Foundation For Social Health

Health Concerns:- Global Overview

In most countries, the poor account for a larger share of the incidence of communicable diseases and child deaths than their respective share in the population. Most of the malnourished children come from poor background. Poor are less resistant to waterborne diseases because they are not getting potable drinking water. Health inequalities are rampant in most parts of the developing countries of Asia, Africa and Latin America. These inequalities can be conveniently grouped under the following three issues:

The poor often live in regions that are inadequately covered by public health facilities which lack drugs and professionals. Governments spend less than one percent of GDP for providing primary care to the poor. Per capita public health expenditure is pitiably low at less than ten dollars per year.

There are a lot of theoretical arguments to support the introduction of user charges in government hospitals so as to improve public health care system. Payments for health care can take away a higher share of the disposable income of the poor. This naturally makes them to seek more loans to fill the income gap. In Vietnam, a single hospital visit costs 40% of monthly income of people in the poorest 20% of the population. This implies that high levels of household health spending pushed three million people to abject poverty (HDR, 2005, 63).

Empirical studies have indicated that user charges though simple to operate, result in undesirable consequences on the poor. (Loewenson R, 1993; Moses S.F. Manji, et al, 1992). This makes us to argue that the user fees have to be removed to increase equity in health delivery. When Uganda did that in 2001, the poorest 20% of the population utilized more public health facilities (HDR, 2005, 62).

It has been observed that in certain countries like India, even where public health services are not properly used by poor people. This is because of the large scale absenteeism of health service providers in the government hospitals and also due to the poor quality of medicines/services provided. In Sub-Saharan Africa, the health workers in public clinics often sell the drugs allotted to them on ghost prescriptions. Public health workers feel that they are not accountable to any body as they are government officials.

Apart from these issues, it is possible to identify several health related problems that warrant the attention of health activists/officials. In an excellent down to earth exposition Angela Marcia shows us how “ the drug companies put most of their efforts in to turning out higher priced versions of existing medicines and persuading us to take more and more of them”. She also argues that the drug industry uses its immense wealth and power to clear all obstacles to succeed (Marcia A, 2004).