Achieving the Health Millennium Development Goals in Asia by Economic & Social Commission for Asia & the Pacific

By Economic & Social Commission for Asia & the Pacific

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Gov/cia/publications/factbook. a 20 GDP per capita data for 2003 (or latest available). CHAPTER 3 Obstacles to Achieving the Health-Related MDGs related MDGs. Other determinants outside the health sector can also impede the ability of individuals to access health services and improve their health status. Multiple linkages between determinants inside and outside the health sector influence health outcomes, each of which will be examined. 1. OBSTACLES WITHIN HEALTH SYSTEMS WHO defines health systems as “all the activities whose primary purpose is to promote, restore or maintain health” (WHO, 2000a).

Equally important to the ability, effectiveness and efficiency of health systems to provide services is the way in which investments are targeted. A highly inequitable distribution of public investments in health exists in many developing countries in the ESCAP region. Resources are heavily concentrated in urban areas and on secondary and tertiary care, often at the expense of even the most essential health care in rural areas. Empirical evidence indicates that people at the bottom of the income scale benefit less from public spending on all types of health services than those in higher income groups.

The total prevalence in China and India combined exceeds 6 million (WHO, 2006c). Mortality rates in Afghanistan and Cambodia among tuberculosis patients are among the highest in the region – 92 and 94 per 100,000 people respectively (WHO, 2006c). 5 million (WHO, 2006). Recently increased levels of detection are in part due to improvements in the coverage of the population by directly observed treatment short-course (DOTS) programmes. 5 per cent in 1995 to 84 per cent in 2004 (WHO, 2006c). Nevertheless, the ESCAP region has made important progress in reducing tuberculosis prevalence and mortality rates during the last decade (WHO, 2005f).

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