UNIT 9 Health
Part 3: Reading the text g9 Task 5: Read the following text.
The quality of public healthcare in many developing 5 10
countries is very poor. What could be done to improve it? The last 20 years have seen enormous improvements in the quality of health provision throughout the world. Much of the credit for this should be given to the Millennium Development Goals – the set of targets established by the United Nations in a range of different social areas – which national governments tried to meet between 2000 and 2015. Millions of people have benefited from these goals. However, huge problems still remain, even despite these achievements. It is not an acceptable state of affairs that an Egyptian child is eight times more likely to die before their fifth birthday than a Norwegian child. Moreover, an Angolan child is an astonishing 50 times more likely not to survive. This essay will look at three major problems, concerning economics, personnel and public health, which mean that these issues remain, even post-2015. It will address each in turn and recommend solutions which could be implemented.
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The major problem with health services in developing countries is economic. There is simply not enough money in the system to support a good service. Many OECD countries invest a large proportion of their GDP in their health services (UNDP, 2014). In Norway, for example, the figure is nearly 10%. In medium- and low-development countries, the figure is much lower – in Angola, less than 4% of government money is spent on health. The solution to this is clear: for things to improve, more money must be directed to this sector. Countries cannot just be ‘spendaholics’ and pump money into the system. It has to be invested in a ‘smart’ way – a targeted way – whereby the maximum benefit can be obtained for the investment. Most health economists (e.g., Blackadder, 2013; Atkinson, 2014) argue that the best ‘rate of return’ for investment is in primary care, but it is often tertiary care which receives any new investment.
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Another major problem, which is linked to this first issue, is the severe lack of qualified general doctors for dealing with routine issues. Since being a doctor is a highly skilled profession, many may go overseas or else might work in private facilities to maximize their income, which means that large parts of the population are left with inadequate or unskilled practitioners. This can be particularly problematic in rural areas. In response to this, governments need to look at how they can encourage skilled medics to stay in their country. Paying higher salaries or providing more benefits could be a way of doing this, although this would obviously require more investment. A second solution would be to make it compulsory for medics to spend some of their time working in the public sector. Von Genschler (2012) suggests that governments in developing countries should make it mandatory for doctors to spend 25% of their working lives doing this kind of work.
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The third problem which will be examined is the poor quality of public health measures, such as improved water sources and better sanitation. In Angola, for example, only around half the population drink clean water and have sufficient toilet facilities (World Bank, 2015). This lack of provision results in illnesses such as diarrhoea, which is particularly serious in young children. A campaign led by a mixture of government and INGOs could help to solve some of these problems, which would also produce financial benefits higher up the system, for secondary and tertiary care. To solve this problem, it is not only better infrastructure that is required, but also better education. As Robinson (2011) identifies, people in poor communities may be sceptical or even suspicious of new interventions. As such, it is crucial that all these new initiatives are accompanied by experts explaining what is going on, and why this is an improvement, rather than simply assuming that people will automatically make the changes.
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In summary, it is clear that there are large parts of the world which still suffer from poor quality healthcare, problems which may be due to geography (e.g., being in a rural area many kilometres from any kind of health provider). Whether the political system is a democracy or a monarchy, or the economic system is one of capitalism or socialism, support has to be provided to developing countries. People without access to healthcare are defenceless, and their freedom is restricted. Without robust health systems, countries go backwards, and it is the duty of the rest of the world to do something about it.
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