World Health Organization ranking of health systems in 2000

The World Health Organization (WHO) ranked the health systems of its 191 member states in its World Health Report[1] 2000. It provided a framework and measurement approach to examine and compare aspects of health systems around the world.[2] It developed a series of performance indicators to assess the overall level and distribution of health in the populations, and the responsiveness and financing of health care services. It was the organization's first ever analysis of the world's health systems.[3]

Ranking

Country Attainment of goals / Health / Level (DALE) Attainment of goals / Health / Distribution Attainment of goals / Health / Overall goal attainment Health expenditure per capita in international dollars Performance / On level of health Performance / Overall health system performance
Afghanistan Afghanistan1640183184150173
 Albania102128861496455
 Algeria446356244581
 Andorra1025172374
 Angola165178181164165181
Antigua and Barbuda Antigua and Barbuda4858715612386
Argentina Argentina396049347175
 Armenia41638110256104
Australia Australia21712173932
Austria Austria178106159
 Azerbaijan659910316260109
 Bahamas10967642213798
 Bahrain617258483042
Bangladesh Bangladesh14012513114410388
 Barbados533638368746
 Belarus8346537411672
 Belgium162613152821
 Belize9495104883469
 Benin15713214317113697
 Bhutan13815814413573124
Bolivia Bolivia133118117101142126
 Bosnia-Herzegovina5679791057090
 Botswana18714616885188169
Brazil Brazil1111081255478125
 Brunei594237327640
Bulgaria Bulgaria6053749692102
 Burkina Faso178137159173162132
 Burundi179154161186171143
Cambodia Cambodia148150166140157174
 Cameroon156160163131172164
Canada Canada12187103530
Cape Verde Cape Verde11812312615055113
 Central African Republic175189190178164189
 Chad161175177175161178
 Chile32133442333
China People's Republic of China8110113213961144
Colombia Colombia744441495122
Comoros Comoros146143137165141118
 Congo150142155122167166
 Cook Islands6792886195107
Costa Rica Costa Rica404545502536
 Croatia383336565743
Cuba Cuba3341401183639
Cyprus Cyprus253128392224
Czech Republic Czech Republic351930408148
Democratic Republic of the Congo Democratic Republic of the Congo174174179188185188
 Denmark28212086534
 Djibouti166169170163163157
 Dominica263542705935
 Dominican Republic799766924251
 Ecuador931331079796111
Egypt Egypt1151411101154363
 El Salvador871151228337115
 Equatorial Guinea152151152129174171
Eritrea Eritrea169167176187148158
Estonia Estonia6943486011577
Ethiopia Ethiopia182176186189169180
 Federated States of Micronesia10411211181110123
 Fiji10671788712496
Finland Finland202722184431
France France3126441
 Gabon14413614195143139
 Gambia143155153158109146
Georgia (country) Georgia44617612584114
Germany Germany22201434125
Ghana Ghana149149139166158135
Greece Greece7623301114
 Grenada498268674985
 Guatemala1291061131309978
 Guinea167166172159160161
 Guinea-Bissau170177180156156176
 Guyana98126116109104128
Haiti Haiti153152145155139138
 Honduras9211912910048131
 Hungary6240435910566
Iceland Iceland192416142715
India India1913121133118112
Indonesia Indonesia1031561061549092
Iran Iran96113114945893
Iraq Iraq12613012411775103
Republic of Ireland Ireland271325253219
Israel Israel23724194028
Italy Italy614111132
 Ivory Coast155181157153133137
 Jamaica36876989853
Japan Japan13113910
Jordan Jordan10183849810083
Kazakhstan Kazakhstan122526211213564
Kenya Kenya162135142152178140
 Kiribati125121123103144142
 Kuwait685446416845
Kyrgyzstan Kyrgyzstan123122135146134151
Laos Laos147147154157155165
 Latvia82566777121105
 Lebanon958893469791
 Lesotho171164173123186183
 Liberia181191187181176186
Libya Libya10710297849487
 Lithuania634852719373
 Luxembourg1822553116
 Macedonia6485891066989
 Madagascar172168167190173159
 Malawi189187182161187185
Malaysia Malaysia894955938649
 Maldives13013412876147147
Mali Mali183180178179170163
 Malta2138313725
 Marshall Islands12112011980140141
Mauritania Mauritania158163169141151162
 Mauritius7877906911384
Mexico Mexico556551556361
 Moldova886491108106101
 Monaco93018121213
 Mongolia131148136145138145
Morocco Morocco11011194991729
 Mozambique180190185160168184
Myanmar Myanmar139162175136129190
 Namibia17717316566189168
 Nauru13651754216698
Nepal Nepal14216116017098150
Netherlands Netherlands1315891917
New Zealand New Zealand311626208041
 Nicaragua117961011047471
 Niger190184188185177170
Nigeria Nigeria163188184176175187
 Niue85100102127108121
North Korea North Korea137145149172153167
 Norway1543161811
Oman Oman7259596218
Pakistan Pakistan12418313314285122
 Palau11266634712582
 Panama479370536795
 Papua New Guinea145157150137146148
Paraguay Paraguay715773915257
 Peru10510311578119129
Philippines Philippines113505412412660
Poland Poland45534588950
Portugal Portugal293432281312
Qatar Qatar665547275344
Romania Romania80787210711199
Russia Russia916910075127130
 Rwanda185185171177181172
 Saint Kitts and Nevis86919851122100
 Saint Lucia548687865468
 Saint Vincent and the Grenadines438992903874
 Samoa978182121131119
San Marino San Marino119212153
 Sao Tome and Principe132139138167117133
Saudi Arabia Saudi Arabia587061631026
Senegal Senegal15110511814313259
 Seychelles1087383528356
Sierra Leone Sierra Leone191186191183183191
Singapore Singapore30292738146
 Slovakia423939458862
Slovenia Slovenia342329296238
 Solomon Islands1271171081342080
 Somalia173179189191154179
South Africa South Africa16012815157182175
South Korea South Korea[4]5137353110758
Spain Spain511192467
Sri Lanka Sri Lanka7680801386676
Sudan Sudan154159148169149134
 Suriname77941057277110
 Swaziland164140164116184177
 Sweden428472123
Switzerland Switzerland810222620
Syria Syria11410711211991108
Tajikistan Tajikistan120124127126145154
Tanzania Tanzania176172158174180156
Thailand Thailand9974576410247
 Togo159170156180159152
 Tonga75848573114116
Trinidad and Tobago Trinidad and Tobago577556657967
 Tunisia9011477794652
Turkey Turkey7310996823370
Turkmenistan Turkmenistan128131130128152153
 Tuvalu119116120151128136
United Arab Emirates United Arab Emirates506244351627
Uganda Uganda186138162168179149
United Kingdom United Kingdom1429262418
Ukraine Ukraine70476011110179
United StatesUnited States24321517237
 Uruguay376850335065
Uzbekistan Uzbekistan100144109120112117
 Vanuatu135127134132120127
Venezuela Venezuela527665682954
Vietnam Vietnam116104140147130160
Yemen Yemen14116514618282120
 FR Yugoslavia46909511347106
 Zambia188171174148190182
 Zimbabwe18498147110191155

Methodology

The rankings are based on an index of five factors:[5]

  • Health (50%) : disability-adjusted life expectancy
    • Overall or average : 25%
    • Distribution or equality : 25%
  • Responsiveness (25%) : speed of service, protection of privacy, and quality of amenities
    • Overall or average : 12.5%
    • Distribution or equality : 12.5%
  • Fair financial contribution : 25%

Criticism

The WHO rankings are claimed to have been subject to many and varied criticisms since its publication. Concerns raised over the five factors considered, data sets used and comparison methodologies have led health bodies and political commentators in most of the countries on the list to question the efficacy of its results and validity of any conclusions drawn. Such criticisms of a broad endeavour by the WHO to rank all the world's healthcare systems must also however be understood in the context of a predisposition to analytical bias commensurate with an individual nation's demographics, socio-economics and politics. In considering such a disparate global spectrum, ranking criteria, methodology, results and conclusions will always be an area for contention.

In over a decade of discussion and controversy over the WHO Ranking of 2000, there is still no consensus about how an objective world health system ranking should be compiled. Indeed, the 2000 results have proved so controversial that the WHO declined to rank countries in their World Health Reports since 2000, but the debate still rages on. With burgeoning and ageing populations, spiralling costs and the recognition by most national governments that constant vigilance and periodic healthcare reform are necessary, the appetite for a means of measuring national performance in broader world contexts is ever increasing and all the more relevant. With this in mind, and in lieu of any further ranking information from the WHO since 2000, there are many analytical bodies now looking at national healthcare delivery in global contexts and publishing their findings. Bloomberg finds "the U.S. spends the most on health care on a relative cost basis with the worst outcome"[6] and notes Cubans live longer than Americans, but Americans pay more than fourteen times as much for less effective health care. The Commonwealth Fund ranked seven developed countries on health care, the US ranked lowest[7](AU, CA, DE, NL, NZ, UK, US[8]).

See also

  • Health systems – explains in some depth the concept of healthcare and its delivery on national and international scales
  • International comparisons of health systems – a section of the above article specifically about international comparisons
  • Healthcare subjects – a list of subjects detailing the complexities behind global healthcare delivery
  • List of countries by quality of healthcare

References

  1. World Health Report 2000.
  2. World Health Organization. World Health Report 2000. Geneva, 2000.
  3. World Health Organization Assesses the World's Health Systems.
  4. World Health Organization. World Health Report 2000. Geneva, 2000.
  5. "Most Efficient Health Care: Countries - bloomberg.com". Bloomberg News.
  6. "U.S. Ranks Last Among Seven Countries on Health System Performance Based on Measures of Quality, Efficiency, Access, Equity, and Healthy Lives - June 23, 2010".
  7. "Overall Rankings - commonwealthfund.org".
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