimal outcomes for vulnerable groups. In Myanmar where the private sector accounts for over seventy per cent of expenditure on health care, the civil society sector has taken significant responsibility for provision of health care services in a policy framework which has often been deficient. This article explores the quality of health care available to Myanmar?s vulnerable populations, the resources and outcomes fostered by civil society initiatives in a context where the state is seeking to ?catch up? with others in the region."