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World Health Organization ranking of health systems in 2000

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]

RankingEdit

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 168 182 183 184 150 173
  Albania 102 129 86 149 64 55
  Algeria 84 110 99 114 45 81
  Andorra 10 25 17 23 7 4
  Angola 165 178 181 164 165 181
  Antigua and Barbuda 48 58 71 43 123 86
  Argentina 39 60 49 34 71 75
  Armenia 41 63 81 102 56 104
  Australia 2 17 12 17 39 32
  Austria 17 8 10 6 15 9
  Azerbaijan 65 99 103 162 60 109
  Bahamas 109 67 64 22 137 94
  Bahrain 61 72 58 48 30 42
  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 133 118 117 101 142 126
  Bosnia-Herzegovina 56 79 79 105 70 90
  Botswana 187 146 168 85 188 169
  Brazil 111 108 125 54 78 125
  Brunei 59 42 37 32 76 40
  Bulgaria 60 53 74 96 92 102
  Burkina Faso 178 137 159 173 162 132
  Burundi 179 154 161 186 171 143
  Cambodia 148 150 166 140 157 174
  Cameroon 156 160 163 131 172 164
  Canada 12 18 7 10 35 30
  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
  People's Republic of China 81 101 132 139 61 144
  Colombia 74 44 41 49 51 22
  Comoros 146 143 137 165 141 118
  Congo 150 142 155 122 167 166
  Cook Islands 67 92 88 61 95 107
  Costa Rica 40 45 45 50 25 36
  Croatia 38 33 36 56 57 43
  Cuba 33 41 40 118 36 39
  Cyprus 25 31 28 39 22 24
  Czech Republic 35 19 30 40 81 48
  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 115 141 110 115 43 63
  El Salvador 87 115 122 83 37 115
  Equatorial Guinea 152 151 152 129 174 171
  Eritrea 169 167 176 187 148 158
  Estonia 69 43 48 60 115 77
  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 20 27 22 18 44 31
  France 3 12 6 4 4 1
  Gabon 144 136 141 95 143 139
  Gambia 143 155 153 158 109 146
  Georgia 44 61 76 125 84 114
  Germany 22 20 14 3 41 25
  Ghana 149 149 139 166 158 135
  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 153 152 145 155 139 138
  Honduras 92 119 129 100 48 131
  Hungary 62 40 43 59 105 66
  Iceland 19 24 16 14 27 15
  India 134 153 121 133 118 112
  Indonesia 103 156 106 154 90 92
  Iran 96 113 114 94 58 93
  Iraq 126 130 124 117 75 103
  Ireland 27 13 25 25 32 19
  Israel 23 7 24 19 40 28
  Italy 6 14 11 11 3 2
  Ivory Coast 155 181 157 153 133 137
  Jamaica 36 87 69 89 8 53
  Japan 1 3 1 13 9 10
  Jordan 101 83 84 98 100 83
  Kazakhstan 122 52 62 112 135 64
  Kenya 162 135 142 152 178 140
  Kiribati 125 121 123 103 144 142
  Kuwait 68 54 46 41 68 45
  Kyrgyzstan 123 122 135 146 134 151
  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 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 89 49 55 93 86 49
  Maldives 130 134 128 76 147 147
  Mali 183 180 178 179 170 163
  Malta 21 38 31 37 2 5
  Marshall Islands 121 120 119 80 140 141
  Mauritania 158 163 169 141 151 162
  Mauritius 78 77 90 69 113 84
  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 110 111 94 99 17 29
  Mozambique 180 190 185 160 168 184
  Myanmar 139 162 175 136 129 190
  Namibia 177 173 165 66 189 168
  Nauru 136 51 75 42 166 98
  Nepal 142 161 160 170 98 150
  Netherlands 13 15 8 9 19 17
  New Zealand 31 16 26 20 80 41
  Nicaragua 117 96 101 104 74 71
  Niger 190 184 188 185 177 170
  Nigeria 163 188 184 176 175 187
  Niue 85 100 102 127 108 121
  North Korea 137 145 149 172 153 167
  Norway 15 4 3 16 18 11
  Oman 72 59 59 62 1 8
  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 71 57 73 91 52 57
  Peru 105 103 115 78 119 129
  Philippines 113 50 54 124 126 60
  Poland 45 5 34 58 89 50
  Portugal 29 34 32 28 13 12
  Qatar 66 55 47 27 53 44
  Romania 80 78 72 107 111 99
  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 11 9 21 21 5 3
  Sao Tome and Principe 132 139 138 167 117 133
  Saudi Arabia 58 70 61 63 10 26
  Senegal 151 105 118 143 132 59
  Seychelles 108 73 83 52 83 56
  Sierra Leone 191 186 191 183 183 191
  Singapore 30 29 27 38 14 6
  Slovakia 42 39 39 45 88 62
  Slovenia 34 23 29 29 62 38
  Solomon Islands 127 117 108 134 20 80
  Somalia 173 179 189 191 154 179
  South Africa 160 128 151 57 182 175
  South Korea[4] 51 37 35 31 107 58
  Spain 5 11 19 24 6 7
  Sri Lanka 76 80 80 138 66 76
  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 8 10 2 2 26 20
  Syria 114 107 112 119 91 108
  Tajikistan 120 124 127 126 145 154
  Tanzania 176 172 158 174 180 156
  Thailand 99 74 57 64 102 47
  Togo 159 170 156 180 159 152
  Tonga 75 84 85 73 114 116
  Trinidad and Tobago 57 75 56 65 79 67
  Tunisia 90 114 77 79 46 52
  Turkey 73 109 96 82 33 70
  Turkmenistan 128 131 130 128 152 153
  Tuvalu 119 116 120 151 128 136
  United Arab Emirates 50 62 44 35 16 27
  Uganda 186 138 162 168 179 149
  United Kingdom 14 2 9 26 24 18
  Ukraine 70 47 60 111 101 79
 United States 24 32 15 1 72 37
  Uruguay 37 68 50 33 50 65
  Uzbekistan 100 144 109 120 112 117
  Vanuatu 135 127 134 132 120 127
  Venezuela 52 76 65 68 29 54
  Vietnam 116 104 140 147 130 160
  Yemen 141 165 146 182 82 120
  Yugoslavia 46 90 95 113 47 106
  Zambia 188 171 174 148 190 182
  Zimbabwe 184 98 147 110 191 155

MethodologyEdit

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%

CriticismEdit

The WHO rankings 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 alsoEdit

ReferencesEdit

External linksEdit