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Wednesday 26th October 2016

Health inequalities warning

16th October 2008

The United Nations health agency has warned of growing inequalities in healthcare between the world's richest and poorest countries leading to insecurity.


In its World Health Report 2008, the World Health Organisation (WHO) warns that inequalities in health outcomes and access to care are much greater today than they were in 1978.

In far too many cases, people who are well-off and generally healthier have the best access to the best care, while the poor are left to fend for themselves, the agency said in a statement on its website.

It said healthcare was often delivered according to a model that concentrates on diseases, high technology, and specialist care, with health viewed as a product of biomedical interventions and the power of prevention largely ignored.

WHO Director Margaret Chan warned that unequal healthcare provision could lead to global insecurity.

Speaking at the launch of the agency's World Health Report 2008, 30 years after the Alma-Ata International Conference put primary care at the top of international policy agenda, Chan urged governments to take a closer look at inefficiencies and uneven care.

The report aims to set out ways in which governments can move to address the problems.

The study highlights striking inequalities around the availability of healthcare in countries across the world, and shows that the amount of money paid for healthcare worldwide varies greatly.

WHO said life expectancy can vary from country to country by as much as 40 years.

Less than half of the women giving birth this year will receive the assistance of a doctor during childbirth, it added.

Governments, the report said, spend anything from US$20 per person per annum to well over US$6,000.

Most people in poorer countries pay for their own healthcare. In both richer and poorer countries, these personal expenditures push more than 100 million people below the poverty line every year.

The study also found that individual cities and countries vary in terms of the availability of healthcare.

For example, the mortality rate in Nairobi is below 15 per 1,000 in high-income areas, and more than 15 times higher in a slum in the same city.

UNICEF Executive Director Ann Veneman said high maternal, infant, and under-five mortality often indicated lack of access to services like clean water and immunisation programmes.

The report indicates that health care systems across the globe threaten social stability when they are distracted from providing for the impoverished and marginalised.

Primary healthcare is an approach to healthcare formally launched 30 years ago. The study found that poorer countries allocating their funds around its principles provide a higher level of healthcare than do others in the same economic bracket.

Primary healthcare encourage less focus on the eradication of individual diseases and more focus on basic infrastructures and services.

Specialists may perform tasks that are better managed by general practitioners, family doctors, or nurses. This contributes to inefficiency, restricts access, and deprives patients of opportunities for comprehensive care. When health is skewed towards specialist care, a broad menu of protective and preventive interventions tends to be lost, WHO said.

WHO estimates that better use of existing preventive measures could reduce the global burden of disease by as much as 70%.


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