An International Labour Organisation (ILO) study shows that 80 per cent of the population across 44 countries are without any health protection and are therefore deprived of the right to health. These countries include Burkina Faso, Cameroon, Guinea and Sierra Leone. Globally, some 40 per cent of the population is excluded from social protection in health. The study “Addressing the Global Health Crisis: Universal Health Protection Policies ” says that similar major gaps also exist in Asia. In India, for example, more than 80 per cent of people lack health protection coverage.

Other countries showing substantial coverage gaps include Azerbaijan, Bangladesh, Haiti, Honduras, and Nepal.

The ILO study points to high impoverishment due to private health spending as a barrier for accessing health care. In many countries, such as Sierra Leone, 75 per cent of total health expenditure comes from private resources in the form of out-of-pocket payments, which has led to deep impoverishment. The extent of impoverishing out-of-pocket payments in a country increases with the level of the population living below the poverty line. “Thus, it is the poorest with the highest needs who suffer the most from having to pay out-of-pocket healthcare expenses,” explained Xenia Scheil-Adlung, Health Policy Coordinator at the ILO.

Another major factor leading to the global health crisis concerns the shortage of health workers, who are often poorly paid. Globally, the ILO estimates that 10.3 million additional health workers are needed to close the current gaps and ensure the delivery of universal health care. In countries such as Haiti, Niger, Senegal and Sierra Leone, as many as 10,000 people have to rely on services provided by five or fewer health workers, whereas in a high-income country like Finland there are 269 health workers available for 10,000 people.

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