After a significant decline in earlier decades, crude [lower-alpha 1] birth rates in Armenia slightly increased from 13.0 (per 1000 people) in the year 1998 to 14.2 in 2015; [1] this timeframe also showed a similar trajectory in the crude death rate, which grew from 8.6 to 9.3. [2] Life expectancy at birth at 74.8 years was the 4th-highest among the Post-Soviet states in 2014. [3]
The Human Rights Measurement Initiative [4] finds that Armenia is fulfilling 74.6% of what it should be fulfilling for the right to health based on its level of income. [5] When looking at the right to health with respect to children, Armenia achieves 97.5% of what is expected based on its current income. In regards to the right to health amongst the adult population, the country achieves 91.3% of what is expected based on the nation's level of income. Armenia falls into the "very bad" category when evaluating the right to reproductive health because the nation is fulfilling only 35.1% of what the nation is expected to achieve based on the resources (income) it has available. [6]
At the time of independence in 1991, no traces of pre-Soviet healthcare traditions were discernible. The Soviet healthcare system was highly centralized. The entire population was guaranteed free medical assistance regardless of social status, and had access to a comprehensive range of secondary and tertiary care options. After independence, Armenia was not in a position to continue to fund it. Following the reform program, all hospitals and polyclinics, rural health units (including village health centers), and health posts from the previous system continued to function. Hospitals which were formerly accountable to the local administration (and ultimately to the Ministry of Health) are now autonomous and increasingly responsible for their own budgets and management. [7]
A Basic Benefits Package was established in 1999. This provided free specific health-care services, including medicines, to vulnerable segments of the population, including children, the elderly and disabled, impoverished people and injured military personnel. Since 2006, primary health care services have been free of charge.
In 2009, more than half of the national health budget was spent on hospitals. At the local community level, the system was weak and in rural areas often non-existent. [8]
Vast improvements of health services in Armenia took place in the 21st century, principally easier accessibility to health-care services and an Open Enrollment program which allows Armenians to freely choose their healthcare service provider. [9]
Health expenditures, as a percentage of government spending were 4th-lowest for the same group in 2008–14, but beat peers in the South Caucasus. [10] Health expenditures in per capita terms (at PPP at constant 2005 USD) were nearly permanently 5th-lowest in the above group in years 1999–2014. [11] Out-of-pocket health expenditures were 4th-highest in the same group in years 2003–06 and 2010–14. [12] In 2014, 4.3% of health expenditures came from sources outside of Armenia. [13]
In 2015, current health expenditures as a percentage of GDP reached 10.1%, while 81.6% of all health spendings were paid out-of-pocket, both values record high since data became available in the year 2000. [14]
Armenian citizens entitled to the Basic Benefits Package receive full coverage with no need to pay fees or subsidized services with the state paying part of the fees but the citizen being obligated to pay for the rest. Most health services are fully private, with the citizen fully responsible for payment. In 2019, healthcare was made free for all citizens under the age of 18. The number of people receiving free or subsidized healthcare under the Basic Benefits Package was also increased, as well as the number of services offered in the program. [15] [16]
In 2023, the Armenian government approved a plan to gradually introduce universal health care. Under the plan, health coverage will be expanded in stages until the entire population is insured in 2027. [17]
Since independence, Armenia's national health system faced criticism because of widespread corruption among doctors and other hospital workers. Because of reduced public funding after the economic collapse of the 1990s, many employees were forced to take bribes and take advantage of their position of power within their workplace in order to make a living. This problem still persists as of today and is one of the main concerns of elected officials. [18]
Certified by the World Health Organization (WHO), Armenia was the first [19] in the European region and as of October 2017 is one of 10 countries worldwide (seven of which are islands) which proved to have eliminated mother-to-child HIV transmission. [20]
In 2010, HIV prevalence was estimated at 0.2% among adults aged 15 to 49. [21]
There have been no recorded cases of poliomyelitis since data became available in the year 2002. [21]
There were no new cases of malaria since the year 2006. [21]
According to WHO data, the infant mortality rate nearly halved from 2002 to 2015. [22] It dropped to 11.3 (0.1%) in 2017, the lowest rate since WHO records began in 1990. [23]
The mortality rate for children aged 5 to 14 ranged from 0.18% to 0.21% in the years 1997-2017. [24]
The probability of dying aged 15–60 was estimated at 11.6% in the year 2016, nearly unchanged since 2000. [25]
According to a 2015-16 survey, [26] 9% of children in Armenia are stunted and of those, 4% are severely stunted, while in 2005-10, 18-19% of children were stunted. The survey also found that 4% of Armenian children are wasted (low weight for height) and 2% severely wasted. The survey also found was that Armenian children tend to be more overweight than stunted due to improper diets. 14% of children under five years of age are overweight. [27]
Undernourishment at 6.3% in 2014 of population remained nearly unchanged since 2007. [28]
In 2017, the obesity rate in Armenia was 19.5%, which is lower than in all regional countries and nearly all European countries. [29] [30]
An anti-smoking law was passed by the Armenian parliament in February 2020. It bans smoking while driving cars or buses and imposes a ban on tobacco advertising. The ban on smoking in cafes, restaurants and other public catering facilities will enter into force in March 2022. The ban on smoking in half-closed premises of public catering facilities will come into force in May 2024. The ban on smoking in hotels came into force in May 2020.
Meanwhile, cannabis in Armenia is currently illegal for all uses.
A health system, health care system or healthcare system is an organization of people, institutions, and resources that delivers health care services to meet the health needs of target populations.
The healthcare delivery system of Pakistan is complex because it includes healthcare subsystems by federal governments and provincial governments competing with formal and informal private sector healthcare systems. Healthcare is delivered mainly through vertically managed disease-specific mechanisms. The different institutions that are responsible for this include: provincial and district health departments, parastatal organizations, social security institutions, non-governmental organizations (NGOs) and private sector. 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's gross national income per capita in 2021 was $4,990 and the total expenditure on health per capita in 2021 was Rs 657.2 Billion, constituting 1.4% of the country's GDP. The health care delivery system in Pakistan consists of public and private sectors. Under the constitution, health is primarily responsibility of the provincial government, except in the federally administered areas. Health care delivery has traditionally been jointly administered by the federal and provincial governments with districts mainly responsible for implementation. Service delivery is being organized through preventive, promotive, curative and rehabilitative services. The curative and rehabilitative services are being provided mainly at the secondary and tertiary care facilities. Preventive and promotive services, on the other hand, are mainly provided through various national programs; and community health workers’ interfacing with the communities through primary healthcare facilities and outreach activities. The state provides healthcare through a three-tiered healthcare delivery system and a range of public health interventions. Some government/ semi government organizations like the armed forces, Sui Gas, WAPDA, Railways, Fauji Foundation, Employees Social Security Institution and NUST provide health service to their employees and their dependants through their own system, however, these collectively cover about 10% of the population. The private health sector constitutes a diverse group of doctors, nurses, pharmacists, traditional healers, drug vendors, as well as laboratory technicians, shopkeepers and unqualified practitioners.
The fundaments of the Brazilian Unified Health System (SUS) were established in the Brazilian Constitution of 1988, under the principles of universality, integrality and equity. It has a decentralized operational and management system, and social participation is present in all administrative levels. The Brazilian health system is a complex composition of public sector (SUS), private health institutions and private insurances. Since the creation of SUS, Brazil has significantly improved in many health indicators, but a lot needs to be done in order to achieve Universal Health Coverage (UHC).
Healthcare in Europe is provided through a wide range of different systems run at individual national levels. Most European countries have a system of tightly regulated, competing private health insurance companies, with government subsidies available for citizens who cannot afford coverage. Many European countries offer their citizens a European Health Insurance Card which, on a reciprocal basis, provides insurance for emergency medical treatment insurance when visiting other participating European countries.
As for many developing countries, health issues in Iran stem from a variety of reasons: namely, water and sanitation, diet and fitness, various addictions, mental fitness, communicable diseases, hygiene and the environment.
Life expectancy has been rising rapidly and South Korea ranked 3rd in the world for life expectancy. South Korea has among the lowest HIV/AIDS adult prevalence rate in the world, with just 0.1% of the population being infected, significantly lower than the U.S. at 0.6%, France's 0.4%, and the UK's 0.3% prevalence rate. South Korea has a good influenza vaccination rate, with a total of 43.5% of the population being vaccinated in 2019. A new measure of expected human capital calculated for 195 countries from 1920 to 2016 and defined for each birth cohort as the expected years lived from age 20 to 64 years and adjusted for educational attainment, learning or education quality, and functional health status was published by the Lancet in September 2018. South Korea had the sixth highest level of expected human capital with 26 health, education, and learning-adjusted expected years lived between age 20 and 64 years.
Although emphasized by the country's ruling Baath Party and improving significantly in recent years, health in Syria has been declining due to the ongoing civil war. The war which has left 60% of the population food insecure and saw the collapse of the Syrian economy, the surging prices of basic needs, the plummeting of the Syrian pound, the destruction of many hospitals nationwide, the deterioration in the functionality of some medical equipment due to the lack of spare parts and maintenance, and shortages of drugs and medical supplies due to sanctions and corruption.
Health in Israel is generally considered good.
Obesity in Canada is a growing health concern, which is "expected to surpass smoking as the leading cause of preventable morbidity and mortality" and represents a burden of Can$3.96 (US$3.04/€2.75) billion on the Canadian economy each year."
The current population of Myanmar is 54.05 million. It was 27.27 million in 1970. The general state of healthcare in Myanmar is poor. The military government of 1962-2011 spent anywhere from 0.5% to 3% of the country's GDP on healthcare. Healthcare in Myanmar is consistently ranked among the lowest in the world. In 2015, in congruence with a new democratic government, a series of healthcare reforms were enacted. In 2017, the reformed government spent 5.2% of GDP on healthcare expenditures. Health indicators have begun to improve as spending continues to increase. Patients continue to pay the majority of healthcare costs out of pocket. Although, out of pocket costs were reduced from 85% to 62% from 2014 to 2015. They continue to drop annually. The global average of healthcare costs paid out of pocket is 32%. Both public and private hospitals are understaffed due to a national shortage of doctors and nurses. Public hospitals lack many of the basic facilities and equipment. WHO consistently ranks Myanmar among the worst nations in healthcare.
According to the World Bank income level classification, Portugal is considered to be a high income country. Its population was of 10,283,822 people, by 1 July 2019. WHO estimates that 21.7% of the population is 65 or more years of age (2018), a proportion that is higher than the estimates for the WHO European Region.
Botswana's healthcare system has been steadily improving and expanding its infrastructure to become more accessible. The country's position as an upper middle-income country has allowed them to make strides in universal healthcare access for much of Botswana's population. The majority of the Botswana's 2.3 million inhabitants now live within five kilometres of a healthcare facility. As a result, the infant mortality and maternal mortality rates have been on a steady decline. The country's improving healthcare infrastructure has also been reflected in an increase of the average life expectancy from birth, with nearly all births occurring in healthcare facilities.
In Kuwait, life expectancy at birth in 2013 was 78 for men and 79 for women.
Examples of health care systems of the world, sorted by continent, are as follows.
Lesotho's Human development index value for 2018 was 0.518—which put the country in the low human development category—positioning it at 164 out of 189 countries and territories. Health care services in Lesotho are delivered primarily by the government and the Christian Health Association of Lesotho. Access to health services is difficult for many people, especially in rural areas. The country's health system is challenged by the relentless increase of the burden of disease brought about by AIDS, and a lack of expertise and human resources. Serious emergencies are often referred to neighbouring South Africa. The largest contribution to mortality in Lesotho are communicable diseases, maternal, perinatal and nutritional conditions.
Health in Malta has seen improvements in recent years, with one of the highest life expectancies in Europe. Malta has a good overall quality of health and has seen rapid growth and improvement in key health indicators. Malta has seen significant development in the practice of mental health which has been supported by new infrastructure and increased government health spending. The introduction of health-focused government initiatives, particularly around nutrition, alcohol, smoking, and health will likely contribute to the further improvement of overall health nationwide.
Health indicators are quantifiable characteristics of a population which researchers use as supporting evidence for describing the health of a population. Typically, researchers will use a survey methodology to gather information about a population sample, use statistics in an attempt to generalize the information collected to the entire population, and then use the statistical analysis to make a statement about the health of the population. Health indicators are often used by governments to guide health care policy or to make goals for improving population health.
This article summarizes healthcare in Texas. In 2022, the United Healthcare Foundation ranked Texas as the 38th healthiest state in the United States. Obesity, excessive drinking, maternal mortality, infant mortality, vaccinations, mental health, and limited access to healthcare are among the major public health issues facing Texas.
Montenegro is a country with an area of 13,812 square kilometres and a population of 620,029, according to the 2011 census. The country is bordered by Croatia, the Adriatic Sea, Bosnia, Herzegovina, Serbia, Kosovo and Albania. The most common health issues faced are non-communicable diseases accounting for 95% of all deaths. This is followed by 4% of mortality due to injury, and 1% due to communicable, maternal, perinatal and nutritional conditions. Other health areas of interest are alcohol consumption, which is the most prevalent disease of addiction within Montenegro and smoking. Montenegro has one of the highest tobacco usage rates across Europe. Life expectancy for men is 74 years, and life expectancy for women is 79.
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