Question

scenario：You have been asked to serve on a committee that advises the World Bank about how to fund a healthcare system in the developing world. As part of this role you need to design a healthcare system for the country described below costing no more than $500 million that keeps the largest possible number of people healthy:
This country is about the size of Texas—250,000 square miles. A mountain range separates the country into two regions.
Ten million people live in the coastal region, while five million live in the inland region.
Half the people live in urban areas, and the other half are evenly distributed through the country.
The coastal region has a hot, moist, tropical climate that supports lush jungles and fertile farmland.
The inland region is dry and cool and is predominantly grassland and forest.
The coastal region is well serviced by roads, but only about half the people in the inland region have convenient access to roads.
Only the largest cities and towns have modern sanitation.
Malnutrition and malaria are problems, few people are vaccinated, and there is little health care currently available.
Most people grow their own food and have little extra money to spend. Few children attend school.
Challenge: Think of health care options for this country in terms of:
1. What are some options which should be included?
2. What are some options which should not be included ?

Answer 1

Some options that can be included are -

• Health care facilities and services are often farther away from coastal areas and it becomes very difficult as well as costly for people living in coastal to get these facilities. Effective universal health coverage policy of WHO must be insured in this country as 10 million people of this country live in coastal areas as compared to 5 million who live in inland region.
• Since half the population of this country lives in countryside, it's important for WHO to ensure that they are getting at least basic healthcare support like primary health care and dental care. Significant steps should be taken by developing such health care system in these remote areas.
• Various financial support system like health insurance with minimum fees must be introduced in these areas.
• Since only half the population in inland regions have better access to roads so different methods like door to door vaccination and weekly healthcare workshops in these areas should be conducted to ensure the healthcare of these people.
• There is a big problem of proper sanitation and vaccination in this country. At the same time there is very little healthcare available and that's why things like malaria and malnutrition exists in a large number in this country. Proper methods and development techniques should be use to increase as well as improve the number of sanitation and healthcare setup in the country.

Some options that should not be included are -

• Introduction to modern, expensive and private healthcare facilities should not be promoted. In fact, more importance should be given to government healthcare facilities with relatively low cost so that more and more people can receive them easily.
• Keeping the budget constraint in mind, instead of introducing a smaller number of big hospitals in the cities, more number of relatively smaller healthcare facilities in remote areas should be introduced.
• No expensive health insurance policy should be introduced to these people as it would be very difficult for them to afford and hence the primary goal of creating a better healthcare system for the country will not be achieved.