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[edit]

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

Methodology[edit]

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

  • Health (50%) : disability-adjusted life expectancy
    • Overall or average : 15%
    • Distribution or equality : 35%
  • 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[edit]

The WHO rankings have been subject to many and varied criticisms since its publication. 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"[4] 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[5](AU, CA, DE, NL, NZ, UK , US[6]).

See also[edit]

References[edit]

External links[edit]