sahr2001 - Health Systems Trust

17 • Health and Related Indicators
International Indicators
Another new addition to the Health and Related Indicators section is a
selection of international comparative data. The World Health Report 2000
attempted, for the first time, to make summary comparisons of health systems
performance and the attainment of health systems goals [World Health Report
2000]. This report was roundly criticised by many Ministries of Health as
unrepresentative of their true performance, and a panel is investigating its
methodology. In that report, while South Africa was ranked 57th in terms of
per capita expenditure on health, it was ranked a lowly 151st in terms of
health goal attainment and 175th out of 191 in terms of overall systems
performance.
Perhaps an easier way of comparing performance is to look at the traditional
indicators of health status (such as the total fertility rate, life expectancy at
birth, infant and under 5 mortality rates, HIV prevalence). Such data are
made available in the United Nations Development Programme’s Human
Development Reports. This report also provides the summary statistic on
quality of life – the human development index (HDI). It was therefore decided
to provide comparative data from a selection of countries chosen as follows:
◆ middle-income countries with human development indices in the middle
order. Those selected were from different parts of the globe, but included
were countries with which South Africa is sometimes compared or
contrasted in terms of health policy approaches – Algeria, Ghana,
Kenya, Thailand, Brazil, Mexico, Venezuela, Turkey
◆ a selection of South Africa’s immediate neighbours – Botswana,
Lesotho, Namibia, Zimbabwe
◆ as an indicator of the upper extremes of each measure, the country
with the highest human development index – Norway.
In addition to the health status indicators, selected demographic and socioeconomic
variables were also listed (populations, adult literacy rates, HDIs,
GDP per capita). The availability of health human resources was also listed
for each (where available). In order to maintain consistency, the figures quoted
in the same sources for South Africa were also provided. It should be noted
however that these figures might vary slightly from those quoted in other
parts of the Health and Related Indicators section. Nonetheless, this section
should not only provide contextual detail for all those that precede it, but
should stimulate thought and debate on the relationships between health
inputs, outputs and outcomes, and between health and economic factors.
Definitions:
See definitions earlier in this chapter under the relevant sections.
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