Health System in developed and developing countries

1. Dr Arvind Dhiman JR-3
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2. 1.Health system.
2.Method to evaluate health systems.
3.Hurdels for poor health system in developing
countries.
4.Features of health system in Developed countries.
5.Recommendations
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3. 3

4. A health system, also sometimes referred to
as health care system or healthcare system, is the
organization of people, institutions, and resources that
deliver health care services to meet the health needs of
target populations.
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5. Concepts-Health and Disease
Ideas- Equity, Coverage, effectiveness ,efficiency
and impact.
Objects-Hospitals, Health Centers and health
programs.
Persons-Providers and consumers
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6. 6

7. Life Expectancy at Birth
IMR
Under 5 mortality
Maternal Mortality
Doctor Population Ratio
Nurse population ratio
GNI per capita
Per capita public expenditure on Health
Adult Literacy rate
Access to safe water % population.
Access to adequate sanitation percent population.
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8.  1 France
 2 Italy
 3 San Marino
 4 Andorra
 5 Malta
 6 Singapore
 7 Spain
 8 Oman
 9 Austria
 10 Japan
 112 India
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9. Government of concerned country is responsible to
provide better health care for people.
High quality health care -Partnerships among federal
state, local governments and the private sector
Central role is to control costs, increase access and
improve quality
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10. Type of Political
System
Developed Developing
Democracy USA India
Autocracy Cuba Vietnam
Monarchy JAPAN Bhutan
Socialistic Norway Poland
Oligarchy Saudi Arab South Africa
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11. 11

12. Country Life
Expectancy
at Birth
Per capita
health
expenditure
Access to
Improved
Water %
population
Access to
Sanitation
%age
population
USA 78.88 9146 US
Dollar
100% 100%
CUBA 81 603 94 93
JAPAN 86 3966 100 100
POLAND 81 895 100 100
SAUDI ARAB 77 808 97 100
INDIA 68 61 93 36
ETHOPIA 65 25 52 24
BHUTAN 68 90 98 47
TANZANIA 61 49 53 12
SOUTH
AFRICA
59 593 95 74 12

13. Country IMR Doctor Population
ratio
Deaths due to
Diabetes per Lakh
USA 6/1000 live births 2.5/1000 15.2/100000
CUBA 5 6.7 14.2
JAPAN 2 2.3 4.5
POLAND 5 2.2 11.1
SAUDI ARAB 13 2.5 22
INDIA 41 0.7 23.8
ETHOPIA 44 0.1 62
BHUTAN 30 0.3 22.3
TANZANIA 38 0.2 53
SOUTH AFRICA 33 0.8 66.7
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14. Wide gap in health sector between Rural and Urban areas.
High out of pocket expenditure.
Claim free public health care but is insufficient.
Selective insurance cover in developing countries.
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15. Brain Drain (Experts go to developed countries to peruse their
profession having good wages)
Popularity of Village doctors (Quakes).
Religious reasons – 30 FHW killed in Peshawar(Pak) and Bill
for willful family planning in Iran.
Lack of Commitment at political,Adminstration and at Public
level.
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16. Corruption-10% and 25% of global spend on public
procurement of health is lost through corruption
Preventive care is at Early stages in developing world.
In developing countries, about 80% of illnesses are linked to
poor water and sanitation conditions.
.
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17. Non communicable Diseases in Developing Countries
Emerging As a Global Health Crisis
In 2013 alone, NCDs killed eight million people before their
sixtieth birthdays in developing countries.
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18. Population growth .
Fertility rate ranges from between three and seven children per
woman.
Sanitation –Out of I billion people in World who has no toilets,
India account for 600 Million.
900 million smokers in Developing countries-Smoking cause
fatal and disabling diseases.
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19. In 2010 2 million people died due to IHD
Lack of efficient Disaster preparedness.
In Nepal earthquake- 9,000 people killed and 23,000 injured.
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20. Universal Health insurance Ex. Japan (life expectancy 86 and
IMR 2/1000)
Focus on Preventive health care like Cuba.
Clinical research oriented Health System.USA is on the top in
clinical research.
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21. Compulsory health checkup for immigrants
No Insurance in Italy, government covers most of their
medical bills, and has low spending.
No Social differentiation in public and Private health facilities.
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22. Every body is covered automatically at birth.
Health coverage stays with person entire life in Canadian
health system.
Technological breakthroughs have occurred in treating
numerous diseases.
Strong awareness programs-Quit rate of Tobacco increased in
US,UK and Brazil etc.
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23. Preparedness for disaster is better in developed world.
Japan and Chile minimized the loss of life and damage due to
Earth quakes and Tsunami.
Sharp decline in fertility in the developed countries near 1.2 to
1.3.
In Europe Deaths may increase for birth by 2025.
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24. Robust financing mechanism.
Well trained and adequately paid workforce.
Reliable information in order to make decisions and
policies.
Well maintained facilities and logistics to deliver
medicine and technologies.
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25. More spending is required on Primary care to:
Enhance access to healthcare services
Better health outcomes
Decrease in hospitalization visits
Use of emergency department visits.
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26. Incentive to draw health care practitioners into rural services.
Public private partnership in Health sector.
Sanitation in Developing countries- Building lavatories but
also changing habits
Promotion of Preventive Health – Preventable diseases and
cost effective.
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28.  1.Health care spending around the world[Internet].Accessed on
22/07/2015.Available
from:http://www.theguardian.com/news/datablog/2012/jun/30/healthcare-spending-
world-country.
 2.National Health Mission[Internet].Accessed on 24/07/2014.Available
from:http://nrhm.gov.in/nhm.html
 3. WHO validates elimination of mother-to-child transmission of HIV and syphilis
in Cuba[WHO validates elimination of mother-to-child transmission of HIV and
syphilis in Cuba [Internet].Accessed on 21/07/2015.Available from
http://www.who.int/mediacentre/news/releases/2015/mtct-hiv-cuba/en/
4.Oxford Text book of Public Health.5th Edition.
5.Maxy-Rosenau-LastPublic Health and Preventive Medicine.15th Edition
6..Top 10 socialistic countries in world .Available from
http://blog.peerform.com/top-ten-most-socialist-countries-in-the-world/ .Accessed
on 23/07/2015.
7.World life expectancy.com
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