JAMAICA'S HEALTH system ranking of 53 in the World Health Report 2000, when placed in a context of the country's expenditure on health as compared with the more developed countries, is not a mean achievement.
For instance, of the 191 countries in the ranking, the USA spends the most per capita (US$3,724) on health each year but ranked 37 in its overall health system performance. Jamaica spends a measly US$78 per capita.
The WHO rankings must be viewed in terms of the paradigmatic shift away from disease treatment and tertiary care to primary care and disease prevention. This shift places more onus on people to make relevant lifestyle changes to hinder the development of the chronic illnesses which the epidemiological studies have indicated are more prevalent as causes of mortality and morbidity than the infectious-type conditions.
While the developed countries might be spending more per capita to provide more high-tech medical equipment, taking into account Jamaica's formidable history in primary care, it could be that the US$78 is being effectively spent in communicating the message of disease prevention which is translating into a relatively healthier population. The report also indicated that Jamaica ranked 36 on the disability-adjusted life expectancy (DALE) scale, comparing well with the US ranking of 24.
It will be difficult to sell the WHO's ranking to patients who face the reality of long waiting lists for elective surgeries and medical personnel who work under less than ideal conditions and in many cases without the basic drugs and sundries. However, the performance index measures not only the health system's ability to treat illness but also how effectively it prevents illness based on the funds available to do so. These statistics should support those in the medical community now fighting what they call the increasing bureaucratisation of health care.
The opinions on this page, except for the above, do not necessarily reflect the views of The Gleaner.
