Health Services in Middle Income Countries

Introduction:

Health care planning in most of the middle income countries focuses on specific priorities to improve health care delivery besides delivering basic health services. Mostly the plans are concerned with ensuring health system efficiency, financial protection and providing health coverage which is a great challenging from technical, political and financial point of view.

Discussion:

The economic situation in middle income countries dictates on those countries provision of basic primary health care; mainly through public and private health care systems. Very few middle income countries (such as in Eastern Europe) highly use out-of-pocket expenditure for funding the health systems. On the other hand, there are countries (such as Middle East and North African region) that are considered as middle income countries and base their health systems financing partially on national health and on health insurance on the other part. Health insurance in some of those countries is expanding and growing in a relatively fast speed (Schieber, 2004).

The Challenges:

Health care cost is increasing by the day as more innovations and more expensive treatments are introduced to the field. Therefore more or less middle income countries have the same health priorities which include efficiency, universal coverage and financial protection. Those health care systems are faced with several challenges on their pathway for strategic planning. Some of the challenges could be as listed below:

1- Increasing the demand for more expensive treatments and technologies in addition to the increase in non-communicable diseases and aging of the population.

2- Out of pocket spending that resembled in fees, cost of drugs and medical or other expenses as under the table payments.

3- Misalignment of incentives and ineffective financing systems in addition to the systems inefficiencies.

4- Limited governmental financial support to the public health systems.

5- Inability to sustain the system due to unstable financing sources.

6- Finding new sources of financing

(Sekhri and Savedoff, 2005).

The Solutions:

To overcome the previous challenges, middle income countries are recommended to have a strategic plan in which they weigh the advantages and the risks of health insurance. The planning should consider factors such as existence of sustainable middle class population, developing of regulations and management oversight, financial markets, and availability of sources for health care funding.

Development of health insurance requires existing of paying customers; who in this case is middle class population. Paying for health

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