Comparative health system performance in six middle-income countries: cross-sectional analysis using World Health Organization study of global ageing and health. (September 2017)

• Record Type: Journal Article
• Authors: Alshamsan, Riyadh; Lee, John Tayu; Rana, Sangeeta; Areabi, Hasan; Millett, Christopher
• Is Part Of: Journal of the Royal Society of Medicine. Volume 110:Number 9(2017)
• Page Start: 365
• Page End: 375
• Publication Date: 2017-09
• Subjects: Health policy -- global health -- public health; Medicine -- Periodicals; Medicine -- Great Britain -- Periodicals; Periodicals; 610.5
• DOI: 10.1177/0141076817724599
• Languages: English
• ISSNs: 0410-0768

Abstract

Objective: To assess and compare health system performance across six middle-income countries that are strengthening their health systems in pursuit of universal health coverage. Design: Cross-sectional analysis from the World Health Organization Study on global AGEing and adult health, collected between 2007 and 2010. Setting: Six middle-income countries: China, Ghana, India, Mexico, Russia and South Africa. Participants: Nationally representative sample of adults aged 50 years and older. Main outcome measures: We present achievement against key indicators of health system performance across effectiveness, cost, access, patient-centredness and equity domains. Results: We found areas of poor performance in prevention and management of chronic conditions, such as hypertension control and cancer screening coverage. We also found that cost remains a barrier to healthcare access in spite of insurance schemes. Finally, we found evidence of disparities across many indicators, particularly in the effectiveness and patient centredness domains. Conclusions: These findings identify important focus areas for action and shared learning as these countries move towards achieving universal health coverage.