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World Health Organization ranking of health systems in 2000

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The World Health Organization (WHO) ranked the health systems of its 191 member states in its World Health Report[1] 2000. It provided a framework and measurement approach to examine and compare aspects of health systems around the world.[2] It developed a series of performance indicators to assess the overall level and distribution of health in the populations, and the responsiveness and financing of health care services. It was the organization's first ever analysis of the world's health systems.[3]

Ranking

Country Attainment of goals / Health / Level (DALE) Attainment of goals / Health / Distribution Attainment of goals / Health / Overall goal attainment Health expenditure per capita in international dollars Performance / On level of health Performance / Overall health system performance
Afghanistan Afghanistan 164 0 183 184 150 173
 Albania 102 128 86 149 64 55
 Algeria 44 63 56 24 45 81
 Andorra 10 25 17 23 7 4
 Angola 165 178 181 164 165 181
 Antigua and Barbuda 48 58 71 56 123 86
Argentina Argentina 39 60 49 34 71 75
 Armenia 41 63 81 102 56 104
Australia Australia 2 17 12 17 39 32
Austria Austria 17 8 10 6 15 9
 Azerbaijan 65 99 103 162 60 109
 Bahamas 109 67 64 22 137 98
 Bahrain 61 72 58 48 30 42
Bangladesh Bangladesh 140 125 131 144 103 88
 Barbados 53 36 38 36 87 46
 Belarus 83 46 53 74 116 72
 Belgium 16 26 13 15 28 21
 Belize 94 95 104 88 34 69
 Benin 157 132 143 171 136 97
 Bhutan 138 158 144 135 73 124
Bolivia Bolivia 133 118 117 101 142 126
 Bosnia-Herzegovina 56 79 79 105 70 90
 Botswana 187 146 168 85 188 169
Brazil Brazil 111 108 125 54 78 125
 Brunei 59 42 37 32 76 40
Bulgaria Bulgaria 60 53 74 96 92 102
 Burkina Faso 178 137 159 173 162 132
 Burundi 179 154 161 186 171 143
Cambodia Cambodia 148 150 166 140 157 174
 Cameroon 156 160 163 131 172 164
Canada Canada 12 18 7 10 35 30
Cape Verde Cape Verde 118 123 126 150 55 113
 Central African Republic 175 189 190 178 164 189
 Chad 161 175 177 175 161 178
 Chile 32 1 33 44 23 33
China People's Republic of China 81 101 132 139 61 144
Colombia Colombia 74 44 41 49 51 22
Comoros Comoros 146 143 137 165 141 118
 Congo 150 142 155 122 167 166
 Cook Islands 67 92 88 61 95 107
Costa Rica Costa Rica 40 45 45 50 25 36
 Croatia 38 33 36 56 57 43
Cuba Cuba 33 41 40 118 36 39
Cyprus Cyprus 25 31 28 39 22 24
Czech Republic Czech Republic 35 19 30 40 81 48
Democratic Republic of the Congo Democratic Republic of the Congo 174 174 179 188 185 188
 Denmark 28 21 20 8 65 34
 Djibouti 166 169 170 163 163 157
 Dominica 26 35 42 70 59 35
 Dominican Republic 79 97 66 92 42 51
 Ecuador 93 133 107 97 96 111
Egypt Egypt 115 141 110 115 43 63
 El Salvador 87 115 122 83 37 115
 Equatorial Guinea 152 151 152 129 174 171
Eritrea Eritrea 169 167 176 187 148 158
Estonia Estonia 69 43 48 60 115 77
Ethiopia Ethiopia 182 176 186 189 169 180
 Federated States of Micronesia 104 112 111 81 110 123
 Fiji 106 71 78 87 124 96
Finland Finland 20 27 22 18 44 31
France France 3 12 6 4 4 1
 Gabon 144 136 141 95 143 139
 Gambia 143 155 153 158 109 146
Georgia (country) Georgia 44 61 76 125 84 114
Germany Germany 22 20 14 3 41 25
Ghana Ghana 149 149 139 166 158 135
Greece Greece 7 6 23 30 11 14
 Grenada 49 82 68 67 49 85
 Guatemala 129 106 113 130 99 78
 Guinea 167 166 172 159 160 161
 Guinea-Bissau 170 177 180 156 156 176
 Guyana 98 126 116 109 104 128
Haiti Haiti 153 152 145 155 139 138
 Honduras 92 119 129 100 48 131
 Hungary 62 40 43 59 105 66
Iceland Iceland 19 24 16 14 27 15
India India 19 13 121 133 118 112
Indonesia Indonesia 103 156 106 154 90 92
Iran Iran 96 113 114 94 58 93
Iraq Iraq 126 130 124 117 75 103
Republic of Ireland Ireland 27 13 25 25 32 19
Israel Israel 23 7 24 19 40 28
Italy Italy 6 14 11 11 3 2
 Ivory Coast 155 181 157 153 133 137
 Jamaica 36 87 69 89 8 53
Japan Japan 1 3 1 13 9 10
Jordan Jordan 101 83 84 98 100 83
Kazakhstan Kazakhstan 122 52 62 112 135 64
Kenya Kenya 162 135 142 152 178 140
 Kiribati 125 121 123 103 144 142
 Kuwait 68 54 46 41 68 45
Kyrgyzstan Kyrgyzstan 123 122 135 146 134 151
Laos Laos 147 147 154 157 155 165
 Latvia 82 56 67 77 121 105
 Lebanon 95 88 93 46 97 91
 Lesotho 171 164 173 123 186 183
 Liberia 181 191 187 181 176 186
Libya Libya 107 102 97 84 94 87
 Lithuania 63 48 52 71 93 73
 Luxembourg 18 22 5 5 31 16
 Macedonia 64 85 89 106 69 89
 Madagascar 172 168 167 190 173 159
 Malawi 189 187 182 161 187 185
Malaysia Malaysia 89 49 55 93 86 49
 Maldives 130 134 128 76 147 147
Mali Mali 183 180 178 179 170 163
 Malta 21 38 31 37 2 5
 Marshall Islands 121 120 119 80 140 141
Mauritania Mauritania 158 163 169 141 151 162
 Mauritius 78 77 90 69 113 84
Mexico Mexico 55 65 51 55 63 61
 Moldova 88 64 91 108 106 101
 Monaco 9 30 18 12 12 13
 Mongolia 131 148 136 145 138 145
Morocco Morocco 110 111 94 99 17 29
 Mozambique 180 190 185 160 168 184
Myanmar Myanmar 139 162 175 136 129 190
 Namibia 177 173 165 66 189 168
 Nauru 136 51 75 42 166 98
Nepal Nepal 142 161 160 170 98 150
Netherlands Netherlands 13 15 8 9 19 17
New Zealand New Zealand 31 16 26 20 80 41
 Nicaragua 117 96 101 104 74 71
 Niger 190 184 188 185 177 170
Nigeria Nigeria 163 188 184 176 175 187
 Niue 85 100 102 127 108 121
North Korea North Korea 137 145 149 172 153 167
 Norway 15 4 3 16 18 11
Oman Oman 72 59 59 62 1 8
Pakistan Pakistan 124 183 133 142 85 122
 Palau 112 66 63 47 125 82
 Panama 47 93 70 53 67 95
 Papua New Guinea 145 157 150 137 146 148
Paraguay Paraguay 71 57 73 91 52 57
 Peru 105 103 115 78 119 129
Philippines Philippines 113 50 54 124 126 60
Poland Poland 45 5 34 58 89 50
Portugal Portugal 29 34 32 28 13 12
Qatar Qatar 66 55 47 27 53 44
Romania Romania 80 78 72 107 111 99
Russia Russia 91 69 100 75 127 130
 Rwanda 185 185 171 177 181 172
 Saint Kitts and Nevis 86 91 98 51 122 100
 Saint Lucia 54 86 87 86 54 68
 Saint Vincent and the Grenadines 43 89 92 90 38 74
 Samoa 97 81 82 121 131 119
San Marino San Marino 11 9 21 21 5 3
 Sao Tome and Principe 132 139 138 167 117 133
Saudi Arabia Saudi Arabia 58 70 61 63 10 26
Senegal Senegal 151 105 118 143 132 59
 Seychelles 108 73 83 52 83 56
Sierra Leone Sierra Leone 191 186 191 183 183 191
Singapore Singapore 30 29 27 38 14 6
 Slovakia 42 39 39 45 88 62
Slovenia Slovenia 34 23 29 29 62 38
 Solomon Islands 127 117 108 134 20 80
 Somalia 173 179 189 191 154 179
South Africa South Africa 160 128 151 57 182 175
South Korea South Korea[4] 51 37 35 31 107 58
Spain Spain 5 11 19 24 6 7
Sri Lanka Sri Lanka 76 80 80 138 66 76
Sudan Sudan 154 159 148 169 149 134
 Suriname 77 94 105 72 77 110
 Swaziland 164 140 164 116 184 177
 Sweden 4 28 4 7 21 23
Switzerland Switzerland 8 10 2 2 26 20
Syria Syria 114 107 112 119 91 108
Tajikistan Tajikistan 120 124 127 126 145 154
Tanzania Tanzania 176 172 158 174 180 156
Thailand Thailand 99 74 57 64 102 47
 Togo 159 170 156 180 159 152
 Tonga 75 84 85 73 114 116
Trinidad and Tobago Trinidad and Tobago 57 75 56 65 79 67
 Tunisia 90 114 77 79 46 52
Turkey Turkey 73 109 96 82 33 70
Turkmenistan Turkmenistan 128 131 130 128 152 153
 Tuvalu 119 116 120 151 128 136
United Arab Emirates United Arab Emirates 50 62 44 35 16 27
Uganda Uganda 186 138 162 168 179 149
United Kingdom United Kingdom 14 2 9 26 24 18
Ukraine Ukraine 70 47 60 111 101 79
United States United States 24 32 15 1 72 37
 Uruguay 37 68 50 33 50 65
Uzbekistan Uzbekistan 100 144 109 120 112 117
 Vanuatu 135 127 134 132 120 127
Venezuela Venezuela 52 76 65 68 29 54
Vietnam Vietnam 116 104 140 147 130 160
Yemen Yemen 141 165 146 182 82 120
 FR Yugoslavia 46 90 95 113 47 106
 Zambia 188 171 174 148 190 182
 Zimbabwe 184 98 147 110 191 155

Methodology

The rankings are based on an index of five factors:[2]

  • Health (50%) : disability-adjusted life expectancy
    • Overall or average : 25%
    • Distribution or equality : 25%
  • Responsiveness (25%) : speed of service, protection of privacy, and quality of amenities
    • Overall or average : 12.5%
    • Distribution or equality : 12.5%
  • Fair financial contribution : 25%

Criticism

The WHO rankings are claimed to have been subject to many and varied criticisms since its publication.[citation needed] Concerns raised over the five factors considered, data sets used and comparison methodologies have led health bodies and political commentators in most of the countries on the list to question the efficacy of its results and validity of any conclusions drawn. Such criticisms of a broad endeavour by the WHO to rank all the world's healthcare systems must also however be understood in the context of a predisposition to analytical bias commensurate with an individual nation's demographics, socio-economics and politics. In considering such a disparate global spectrum, ranking criteria, methodology, results and conclusions will always be an area for contention.

In over a decade of discussion and controversy over the WHO Ranking of 2000, there is still no consensus about how an objective world health system ranking should be compiled. Indeed, the 2000 results have proved so controversial that the WHO declined to rank countries in their World Health Reports since 2000, but the debate still rages on. With burgeoning and ageing populations, spiralling costs and the recognition by most national governments that constant vigilance and periodic healthcare reform are necessary, the appetite for a means of measuring national performance in broader world contexts is ever increasing and all the more relevant. With this in mind, and in lieu of any further ranking information from the WHO since 2000, there are many analytical bodies now looking at national healthcare delivery in global contexts and publishing their findings. Bloomberg finds "the U.S. spends the most on health care on a relative cost basis with the worst outcome"[5] and notes Cubans live longer than Americans, but Americans pay more than fourteen times as much for less effective health care. The Commonwealth Fund ranked seven developed countries on health care, the US ranked lowest[6](AU, CA, DE, NL, NZ, UK, US[7]).

See also

References

  1. ^ " World Health Report 2000." (PDF). Archived (PDF) from the original on 2013-01-17. Retrieved 2009-08-26.
  2. ^ a b World Health Organization. World Health Report 2000. Archived 2013-01-17 at the Wayback Machine Geneva, 2000.
  3. ^ "World Health Organization Assesses the World's Health Systems". World Health Organization. 7 February 2000. Archived from the original on 2013-01-17. Retrieved 2011-06-23.
  4. ^ Tandon, Ajay; Murray, Christopher JL; Lauer, Jeremy A; Evans, David B. "Measuring Overall Health System Performance For 191 Countries" (PDF). GPE Discussion Paper Series: No. 30. World Health Organization. Archived (PDF) from the original on 2011-08-05.
  5. ^ "Most Efficient Health Care: Countries - bloomberg.com". Bloomberg News. Archived from the original on 2014-09-06. Retrieved 2017-03-12.
  6. ^ "U.S. Ranks Last Among Seven Countries on Health System Performance Based on Measures of Quality, Efficiency, Access, Equity, and Healthy Lives - June 23, 2010". Archived from the original on January 22, 2014. Retrieved March 8, 2014.
  7. ^ "Overall Rankings - commonwealthfund.org". Archived from the original on 2015-09-23. Retrieved 2014-03-08.
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