Healthcare by country

Question

This piglix contains articles or sub-piglix about Healthcare by country

Answer 1

Healthcare in Madagascar

Medical centers, dispensaries and hospitals are found throughout the island of Madagascar, although they are concentrated in urban areas and particularly in Antananarivo. Access to medical care remains beyond the reach of many Malagasy.

In addition to the high expense of medical care relative to the average Malagasy income, the prevalence of trained medical professionals remains extremely low. In 2010 Madagascar had an average of three hospital beds per 10,000 people and a total of 3,150 doctors, 5,661 nurses, 385 community health workers, 175 pharmacists and 57 dentists for a population of 22 million. 14.6 percent of government spending in 2008 was directed toward the health sector. Approximately 70% of spending on health was contributed by the government, while 30% originated with international donors and other private sources. The government provides at least one basic health center per commune. Private health centers are concentrated within urban areas and particularly those of the central highlands.

Despite these barriers to access, health services have shown a trend toward improvement over the past twenty years. Child immunizations against such diseases as hepatitis B, diphtheria and measles increased an average of 60% in this period, indicating low but increasing availability of basic medical services and treatments. The Malagasy fertility rate in 2009 was 4.6 children per woman, declining from 6.3 in 1990. Teen pregnancy rates of 14.8% in 2011, much higher than the African average, are a contributing factor to rapid population growth. In 2010 the maternal mortality rate was 440 per 100,000 births, compared to 373.1 in 2008 and 484.4 in 1990, indicating a decline in perinatal care following the 2009 coup. The infant mortality rate in 2011 was 41 per 1,000 births, with an under-five mortality rate at 61 per 1,000 births. Schistosomiasis, malaria and sexually transmitted diseases are common in Madagascar, although infection rates of AIDS remain low relative to many countries in mainland Africa, at only 0.2% of the adult population. The malaria mortality rate is also among the lowest in Africa at 8.5 deaths per 100,000 people, in part due to the highest frequency use of insecticide treated nets in Africa. Adult life expectancy in 2009 was 63 years for men and 67 years for women.

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Answer 2

Healthcare in Kenya

Kenya’s health care system is structured in a step-wise manner so that complicated cases are referred to a higher level. Gaps in the system are filled by private and church run units.

The government runs dispensaries across the country and are the lowest point of contact with the public. These are run and managed by enrolled and registered nurses who are supervised by the nursing officer at the respective health centre. They provide outpatient services for simple ailments such as common cold and flu, uncomplicated malaria and skin conditions. Those patients who cannot be managed by the nurse are referred to the health centres there.

Most private clinics in the community are run by nurses. In 2011 there were 65,000 nurses on their council's register. A smaller number of private clinics, mostly in the urban areas, are run by clinical officers and doctors who numbered 8,600 and 7,100 respectively in 2011. These figures include those who have died or left the profession hence the actual number of workers is lower.

All government health centres have a clinical officer as the in-charge and provide comprehensive primary care. Because of their heavy focus on preventive care such as childhood vaccination, rather than curative services, local council (municipal) and most mission, as well as many private health centres, do not have clinical officers but instead have a nurse as the in-charge.

Health centres are medium-sized units which cater for a population of about 80,000 people. A typical health centre is staffed by:

All the health centre staff report to the clinical officer in-charge except the public health officers and technicians who are deployed to a geographical area rather than to a health unit and report to the district public health officer even though they may have an office at the health centre.

The health centre has the following departments:

These are similar to health centres with addition of a surgery unit for Caeserian section and other procedures. Many are managed by clinical officers. A good number have a medical officer and a wider range of surgical services.

These are owned privately by individuals or churches and offer services roughly similar to those available at a sub-district or district hospital. They are also believed to provide better medical services compared to public hospitals.

Each sub county formally district in the country has a subcounty or district hospital which is the co-ordinating and referral centre for the smaller units. They usually have the resources to provide comprehensive medical and surgical services. They are managed by medical superintendents.

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Answer 3

Healthcare in Malawi

Healthcare in Malawi and its limited resources are inadequate to fully address factors plaguing the population, including infant mortality and the very high burden of diseases, especially HIV/AIDS, malaria and tuberculosis.

Malawi has a three-tier healthcare system in which each level is connected by a patient referral system. However the health system structure exist in publications only where it mirrors national health systems in the West and just whilst just like other systems in Malawi, it does not function. This is largely due to lack of manpower, lack of basic/expert skills set, overpopulation, lack of equipment/technology, corruption, lack of political commitment, lack of sufficient funds, poor prioritisation in budgeting and low motivation among personnel. According to World Heath Organization Report, Malawi health system ranks number 185 out of 190. The figurative picture of the health system can be created by understanding the indicators of a failing system or the mere non existence of the system. There is no emergency systems in place for medical servives, fire service or crime response ( no ambulated paramedic response system ( as in a 112 no 999 service). Where there's need to obtain such services, victims are required to meet the cost. Only the very few privately run hospitals in the two major cities of Blantyre and Lilongwe have very limited non purposely built vehicles serving as basic ambulances used to transport their paying patients mostly without life saving equipment onboard or an on-board paramedic. In April 2012 the then State President suffered a cardiac arrest which resulted to his death due to lack of medication both within the presidential medical team and at the main referral hospital where he was attended to. As of 2016 Malawi has only one qualified cardiologist consultant who is based at a private hospital. Recent survey indicate that, unlike in cases of HIV, Malaria or TB, patients suffering from diseases which require expert clinical skills and equipment i.e. cardio or neural related problems, are likely to receive wrong diagnosis and incorrect treatment or medication resulting to in unnecessarily high mortality rates. There is no provider og aeromedical service within Malawi. Malawi has the lowest ranking on heath system among countries which are not affected by civil wars, however the medical services delivered still rank lower than some war torn countries. There is no national record information system for patients records. Most common medication found in hospital pharmacies in the west are not available locally i.e. treatment for the heart diseases or cancer are unavailable. There is an uncontrolled circulation of internationally banned drugs or out-of-date drugs in flea markets.

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Answer 4

Healthcare in Malaysia

Healthcare in Malaysia is mainly under the responsibility of the government's Ministry of Health. Malaysia generally has an efficient and widespread system of health care, operating a two-tier health care system consisting of both a government-run universal healthcare system and a co-existing private healthcare system. Infant mortality rate – a standard in determining the overall efficiency of healthcare – in 2005 was 10, comparing favourably with the United States and western Europe. Life expectancy at birth in 2005 was 74 years.

Healthcare in Malaysia has undergone radical transformations. Earliest pre-colonial medical care was confined to traditional remedies current among local populations of Malays, Chinese, Indian and other ethnic groups. The advent of colonialism brought western medical practice into the country. Since the country's independence in August 1957, the system of medical care transferred from the British colonial rule has been transformed to meet the needs of emerging diseases, as well as national political requirements.

Malaysia has a widespread system of health care. It implements a universal healthcare system, which exists along the private healthcare system. Infant mortality rate, a standard in determining the overall efficiency of healthcare, in 2005 was 10, comparing favourably with the United States and Western Europe. Life expectancy at birth in 2005 was 74 years. Infant mortality fell from 75 per 1000 live births in 1957 to 7 in 2013.

Healthcare in Malaysia is divided into private and public sectors. Public provision is rather basic, especially in rural areas. The government produced a plan, 1Care for 1Malaysia, in 2009, with the intention of reform based on the principle ‘use according to need, pay according to ability’, but little progress towards its implementation has been made. Malaysian society places importance on the expansion and development of healthcare, putting 5% of the government social sector development budget into public healthcare, an increase of more than 47% over the previous figure. This has meant an overall increase of more than RM 2 billion. With a rising and ageing population, the Government wishes to improve in many areas including the refurbishment of existing hospitals, building and equipping new hospitals, expansion of the number of polyclinics, and improvements in training and expansion of telehealth. Over the last couple of years, they have increased their efforts to overhaul the systems and attract more foreign investment.

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Answer 5

Healthcare in Malta

Malta has a long history of providing publicly funded health care. The first hospital recorded in the country was already functioning by 1372. Today, Malta has both a public healthcare system, known as the government healthcare service, where healthcare is free at the point of delivery, and a private healthcare system. Malta has a strong general practitioner-delivered primary care base and the public hospitals provide secondary and tertiary care. The Maltese Ministry of Health advises foreign residents to take out private medical insurance.

In 2000, Malta was ranked number five in the World Health Organization's ranking of the world's health systems, compared to the United States (at 37), Australia (at 32), United Kingdom (at 18) and Canada (at 30). The healthcare system in Malta closely resembles the British system, as healthcare is free at the point of delivery.

It moved up four places in the Euro health consumer index from position 27 in 2014 to 23 in 2015. It was said to have decent accessibility to healthcare, but indifferent treatment results.

The Mater Dei Hospital, Malta's primary hospital, opened in 2007. It has one of the largest medical buildings in Europe.

The University of Malta has a medical school and a Faculty of Health Sciences, the latter offering diploma, degree (BSc) and postgraduate degree courses in a number of health care disciplines.

Malta also has voluntary organisations such as Alpha Medical (Advanced Care), the Emergency Fire & Rescue Unit (E.F.R.U.), St John Ambulance and Red Cross Malta who provide first aid/nursing services during events involving crowds.

The Medical Association of Malta represents practitioners of the medical profession. The Malta Medical Students' Association (MMSA) is a separate body representing Maltese medical students, and is a member of EMSA and IFMSA. MIME, the Maltese Institute for Medical Education, is an institute set up recently to provide CME to physicians in Malta as well as medical students. The Foundation Program followed in the UK has been introduced in Malta to stem the 'brain drain' of newly graduated physicians to the British Isles. The Malta Association of Dental Students (MADS) is a student association set up to promote the rights of Dental Surgery Students studying within the faculty of Dental Surgery of the University of Malta. It is affiliated with IADS, the International Association of Dental Students.

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Answer 6

Healthcare in Mexico

Healthcare in Mexico is provided via public institutions, private entities, or private physicians. Healthcare delivered through private organizations operates entirely on the free-market system, i.e., it is available to those who can afford it. This is also the case of healthcare obtained from private physicians at their private office or clinic. Public healthcare delivery, on the other hand, is accomplished via an elaborate provisioning and delivery system put in place by the Mexican Federal Government. In 2012, Mexico instituted universal healthcare. As of December 31, 2013, there were 4,466 hospitals in Mexico.

Hospitals were established in Mexico in the early sixteenth century, including ones exclusively for Indians. Some were established by the crown, others by private endowment, but most by the Catholic Church. Bishop Vasco de Quiroga established hospital complexes in Michoacan in the sixteenth century. In Mexico City, conqueror Hernán Cortés established the Hospital de Jesús Nazareno for Indians, which still functions as a hospital. The Hospicio Cabañas in Guadalajara, Jalisco, Mexico, was founded in 1791. The institution, still functioning, is now a World Heritage Site. It is one of the oldest and largest hospital complexes in Latin America. The complex was founded by the Bishop of Guadalajara to combine the functions of a workhouse, hospital, orphanage, and almshouse.

The Mexican healthcare program IMSS was founded in 1943 during the presidency of Manuel Avila Camacho. In the early 1990s, Mexico showed clear signs of having entered a transitional stage in the health of its population. When compared with 1940 or even 1970, Mexico in the 1990s exhibited mortality patterns that more closely approximated those found in developed societies. By 2009, during the notorious swine flu pandemic, the World Health Organization director said that Mexico "gave the world a model of rapid and transparent reporting, aggressive control measures, and generous sharing of data and samples". The CDC's flu director Nancy Cox, added that Mexico's response "impressed the entire world".

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Answer 7

Healthcare in Norway

In Norway, all hospitals are funded by the public as part of the national budget. However, while medical treatment is free of charge for any person younger than the age of sixteen, residents who have reached adulthood must pay a deductible each year before becoming eligible for an exemption card. The card entitles one to free healthcare for the remainder of that year.

All public hospitals in Norway are run by four Regional Health Authorities (RHA) overseen by the Ministry of Health and Care Services. In addition to these public hospitals, there are a small number of privately owned health clinics currently operating.

Expenditure on healthcare is about US$9715 per head per year, the highest in the world. It has the highest proportion of nurses and midwives per head in Europe - 1744 per 100,000 in 2015.

While the availability of public healthcare is universal in Norway, there are certain payment stipulations.

Children aged sixteen or younger, and pregnant and/or nursing women are given free healthcare regardless of the coverage they may have had in previous situations. All citizens are otherwise responsible for the annual deductible - which averages around 2040 Norwegian krone. Norway’s health system also does not cover specialized care for those above 16 years of age, and anyone needing treatment such as specialized physiotherapy is required to pay an additional deductible. While health appointments themselves are encompassed by the deductible, extra materials and medical equipment are often covered by the patient.

In terms of emergency room admission, all immediate healthcare costs are covered. In the case that hospitals in Norway are unable to treat a patient, then treatment abroad is arranged free of charge.

Norway does not produce the bulk of pharmaceuticals consumed domestically, and imports the majority that are used in its health system. This has resulted in most residents having to pay full price for any prescription. Pharmaceutical exporting is overseen by the Ministry of Health and Care Services. Insurance coverage for medicine imported from outside the country is managed through the Norwegian Health Economics Administration (HELFO). −gl6j

Norway has four designated Regional Health Authorities. They are: Northern Norway Regional Health Authority, Central Norway Regional Health Authority, Western Norway Regional Health Authority, and Southern and Eastern Norway Regional Health Authority. According to the Patients' Rights Act, all eligible persons have the right to a choice in hospitals when receiving treatment.

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Answer 8

Health care in the Palestinian territories

Healthcare in the Palestinian territories refers to the governmental and private healthcare providers to which residents in the Palestinian region have access. Since 1967, there have been improvements in the access to healthcare and the overall general health conditions for residents in that region. Advances in training, increased access to state-of-the-art medical technology, and various governmental provisions have allowed per-capita funding to increase, and therefore the overall health of residents in the region to increase. Additionally, the enhanced access to and funding from international organizations like the World Health Organization, the United Nations, the Palestinian Ministry of Health, and the World Bank Education and Health Rehabilitation Project have contributed to the current state of affairs within the healthcare segment of the Palestinian territories. However, while many efforts at enhancing the state of health affairs within the Palestinian territories have shown improvement, there are still efforts to be made. Continued efforts to recognize and address the geopolitical barriers will be necessary in order to continue to have significant success in this field. Finally, addressing demographic trends within the region, like differing pregnancy rates and mortality rates, will be necessary to enhance the state of health affairs that the Palestinian territories face. This article addresses each of these issues in more explanatory detail, giving an overview of the major legal and ethical developments in healthcare within the Palestinian territories, and discussing further obstacles that the region faces due to infrastructural and political barriers.

Between 1993 and 1995, the State of Israel and the Palestine Liberation Organization (PLO) reached a series of pacts collectively known as the Oslo Accords. The accords were facilitated by the international community, led by the United States and the Russian Federation. Significantly, the pacts set a timeline for the final status negotiations of the occupied Palestinian territories (Gaza and the West Bank) and established an autonomous Palestinian National Authority (PNA) that could administrate the occupied territories during the ensuing interim period. Hence, a "phased" peace process was set in motion wherein the Palestinians would have an interim governmental body (the PNA) until such a time as "final status" negotiations would establish an official Palestinian state as part of a two state solution. The accords transferred jurisdiction over Palestinians living in the Gaza Strip and the West Bank from Israel to the PNA, whose charter calls for the creation of a democratically elected Legislative Council that could write laws pertaining to the economic, security, educational and health care needs of Gaza and West Bank Palestinians. Meanwhile, the Palestinian refugees residing in Jordan, Lebanon and Syria remained under the auspices of United Nations Relief and Works Agency for Palestine Refugees (UNRWA), pending a final agreement to determine their status. Historically, after their initial displacement, the United Nations (UN) created an ad hoc agency to service the needs of Palestinian refugees rather than placing them under the care of the United Nations High Commissioner for Refugees (UNHCR). Thus, the accords maintained the status quo for the refugees living in Lebanon, Jordan and Syria as they have been under UNRWA protection since 1949.

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Answer 9

Healthcare in Pakistan

Healthcare in Pakistan is administered mainly in the private sector which accounts for approximately 80% of all outpatient visits. The public sector was until recently led by the Ministry of Health, however the Ministry was abolished in June 2011 and all health responsibilities (mainly planning and fund allocation) were devolved to provincial Health Departments which had until now been the main implementers of public sector health programs. Like other South Asian countries, health and sanitation infrastructure is adequate in urban areas but is generally poor in rural areas.

Pakistan's health care delivery system includes both state and non-state; and profit and not for profit service provision. The provincial and district health departments, para-statal organizations, social security institutions, non-governmental organizations (NGOs) and private sector finance and provide services mostly through vertically managed disease-specific mechanisms. The country’s health sector is also marked by urban-rural disparities in healthcare delivery and an imbalance in the health workforce, with insufficient health managers, nurses, paramedics and skilled birth attendants in the peripheral areas.

Pakistan per capita income (PPP current international $, 2013) is 5,041 and the total expenditure on health per capita (intl $, 2014) is 129 which is only 2.6% of GDP (2014)

Cancer information on Pakistan Approximately one in every 9 Pakistani women is likely to suffer from breast cancer which is one of the highest incidence rates in Asia.

Major cancer centers in Pakistan include the Shaukat Khanum Cancer Hospital & Research Center in Lahore and Peshawar, Aga Khan University Hospital in Karachi and the National Institute of Blood Diseases (NIBD) in Karachi.

Among Asian countries, Pakistan has the highest rates of breast and ovarian cancer. The genetic findings show that BRCA mutation (BRCA1 and BRCA2) mutations account for a substantial proportion of hereditary breast/ovarian cancer and early-onset breast and ovarian cancer cases in Pakistan.Breast cancer is the most common cancer in Pakistan as different studies show it kills nearly 40,000 women every year. According to World Health Organization (WHO), breast cancer rates are getting worse and it is not sparing even younger age group.

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Answer 10

Health care in New Zealand

The health care system of New Zealand has undergone significant changes throughout the past several decades. From an essentially fully public system in the early 20th century, reforms have introduced market and health insurance elements primarily in the last three decades, creating a mixed public-private system for delivering healthcare.

In 2012, New Zealand spent 8.7% of GDP on health care, or US$3,929 per capita. Of that, approximately 77% was government expenditure. In a 2010 study, New Zealand came last in a study for the level of medications use in 14 developed countries (i.e. used least medicines overall), and also spent the lowest amount on healthcare amongst the same list of countries, with US$2510 ($3460) per capita, compared to the United States at US$7290.

The Ministry of Health is responsible for the oversight and funding of the twenty District Health Boards (DHBs). These are responsible for organizing healthcare in the district and meeting the standards set by the Ministry of Health. Twenty-one DHBs came into being on January 1, 2001 with Southland and Otago DHBs merging into Southern DHB on 1 May 2010.

The boards for each DHB are elected in elections held every three years, with the exception of one of the eight board members, who is appointed by the Ministry of Health.

The DHBs oversee the forty six Primary Health Organizations established throughout the country. These were first set up in July, 2002, with a mandate to focus on the health of communities. Originally there were 81 of these, but this has been reduced down to 46 in 2008. They are funded by DHBs, and are required to be entirely non-profit, democratic bodies that are responsive to their communities' needs. Almost all New Zealanders are enrolled in a PHO, as there are financial incentives for the patients to become enrolled.

The Northern Region DHBs also use shared services provided by the Northern DHB Support Agency and HealthAlliance. These services deliver region wide health initiatives and shared IT services and logistics.

The Canterbury District health board has been successful in redesigning services to reduce hospital use. Some of this transformation was precipitated by the 2011 Christchurch earthquake when several healthcare buildings were damaged or destroyed. It now has lower rates of acute medical admissions, low rates of average length of stay, fewer readmissions in acute care, fewer cancelled planned admissions and more conditions treated out of hospital.

Hospital and specialist care in New Zealand is totally covered by the government if the patient is referred by a general or family practitioner and this is funded from government expenditure (approx. 77%). Private payment by individuals also plays an important role in the overall system although the cost of these payments are comparatively minor. Those earning less than certain amounts, depending on the number of dependents in their household, can qualify for a Community Services Card (CSC). This reduces the cost of after-hours doctors' visits, and prescription fees, but no longer reduces the cost of visits to a person's regular doctor.

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