WHO checks the pulse of world, finds primary healthcare lacking

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Despite measures taken by governments to improve public healthcare facilities, the World Health Report 2008 has found striking inequalities within as well as between countries in healthcare access, costs and outcomes. To fix these symptoms, the report has called upon countries to build up political will and re-orient their focus on primary health care (PHC), a holistic approach to health care formally launched 30 years ago.

In fact, as an example of ambitious PHC-focussed reforms, the report released by the World Health Organisation (WHO) on Tuesday, has cited India ‘s case. “The country’s health missions introduced in rural and urban areas have also been accompanied by a doubling of public expenditure on the health sector,” it points out.

‘When countries at the same level of economic development are compared, those where health care is organised around the tenets of PHC produce a higher level of heath for the same investment. Such lessons take on critical importance at a time of global financial crisis,’ the report states.

In 1978, about two thirds of the world’s population lived in countries that went on to experience increases in life expectancy at birth and considerable economic growth. The most impressive relative gains were in a number of low-income countries in Asia, including India , Latin America and northern Africa . These countries, whose population has gone up from 1.1 billion in 1978 to nearly 2 billion today, have seen life expectancy at birth increase by 12 years while GDP per capita has increased 2.6 times.

But differences in life expectancy between the richest and poorest countries now exceed about 40 years. Life expectancy at birth was less than 60 years towards the end of 1970s which has now surpassed 74 years. Of the estimated 136 million women who will give birth this year, around 58 million are not going to receive any medical help during childbirth and the postpartum period, endangering their lives and that of their infants.

Globally, annual government expenditure on health varies from as little as 20 dollars per person to anything over 6000 dollar. For 5.6 billion people in low—and middle-income countries, more than half of all health care expenditure is through out-of-pocket payments. With costs of health care rising and systems for financial protection in disarray, personal expenditures on health now push more than 100 million people below the poverty line each year.