Titre : | The Lao People's Democratic Republic Health System Review |
Auteurs : | K. Akkavon ; C. Paphassarang ; C. Phoxay ; et al. |
Type de document : | Ouvrage |
Editeur : | Brisbane [Philippines] : Wesley Research Institute, 2014 |
Collection : | Health systems in transition , num. vol. 4, n° 1 |
Description : | XV+134p. / tabl., fig. |
Langues: | Anglais |
Mots-clés : | Démographie médicale ; Médicament ; Donnée statistique ; Assurance maladie ; Evaluation ; Politique santé ; Economie santé ; Système santé ; Système soins ; Organisation soins ; Santé mentale ; Dépense santé ; Régulation ; Planification sanitaire ; Décentralisation ; Financement soins ; Réforme ; Etat santé ; Offre soins ; Dépense pharmaceutique ; Ethnie ; Ressource humaine ; Soins dentaires ; Laos |
Résumé : | [BDSP. Notice produite par IRDES lR0xj9Es. Diffusion soumise à autorisation]. Lao PDR produced its first Health in Transition review (HiT), reporting on impressive health gains over the past 3 decades due to strong political commitment to develop the health system. Between 1980 and 2010, life expectancy at birth increased by 18 years, from 49 to 67. Both communicable and noncommunicable diseases are major causes of mortality and morbidity ; the prevalence of tuberculosis, malaria and dengue and the high rate of traffic accidents are of particular concern, although there has been some significant success with malaria control over the last decade. Millennium Development Goals (MDGs) 4,5 and 6 are on track to be achieved by 2015. The public health sector has transitioned from a centralized system under which the Government provided free services, to charging the users of government health services, followed by the slow reintroduction of user fee exemption for some target populations such as health care for the poor, maternal health and children under the age of 5. Population coverage by the four main prepayment schemes is limited to around 19.6% of the population (police and military personnel are not included). Out-of-pocket payments are high. There is strong political commitment to the development of the health system, and there have been some major achievements in terms of health-related strategies and policies. The results, however, have been mixed. While there are strong efforts to increase public spending on health and move towards the expansion of insurance-based risk-pooling and prepayment health-financing schemes, out-of-pocket payments by households are still high. The decade-long stagnation in the number of health workers was alleviated very recently with the creation of a substantial number of new posts, which is needed as the current level of 0.6 health workers per 1000 population is inadequate to reach a desired level of service coverage. Also, the uneven distribution of the health workforce in favour of cities exacerbates the problem of shortages in rural areas. Within a short timeframe and in a very challenging environment, the Government has undertaken some major health sector reforms, guided by the socioeconomic changes in the country, with a view to providing better health services for all people in the country. Despite strong government commitments to health, as reflected by a number of policy statements, decrees, national strategies and plans, the challenge now is to address the gaps between policy intentions and effective implementation. |
En ligne : | http://www.wpro.who.int/asia_pacific_observatory/hits/series/lao/en/ |
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