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Background

Health systems in developing countries


Patients receiving treatment in Madagascar.

Many de­vel­op­ing coun­tries and emerging economies do not have sufficiently efficient health systems. Large parts of the popu­la­tion – especially the poor and those living in rural regions – do not have access to adequate and appropriate medical services where they live. Public health services are generally only available in towns and cities; even basic health care is often lacking in rural regions.

There are many reasons why this is the case, including a shortage of health care professionals, a lack of or defective equipment in health care facilities, poor provision of medicines and badly organised structures in the health system. The coun­tries affected generally have very limited national health budgets. In addition, the money often takes a long time to arrive where it is most needed. Centralised organisational structures and a lack of management skills in many cases prevent health care being geared to the needs of the popu­la­tion.

Facing huge challenges

It is especially well-known infectious diseases such as AIDS, tuberculosis and malaria and relatively unknown diseases such as dengue fever and leishmaniosis that cause massive health problems in de­vel­op­ing coun­tries.

Poor nutrition and unsafe drinking water are responsible for many children in de­vel­op­ing coun­tries getting sick. Women are often at par­tic­u­lar­ly high risk during pregnancy and childbirth. However, more and more people are suffering from chronic, non-infectious diseases such as cardio-vascular diseases, metabolic diseases such as diabetes, and accidents, which is why public health systems need to be further expanded.

Costs of treatment and access

Patients in de­vel­op­ing coun­tries usually have to pay the lion’s share of the costs of treatment themselves. Poor patients and their families are often unable to pay for the full course of lengthy treatments. They then discontinue the treatment – and are thus not able to make a full recovery.

Health and long-term nursing care insurances are not available in most de­vel­op­ing coun­tries.

However, whether someone who is sick will receive the necessary medical care is not only dependent on whether they can pay for the treatment, but also on their gender, ethnicity, age, level of education and where they live. People with disabilities are frequently at a disadvantage.

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