Modern Mongolia inherited a relatively good healthcare system from its socialist period, a world bank report from 2007 notes "despite its low per capita income, Mongolia has relatively strong health indicators; a reflection of the important health gains achieved during the socialist period." On average Mongolia's infant mortality rate is less than half of that of similarly economically developed countries, its under-five mortality rate and life expectancy are all better on average than other nations with similar GDP per capita. [1]
Since 1990, key health indicators in Mongolia like life expectancy and infant and child mortality have steadily improved, both due to social changes and to improvement in the health sector. Echinococcosis was one of the commonest surgical diagnoses in the 1960s, but now has been greatly reduced. [2] Yet, adult health deteriorated during the 1990s and the first decade of the 21st century and mortality rates increased significantly. [3] Smallpox, typhus, plague, poliomyelitis, and diphtheria were eradicated by 1981. The Mongolian Red Cross Society focuses on preventive work. The Confederation of Mongolian Trade Unions established a network of sanatoriums. [4]
Serious problems remain, especially in the countryside. [5] According to a 2011 study by the World Health Organization, Mongolia's capital city, Ulaanbaatar, has the second highest level of fine particle pollution of any city in the world. [6] Poor air quality is also the largest occupational hazard, as over two-thirds of occupational disease in Mongolia is dust induced chronic bronchitis or pneumoconiosis. [7]
Average childbirth (fertility rate) is around 2.25 [8] –1.87 [9] per woman (2007) and average life expectancy is 68.5 years (2011). [10] Infant mortality is at 1.9% [11] to 4% [12] and child mortality is at 4.3%. [13]
Mongolia has the highest rate of liver cancer in the world by a significant margin. [14]
The Human Rights Measurement Initiative [15] finds that Mongolia is fulfilling 78.7% of what it should be fulfilling for the right to health based on its level of income. [16] When looking at the right to health with respect to children, Mongolia achieves 96.2% of what is expected based on its current income. [16] In regards to the right to health amongst the adult population, the country achieves only 79.2% of what is expected based on the nation's level of income. [16] Mongolia falls into the "very bad" category when evaluating the right to reproductive health because the nation is fulfilling only 60.8% of what the nation is expected to achieve based on the resources (income) it has available. [16]
Before the 1920s Mongolia had no medical services aside from what was provided by the Lama's. [17] [18] Healthcare in Mongolia was developed from 1922 under the Soviet Semashko model with a large hospital and clinical network. This needed a large supply of clinically trained staff, which was not forthcoming. The isolation of the country meant that developments in medicine were slow to reach it. The ratio of doctors to the general population increased dramatically, so that in 1990, there were more than 6,000 physicians, three-quarters of whom were women.The medical care system was accessible at little or no cost even in the most remote areas. State-sponsored maternity rest homes for pastoral women in the last stages of pregnancy helped to lower infant mortality from 109 per 1,000 live births in 1960 to 57.4 in 1990, and maternal mortality by about 25 percent from 1960 to 1990. [18] As recently as 2000 there were only 106 anaesthetists in the country. [19]
The Ministry of Health is responsible for the provision of Public healthcare under the Citizen's Health Insurance Law. Citizens are legally required to register and have annual check-ups. Finance is through the Health Insurance Fund established in 1994. Patients are required to make copayments of 10% for secondary care and 15% for tertiary care. in 2009 out-of-pocket payments made up 49% of total health expenditure.
Until the end of the 19th century, medical services were provided by Buddhist monks who practised traditional medicine and knew Chinese, Tibetan, and Indian remedies. [2]
Mongolian traditional medicine was repressed after 1922 but is now recognized. The Institute of Traditional Medicine was established in 1961, and the Institute of Natural Compounds in 1973. The National Specialized Hospital caters for traditional medicine patients and has 100 beds. It sees 40-50 outpatients daily. In 2006 about 5% of all hospital in-patients were treated by traditional medicine. In 2012 there were 82 private traditional medicine clinics, 63 of them in Ulaanbaatar. Since 1990 the Mongolian National University of Medical Sciences has had a Traditional Medicine Faculty. In 2007 there were 1,538 doctors trained in traditional medicine. [20]
Mongolia had the highest consumption of antibiotics of any country in the world in 2015 with a rate of 64.4 defined daily doses per 1,000 inhabitants per day. [21]
A hierarchy of clinics and hospitals was established in the 1980s. A somon medical station, with a doctor, then an inter-somon hospital, covering a wider area and above that an aymag general hospital covering an area of about a 200-kilometre radius. An Aymag hospital would have more than 100 beds. A somon hospital has 10 to 20 beds and 1 or 2 general practitioners. There were 4,600 physicians in the country in 1985, 24.8 per 10,000 people. About half of them were in Ulaanbaatar where there was an oncology centre and a 600-bed isolation hospital for infectious diseases. There were about 8,500 nurses and 3,800 physician's assistants. In 1986 there were 112 hospitals. [4] The Health Insurance Fund will not pay for people who go directly to hospitals without a referral.
The health sector comprises 17 specialized hospitals and centers, 4 regional diagnostic and treatment centers, 9 district and 21 aimag general hospitals, 323 soum hospitals, 18 feldsher posts, 233 family group practices, 536 private hospitals, and 57 drug supply companies/pharmacies. In 2002, the total number of health workers was 33,273, of whom 6823 were doctors, 788 pharmacists, 7802 nurses, and 14,091 mid-level personnel. At present, there are 27.7 physicians and 75.7 hospital beds per 10,000 inhabitants.
The Mongolian armed forces run a Hospital Unit in Darfur with 68 personnel, 34 men and 34 women, which provides health care, emergency resuscitation and stabilization, surgical interventions, and basic dental care for UN personnel. It administers vaccinations and other preventive measures. It has also treated more than 10,000 people from the local communities. [22]
There has been a reduction in the number of public hospitals since 1998. The number of private hospitals (mostly very small) and clinics has increased from 683 in 2005 to 1184 in 2011.
Source: [23]
132 items are included on the Essential Drugs List. If they are prescribed in the public health system pharmacies are reimbursed for 50-80% of the price, which is controlled. Medication is not always available in rural areas. There are 5 traditional medicine manufacturing units and they produce more than 200 types of traditional medicine. The total value in 2009 was US$1.4 million. 30 traditional products have been registered and some are included on the Essential Drugs List. [26]
The health care system in Japan provides different types of services, including screening examinations, prenatal care and infectious disease control, with the patient accepting responsibility for 30% of these costs while the government pays the remaining 70%. Payment for personal medical services is offered by a universal health care insurance system that provides relative equality of access, with fees set by a government committee. All residents of Japan are required by the law to have health insurance coverage. People without insurance from employers can participate in a national health insurance program, administered by local governments. Patients are free to select physicians or facilities of their choice and cannot be denied coverage. Hospitals, by law, must be run as non-profits and be managed by physicians.
Health in Cuba refers to the overall health of the population of Cuba. Like the rest of the Cuban economy, Cuban medical care suffered following the end of Soviet subsidies in 1991; the stepping up of the US embargo against Cuba at this time also had an effect.
Health in the Comoros continues to face public health problems characteristic of developing countries. After Comoros's independence in 1975, the French withdrew their medical teams, leaving the three islands' already rudimentary health care system in a state of severe crisis. French assistance was eventually resumed, and other nations also contributed medical assistance to the young republic.
Healthcare in Russia is provided by the state through the Federal Compulsory Medical Insurance Fund, and regulated through the Ministry of Health. The Constitution of the Russian Federation has provided all citizens the right to free healthcare since 1993. In 2008, 621,000 doctors and 1.3 million nurses were employed in Russian healthcare. The number of doctors per 10,000 people was 43.8, but only 12.1 in rural areas. The number of general practitioners as a share of the total number of doctors was 1.26 percent. There are about 9.3 beds per thousand population—nearly double the OECD average.
Healthcare in Taiwan is administered by the Ministry of Health and Welfare of the Executive Yuan. As with other developed economies, Taiwanese people are well-nourished but face such health problems as chronic obesity and heart disease. In 2002 Taiwan had nearly 1.6 physicians and 5.9 hospital beds per 1,000 population. In 2002, there were 36 hospitals and 2,601 clinics in the country. Per capita health expenditures totaled US$752 in 2000. Health expenditures constituted 5.8 percent of the gross domestic product (GDP) in 2001 ; 64.9 percent of the expenditures were from public funds. Overall life expectancy in 2019 was averaged at 81 years.
Healthcare in Laos is provided by both the private and public sector. It is limited in comparison with other countries. Western medical care is available in some locations, but remote areas and ethnic groups are underserved. Public spending on healthcare is low compared with neighbouring countries. Still, progress has been made since Laos joined the World Health Organization in 1950: life expectancy at birth rose to 66 years by 2015; malaria deaths and tuberculosis prevalence have plunged; and the maternal mortality ratio (MMR) has declined by 75 percent.
In precolonial Ghana, infectious diseases were the main cause of morbidity and mortality. The modern history of health in Ghana was heavily influenced by international actors such as Christian missionaries, European colonists, the World Bank, and the International Monetary Fund. In addition, the democratic shift in Ghana spurred healthcare reforms in an attempt to address the presence of infectious and noncommunicable diseases eventually resulting in the formation of the National Health insurance Scheme in place today.
Healthcare in Georgia is provided by a universal health care system under which the state funds medical treatment in a mainly privatized system of medical facilities. In 2013, the enactment of a universal health care program triggered universal coverage of government-sponsored medical care of the population and improving access to health care services. Responsibility for purchasing publicly financed health services lies with the Social Service Agency (SSA).
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.
The Republic of Moldova has a universal health care system.
Examples of health care systems of the world, sorted by continent, are as follows.
The WHO's estimate of life expectancy for a female child born in Guinea-Bissau in 2008 was 49 years, and 47 years for a boy. in 2016 life expectancy had improved to 58 for men and 61 for women.
Zambia is a landlocked country in Sub Saharan Africa which experiences a burden of both communicable and non-communicable diseases. In line with WHO agenda for equity in health, it has adopted the Universal Health Coverage agenda to mitigate the challenges faced within the health sector. The Ministry of Health (MOH) provides information pertaining to Zambian health. The main focus of the Ministry of Health has been provision of uninterrupted care with emphasis on health systems strengthening and services via the primary health care approach.
For the period between 2005 and 2010, El Salvador had the third-lowest birth rate in Central America, with 22.8 births per 1,000. However, during the same period, it had the highest death rate in Central America, 5.9 deaths per 1,000. In 2015 life expectancy for men was 67.8 years and 77.0 years for women. Healthy life expectancy was 57 for males and 62 for females in 2003. There was considerable improvement in socioeconomic and health status from 1990 to 2015. On June 22, 2020, the Hospital El Salvador, a permanent hospital conversion of the convention center in San Salvador, was opened to the public; it is Latin America's largest hospital and was built to receive COVID-19 patients.
The fertility rate was approximately 3.7 per woman in Honduras in 2009. The under-five mortality rate is at 40 per 1,000 live births. The health expenditure was US$197 per person in 2004. There are about 57 physicians per 100,000 people.
As of 2019 Lithuanian life expectancy at birth was 76.0 and the infant mortality rate was 2.99 per 1,000 births. This is below the EU and OECD average.
Compared with other neighbouring countries, Guyana ranks poorly in regard to basic health indicators. Basic health services in the interior are primitive to non-existent, and some procedures are not available at all. Although Guyana's health profile falls short in comparison with many of its Caribbean neighbours, there has been remarkable progress since 1988, and the Ministry of Health is working to upgrade conditions, procedures, and facilities. Many Guyanese seek medical care in the United States, Trinidad and Tobago or Cuba.
Brunei's healthcare system is managed by the Brunei Ministry of Health and funded by the General Treasury. It consists of around 15 health centers, ten clinics and 22 maternal facilities, considered to be of reasonable standard. There are also two private hospitals. Cardiovascular disease, cancer, and diabetes are the leading cause of death in the country, with life expectancy around 75 years, a vast improvement from 1961. Brunei's human development index (HCI) improved from 0.81 in 2002 to 0.83 in 2021, expanding at an average annual rate of 0.14%. According to the UN's Human Development Report 2020, the HCI for girls in the country is greater than for boys, though aren't enough statistics in Brunei to break down HCI by socioeconomic classes. Brunei is the second country in Southeast Asia after Singapore to be rated 47th out of 189 nations on the UN HDI 2019 and has maintained its position in the Very High Human Development category. Being a culturally taboo subject, the rate of suicide has not been investigated.
In 2016, life expectancy in Tunisia was 74 years for males and 78 years for females. By comparison, in the 1960s it was only 47.1 years. Infant mortality in 2017 was 12.1 per 1,000 live births.
The Health in Eswatini is poor and four years into the United Nations sustainable development goals, Eswatini seems unlikely to achieve goal on health. As a result of 63% poverty prevalence, 27% HIV prevalence, and poor health systems, maternal mortality rate is a high 389/100,000 live births, and under 5 mortality rate is 70.4/1000 live births resulting in a life expectancy that remains amongst the lowest in the world. Despite significant international aid, the government fails to adequately fund the health sector. Nurses are now and again engaged in demonstrations over poor working conditions, drug stock outs, all of which impairs quality health delivery. Despite tuberculosis and AIDS being major causes of death, diabetes and other non-communicable diseases are on the rise. Primary health care is relatively free in Eswatini save for its poor quality to meet the needs of the people. Road traffic accidents have increased over the years and they form a significant share of deaths in the country.
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