Written By: Pragya Thapa
“The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition”.
It’s been almost 70 years these words were adopted in the Constitution of the World Health Organization, and yet healthcare is a luxury rather than a basic necessity for people living in developing countries.
Healthcare is a major area that most developing countries fall behind in. Effective health care interventions are underutilized in the developing world by those who can afford it. The ones at an economic disadvantage are even less likely than the better off to receive effective health care. Access to effective health care is a major problem in the developing world. There are two sides to the access problem. On the supply side, good quality, effective health care may not be offered. On the demand side, individuals may not utilize services from which they could benefit or they may not be able to afford healthcare services.
In developing countries,a considerable number of people suffer and die from conditions for which there exist effective interventions.Three diseases – diarrhea, pneumonia, and malaria – are responsible for child deaths in such countries.For each disease, there is at least one effective prevention and one effective treatment.Sadly, due to socio-economic conditions, many people are unable to prevent as well as treat such diseases.
Within health care itself, developing countries generally struggle with reproductive healthcare.The major reason for this problem is stigma related to sexual and reproductive health.Some other factors responsible for this are lack of awareness, resources and economy to afford such services.For example, in South Asia, less than half of pregnant women get an antenatal check-up, and only one-fifth of births are supervised by someone with medical training.Coverage rates for antiretroviral therapy for AIDS do not exceed 5% in low- and middle-income countries.
Because of this gross underutilization of effective health care, there exist large unrealized health gains in developing countries.Child deaths could be cut by 63% worldwide if coverage rates of effective prevention and treatment interventions were to increase from current levels to 99%.Raising coverage rates of maternal health interventions (the most important of which is essential obstetric care to the same level would reduce maternal deaths by three-fourths.
One of the major drawbacks of healthcare system in developing countries is unequal access to healthcare services.Utilization of healthcare services is very concentrated on the better off.Many factors are responsible for the underutilization of effective health care interventions in the developing world.Most obviously, economic resources are often insufficient to support the provision of essential services.A second problem is that the available resources are not allocated to the most effective interventions, are geographically concentrated in large cities, and do not reach the poor.Insufficient resources, inappropriate allocation, and inadequate quality are major impediments to the delivery of effective health care that reaches the poor.
Some factors contributing to unequal access to healthcare in developing countries include:-
• Culture and gender issues
Low demand for modern health interventions often derives from deep-rooted attitudes that reflect culture and social norms.One example are continued preferences for traditional over modern therapies.Gender attitudes and roles are particularly important determinants of health seeking behavior. Raising access to maternal, reproductive, and child health interventions is a major challenge within societies that restrict the public lives of women.
• Knowledge and education
Recognition of illness and the potential benefits of treatment are prerequisites for health care demand.Where a large proportion of the population is in poor health, this becomes the norm and illness is not easily recognized. If treatment coverage is low, there is less opportunity to learn of its benefit.The unfortunate outcome can be the continued toleration of illness and disease.There is substantial evidence from developing countries that the socioeconomic environment influences concepts of illness.Reported rates of illness are often higher among the better off than the poor.
• Demand responses to poor quality
Poor quality of health services is a major problem in many, but not all, developing countries.Facilities open and close irregularly; absenteeism rates of doctors and nurses can be very high; staff can be hostile, even violent to patients; misdiagnosis is not uncommon; medicines are all too often unavailable, sometimes due to staff pilfering for use in private practice; and there is inappropriate prescribing and treatment. Deficiencies in quality have direct implications for access to effective health care.
Covid-19 has taken a toll on the entire world,but the ones at a major disadvantage comparatively are the people of developing countries.I’d like to explain the matter with reference to Nepal.
Nepal is now reporting about 20 daily Covid-19 cases per 100,000 people-about the same number as India was reporting two weeks ago.The sudden increase in Nepal’s Covid has prompted concern the country’s outbreak could mimic India’s.
The hospitals are running out of beds and oxygen cylinders already and the situation doesn’t seem to be getting better anytime soon.Health Ministry of Nepal has asked people to be sensible, saying the health system can't cope.
Nepal is currently depending on its neighbouring countries-India and China for vaccines as well as oxygen.With the healthcare system of both of its neighbouring countries failing, especially India, Nepal is definitely heading towards an impending doom.
Nepal is simply a representation of the developing nations in current scenario.Due to lack of enough resources, the healthcare system of developing countries has failed its people, especially in a time like this when they require proper healthcare more than ever.