Good Health at Low Cost Part 1: Factors to Success among Nine Examples

Abstract

Study of “Good Health at Low Cost” had been conducted twice. In 1985, the first study was carried out in four countries namely China, Costa Rica, India only Kerala and Sri Lanka. In 2010, 25 years later, the second round was conducted in five developing countries namely Bangladesh, Ethiopia, India only Tamil Nadu, Kyrgyz Republic and Thailand. When compared to other similar income countries, these developing countries had good health outcome of population at the relatively low health expenditure. Both studies were aimed at investigating factors determining successful performance of each country.

The results explained process and model of health system development or health care reform. The common strategy was to revitalize or strengthen primary health care system in terms of quality and availability. Factors within health sector which determining health system development were strong leadership, high policy intention, evidence based policy design and formulation, adequate and sustainable investment for health, competent staffs at all levels, participation of all stakeholders, good governance. Meanwhile, there were many significant factors outside health sector such as political commitment, economic growth, poverty reduction, education of population or literacy rate, community engagement and gender equity.