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سلامت محور توسعه - Health, Core of Development
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سلامت محور توسعه - Health, Core of Development

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  • 1. Health, Core of Development Farhad Zargari, MD drzargari@gmail.com
  • 2. MARTIN LUTHER KING : “OF ALL THE FORMS OF INEQUALITY, INJUSTICE IN HEALTH CARE IS THE MOST SHOCKING AND INHUMANE
  • 3. (WHO)
  • 4. HumanCapital Theory Aging
  • 5. - - - -- -
  • 6. - - - -
  • 7. - - -
  • 8. -
  • 9. - - - - -
  • 10. - - - - -
  • 11. : . : .: .  . : 1 . 2 3 4
  • 12. - - - - - - - - - - - - - - - - - -
  • 13.      
  • 14. .1 .2 .3 .4 .5 .6 .7 .8
  • 15. package
  • 16. -        
  • 17. -package         
  • 18. -    Evidence Based    
  • 19. - • • - • • • - • •
  • 20.  All Ages  Both Sexes  Comprehensive  Integrated
  • 21. Comprehension  Social Factors  Psychological Factors  Spiritual Factors  Biological Factors
  • 22. Integration  Preventive Measures  Therapeutic Measures  Rehabilitative Measures
  • 23. - - - - - - - - - - - - - - - -Life Style -Self Care
  • 24. ‫ك‬ ‫ي‬‫ت‬ ً‫ژ‬ ّ ‫ك‬ ‫يْلْژي‬ ‫ب‬ ‫ل‬ ‫سائ‬ ‫ه‬ ‫كي‬ ‫يزي‬ ‫ف‬ ‫يط‬‫هح‬ ‫تصادي‬ ‫اق‬ ّ ‫تواعي‬ ‫اج‬ ‫يط‬‫هح‬ ‫تي‬ ‫ساله‬ ‫ذهات‬ ‫خ‬ َ ‫ارائ‬ ‫ًظام‬
  • 25.     - 
  • 26. - -
  • 27.
  • 28.  
  • 29.  ---
  • 30.   - -
  • 31. 50 1000 2000 5400 19000 ‫اّايل‬ 1800 1930 1992 2100 ‫هيليْى‬ َ‫ب‬ ‫ت‬ ‫جوعي‬
  • 32. 1.7 0.8 2.25 0.85 2.9 0.9 3.55 0.95 4.2 1 4.9 1.2 5.75 1.25 6.2 1.3 6.65 1.35 7.3 1.4 8 1.5 1950 1970 1990 2010 2030 2050 َ‫يافت‬ َ‫تْسع‬ ‫كوتر‬ ‫كشْرُاي‬ َ‫يافت‬ َ‫تْسع‬ ‫بيشتر‬ ‫كشْرُاي‬
  • 33. 3.8 2.4 2.6 2 2.9 3.6 2 ‫ى‬‫ارد‬ ‫ق‬‫عرا‬ ‫ى‬‫ٌا‬‫ب‬‫ل‬ ‫هصر‬ ‫ى‬‫تا‬‫س‬‫عرب‬ ‫ي‬‫سعْد‬ ‫ى‬‫عوا‬ ‫ى‬‫سْدا‬
  • 34. 1881 1891 1901 1911 1921 1926 1931 1936 1941 1946 1951 1956 1966 1976 1986 1991 1996 2000 0 1 2 3 4 5
  • 35. Population Pyramid - Iran DHS2000 95+ 90-94 85-89 80-84 75-79 70-74 65-69 60-64 55-59 50-54 45-49 40-44 35-39 30-34 25-29 20-24 15-19 10-14 5-09 0-04 0.02.04.06.08.0 0.0 2.0 4.0 6.0 8.0 Female Male
  • 36. 2.71 3.2 2.46 2.3 1.75 1.41 1355 1365 1370 1372 1373 1375
  • 37. 23 26 18 29 48 1335- 1345 1345- 1355 1355- 1365 1365- 1370 1370- 1375
  • 38. - - - -  STD -
  • 39. IQ Reproduction IQ IQ IQ
  • 40. -
  • 41.
  • 42. GDP GDP 
  • 43. Global Health Expenditure 1997 = US$2.6 Trillion Africa 0.4% Middle East and N Africa 1.5% Europe 2.4% Americas 3.2 Asia 3.5% Developed Countries 88.9%
  • 44. Out of Pocket
  • 45. GDP 4.4% 3.7% 5.2% 3.3% 4.2% 2.5% 10.5% 9.8% 9.3% 7.3% 13.7% 8.6% 10.1% ‫ى‬‫را‬‫اي‬ ‫هصر‬ ‫ى‬‫ارد‬ ‫ت‬‫كْي‬ ‫ق‬‫عرا‬ َ‫سْري‬ ‫ى‬‫وا‬‫ال‬ َ‫س‬ً‫را‬‫ف‬ ‫يا‬‫تال‬‫اي‬ ‫ي‬‫ژاپ‬ ‫كا‬‫ري‬‫اه‬ ‫ا‬‫كاًاد‬ ‫س‬‫ي‬‫سْئ‬
  • 46. MENAMENA ‫در‬ ‫سالهت‬ ‫ی‬ ٌَ‫ُزي‬ ًَ‫سرا‬ 1,747 855 835 666 499 430 352 222 134 122 107 105 58 58 56 38 19 0 200 400 600 800 1,000 1,200 1,400 1,600 1,800 2,000 OECD ‫اهارات‬ ‫قطر‬ ‫کْيت‬ ‫لبٌاى‬ ‫بحريي‬ ‫عربستاى‬ ‫عواى‬ ‫اردى‬ ‫فلسطيي‬ ‫ايراى‬ ‫تًْس‬ ٍ‫لجزير‬ ‫ا‬ ْ‫هْراک‬ ‫دجيبْتی‬ ‫هصر‬ ‫يوي‬ ‫آهريکا‬ ‫دالر‬ َ‫ب‬ ‫سالهت‬ ٌَ‫ُزي‬ ًَ ‫سرا‬
  • 47. $20 $11 $20 $42 $17 $17 $30 $1,402 $2,125 $2,365 $3,724 $1,322 $2,644 $1,757 ‫ى‬‫وا‬‫ال‬ َ‫س‬ً‫را‬‫ف‬ ‫يا‬‫تال‬‫اي‬ ‫ي‬‫ژاپ‬ ‫كا‬‫ري‬‫اه‬ ‫ا‬‫كاًاد‬ ‫س‬‫ي‬‫سْئ‬ َ ً‫سرا‬ ‫ن‬ ‫ي‬‫ق‬‫ت‬‫س‬ ‫ه‬ ‫ن‬ ِ‫س‬
  • 48. $13 $57 $73 $33 $41 $66 $178$118 $200 $110 $2 $605 ‫ى‬‫را‬‫اي‬ ‫هصر‬ ‫ى‬‫ارد‬ ‫ت‬‫ْي‬‫ك‬ ‫ق‬‫عرا‬ َ‫سْري‬ َ ً‫سرا‬ ‫ن‬ ‫ي‬‫ق‬‫ت‬‫س‬ ‫ه‬ ‫ن‬ ِ‫س‬
  • 49. 0 5,000 ,000 ,000 10 ,000 ,000 ,000 15 ,000 ,000 ,000 20 ,000 ,000 ,000 25 ,000 ,000 ,000 30 ,000 ,000 ,000 35 ,000 ,000 ,000 40 ,000 ,000 ,000 45 ,000 ,000 ,000 50 ,000 ,000 ,000 1360 1361 1362 1363 1364 1365 1366 1367 1368 1369 1370 1371 1372 1373 1374 1375 1376 1377 1378 1379 1380 íÑÇÌ íÚÇãÊÌÇÑæãÇ íäÇÑãÚíÚÇãÊÌÇÑæãÇ íÑÇÌåí ÐÛÊ æäÇãÑÏ ¡ÊÔÇÏåÈáÕÝ íä ÇÑãÚ åí ÐÛÊæäÇãÑÏ¡ÊÔÇÏåÈ áÕÝ
  • 50. - 95 120 130 166 200 221 230 256 280 326 268 253 254 252 245 202 175 167 172 202 298 283 268 266 214 238 325 323 50 55 60 96 95 93 100 117 135 158 195 236 300 351 337 278 320 383 354 406 459 442 335 368 396 358 354 354 140 180 210 262 300 315 345 373 400 484 463 489 560 603 582 480 515 550 526 608 757 725 603 634 610 596 679 677 0 100 200 300 400 500 600 700 800 1350 1351 1352 1353 1354 1355 1356 1357 1358 1359 1360 1361 1362 1363 1364 165 1366 1367 1368 1369 1370 171 1372 1373 1374 1375 1376 1377 ‫ت‬ ‫دّل‬ ‫ش‬ ‫خ‬‫ب‬ ‫اى‬ ‫دره‬ ّ ‫ت‬ ‫ش‬ ‫ذا‬ ِ‫ب‬ ‫اي‬ ُ َ ٌ ‫زي‬ ُ ‫ل‬ ‫ك‬ ‫ي‬‫خصْص‬ ‫ش‬ ‫خ‬‫ب‬ ‫اى‬ ‫دره‬ ّ ‫ت‬ ‫ش‬ ‫ذا‬ ِ‫ب‬ ‫اي‬ ُ َ ٌ ‫زي‬ ُ ‫ل‬ ‫ك‬ ‫ى‬‫ا‬ ‫دره‬ ّ ‫ت‬ ‫ش‬ ‫ذا‬ ِ‫ب‬ ‫اي‬ ُ َ ٌ ‫زي‬ ُ ‫ل‬ ‫ك‬
  • 51. 0 50 100 150 200 250 300 350 400 450 1361 1362 1363 1364 1365 1366 1367 1368 1369 1370 1371 1372 1373 1374 1375 1376 1377 1378 ‫ي‬‫ٌگ‬ ‫ذي‬ ‫ق‬ ً G.D.P ‫اري‬‫ج‬ ‫ت‬ ‫دّل‬ ‫ـ‬ ‫اى‬ ‫دره‬ ّ ‫ت‬ ‫ش‬ ‫ذا‬ ِ‫ب‬ ‫اري‬‫ج‬ ‫اي‬ ُ َ ٌ ‫زي‬ ُ ‫شْر‬ ‫ك‬ ‫ـ‬ ‫اى‬ ‫دره‬ ّ ‫ت‬ ‫ش‬ ‫ذا‬ ِ‫ب‬ ‫اي‬ ُ َ ٌ ‫زي‬ ُ
  • 52. 0 100 200 300 400 500 600 700 800 1338 1340 1342 1344 1346 1348 1350 1352 1354 1356 1358 1360 1362 1364 1366 1368 1370 1372 1374 ‫ت‬ ‫ش‬ ‫ذا‬ ِ‫ب‬ ‫در‬ ‫ْرم‬‫ت‬ ‫ل‬ ‫ك‬ ‫شاخص‬
  • 53. Out of Pocket  - - - - CatastrophicNon-Catastrophic
  • 54. 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Catastrophic NonCatastrophic Drug Dental Outpatient Inpatient Out of Pocket
  • 55. Other Government Incomes Household Income Public Fund Insurance Fund Health Care Facility Health Care Provider Resource Generators Client Foreign Resources Tax Premium Out of Pocket Charities
  • 56. Out of Pocket        
  • 57. 35% 65% 0% 10% 20% 30% 40% 50% 60% 70% Insured UnInsured