healthcare in cyprusIn the small Mediterranean country of Cyprus, healthcare systems function quite well. Though the World Health Organization recognizes it as being at the same level as that of other developed countries — the Cypriot Ministry of Health has decided to reform it. Here are four things to know about healthcare in Cyprus.

Important Points About Healthcare in Cyprus

Cyprus does not have universal healthcare. Instead, it is a system that is split between a private and a public sector. This, in turn, causes an imbalance. In the public system, “Entitlement to receive free health services is based on residency and income level.” Patients must endure long waiting lists for several services — a problem that has only worsened, recently. According to Cypriot Minister of Health Dr. Androulla Agrotou, “the majority of the population has the right to a free of charge access to public health services while the remaining population must pay per fee schedules set by the Ministry of Health.”

The private system is largely unregulated and financed out-of-pocket by entrepreneurs and voluntary health insurance providers. Moreover, the private system has a surplus of expensive medical technology that often goes underutilized. It also experiences staffing issues, problems with the quality of services and developing health facilities. According to Dr. Agrotou, the lack of a unifying base between the private and the public sector causes “a significant disequilibrium.”

Recent reforms

Despite the aforementioned flaws, the Cypriote Ministry of Health has recently unveiled a new, more comprehensive healthcare system in 2015. The title of the new system is — the General Health Insurance System (GHIS). It aims to provide universal coverage within many areas of the health system. In this same vein, the new healthcare system plans to provide more autonomy to and better management of public hospitals. To do this, GHIS will merge public and private health resources to introduce “information technology systems” and involve patients and the public “in developing and designing services.” In early 2019, the process of giving public hospitals more autonomy began and it aims to finish implementing the reforms in June 2020.

Where Healthcare in Cyprus Currently Stands

Healthcare in Cyprus is considered comparable to that of the U.K. or the U.S. It has made significant progress in disease prevention, as well as surveillance and control mechanisms. Notably, the indicators for life expectancy at birth are at about 75 and 80 years — for men and women, respectively. Other indicators, such as infant mortality and incidence of communicable diseases are also quite low, and “rank Cyprus in high positions in E.U.-wide and international comparisons” says Dr. Agrotou.

Future Outlook

In conclusion, though Cyprus lacks a universal healthcare plan, it is in the process of reforming its system to provide universal coverage to its citizens. Despite the split between the private and public systems, the current system is good enough as some considered it to be a high-quality service provider. However, despite this promising status, the Cypriot government is not settling for “good enough;” and valiant efforts to further improve healthcare in Cyprus are now underway.

Mathilde Venet
Photo: Flickr

healthcare in Slovakia
The Eastern European country of Slovakia has a universal healthcare system for its population of 5.5 million people. Considering insurance, life expectancy and migration, there is a multitude of factors that play a role in the healthcare system of Slovakia. Here are five facts about healthcare in Slovakia.

5 Facts About Healthcare in Slovakia

  1. Slovakia has a relatively low life expectancy. The average life expectancy in Slovakia is 77.3 years, which is lower than the average life expectancy in the E.U. The life expectancy for women is 80.7 years while the average life expectancy for men is 73.8 years. Higher education levels can correlate with living a longer life. As a specific example, men with the highest level of education are predicted to live 14 years longer than those less educated.
  2. Slovakia supports universal healthcare. The country of Slovakia has universal healthcare coverage. Moreover, there are 44 state hospitals within the country. Citizens can choose between three nationwide health insurance companies; one is private while the two are public. There is a national average of 3.4 doctors per 1,000 people. In the capital region of Bratislava, there is a higher concentration of doctors with 6.9 physicians per 1,000 people.
  3. The country is lacking healthcare workers. The migration of doctors to neighboring countries has resulted in a shortage of healthcare workers within the country. After Slovakia became a member of the E.U., an estimated 300,000 workers left for countries with better pay, between 2004 and 2019. This affected the number of people in the healthcare field and resulted in a below-average amount of nurses. To keep healthcare professionals in the country, many Slovakians believe that the government should allocate more funding toward the healthcare sector. In this same vein, the government could pay doctors and nurses higher wages.
  4. Risk factors including obesity and smoking affect Slovakians’ lifespans. Obesity is increasing in Slovakia, with 14% of the population identified as overweight. Moreover, when considering the adult population, 20% smoke tobacco products — which contributed to more than 9,000 deaths in 2017. Slovakian men have shorter lifespans than Slovakian women due to partaking in more behavioral risk factors. However, half of the deaths related to these risk factors are preventable.
  5. Roma populations face social discrimination, which leads to health inequalities. Regions such as Kosice and Presov, with large Roma populations, also have a lower life expectancy as well as an infant mortality rate that is twice the national average. The Roma Health Mediators Programme is working to eliminate the barriers of access to medical care. Some of these initiatives include language translations for doctors and enforcing insurance rights to promote the use of health services by the Roma population.

A Bright Future

In 2018, the Slovakian government created the public eHealth initiative to improve technology within hospitals and create electronic medical records. Interestingly, Slovakia has a low healthcare budget as compared with the rest of the E.U. countries. In 2019, the country increased its budget by €300 million, resulting in a total healthcare budget of €5.2 billion. If the government continues to follow this trend of investing more in its hospitals as it currently does — healthcare in Slovakia will greatly improve with additional support from nurses and technological advancements.

Hannah Nelson
Photo: Pikist

healthcare in portugal
Portugal is part of the Iberian Peninsula and lies along the coast of the Atlantic Sea. It is located in Southern Europe and bordered on its northern and eastern sides by Spain. Many know Portugal for its resorts and beaches, cuisine and soccer team, especially its star athlete: Cristiano Ronaldo. However, many also know this country for its amazing, world-renowned healthcare systems and facilities. The following are eight facts about healthcare in Portugal.

8 Facts About Healthcare In Portugal

  1. Universal Health Coverage: Portugal provides healthcare free of charge to children under age 18 and adults over 65. If citizens do not meet these requirements, and unless they need urgent care or have a unique situation, the NHS offers healthcare to them at a low cost. According to internations.org, the average cost of health insurance in Portugal, “could cost between 20 and 50 EUR ($22–55) a month, depending on your age and the extent of your coverage.” This means that a Portuguese citizen could pay, “anywhere between 400 EUR ($440) a year for a basic plan and 1,000 EUR ($1,100) yearly for a more well-rounded coverage.”
  2. Twelfth in the U.N.: In an analysis of the healthcare systems of U.N.-member countries, WHO ranked Portugal 12th best out of 190 countries. Further, Portugal received a 94.5 rating out of 100 on fairness in financing and the efficiency, quality and equity of health responsiveness.
  3. Free Childbirth: Giving birth in Portugal is free if one is a citizen of Portugal. Women receive medical care in all stages of their pregnancy. This includes free appointments with an OB-GYN and delivery, for both natural births and C-sections.
  4. Prevalent Health Conditions: Cancer and cardiovascular diseases are the two most concerning health issues in Portugal. According to the State of Health in the E.U., other causes of death for Portugal’s citizens include diseases in the nervous system (dementia, Alzheimer’s, etc), respiratory diseases and external causes.
  5. High Life Expectancy: The life expectancy of Portugal’s citizens is 82.1 years. Men in the country live for 78 years on average while women can live for about 85 years. Portugal’s life expectancy is higher than the European average of 80.9 years, and expectations have determined that it could keep increasing. U.N. projections have determined that the life expectancy in Portugal could rise to 83.67 by 2030.
  6. NHS-run Hospitals: In 2016, there were about 225 hospitals in Portugal. Portugal’s National Health Service ran 111 of these hospitals, amounting to about 49.3% of the hospitals.
  7. Bad Habits: In 2014, about 17% of adults that resided in Portugal smoked every day, and adult obesity rates had risen to 16%. These habits, when coupled with excessive binge drinking, another popular activity in Portugal, lead to a high prevalence of health issues, such as cancer and cardiovascular disease.
  8. Disability: As of 2000, many Portuguese women can expect to live three-quarters of their life with some type of disability. Meanwhile, men can expect to live three-fifths of their years with some disability, illness or ailment.

These eight facts about healthcare in Portugal demonstrate the benefits that Portuguese people face with their healthcare system as well as some of their challenges. Hopefully, the ability for Portugal’s citizens to obtain free healthcare during early life and old age can serve as an inspiration to other parts of the world.

Kate Estevez
Photo: Pixabay

Healthcare in Maldives
People know the Maldives internationally for its beautiful beaches and remote atolls. This south Asian nation has a unique healthcare system with a design specific for an island. Here are seven facts about healthcare in the Maldives.

7 Facts About Healthcare in the Maldives

  1. Universal Healthcare: The Maldives has universal health insurance that covers a plethora of primary care services. The country’s health scheme is called Husnuvaa Aasandha and the state-owned company Aasandha runs it. Husnuvaa Aasandha means “healthcare for all without a ceiling protection limit” according to the Aasandha website, and it receives funding from the Maldives’ government. Notably, the plan pays for citizens to go abroad for certain medical treatments if the treatments are not available in the Maldives.
  2. Tier-based System: The Maldives has a “tier-based” healthcare system. Every inhabited island, even the most sparsely populated, has a primary care facility. Every inhabited atoll, or island chain, has a secondary care facility. Larger urban areas also have tertiary care centers.
  3. Government Spending: According to a 2018 report from the World Health Organization (WHO), 9% of the Maldives’ GDP goes toward healthcare. The country spends a higher percentage of its GDP on healthcare than any country in Southeast Asia, where the average expenditure for the region is 3.46%.
  4. Operation: Primary medical facilities often struggle to operate effectively. A report from 2019 revealed that a lack of supplies and equipment is a major factor hampering the Maldives’ primary health facilities. These facilities also have high staff turnover rates and are expensive to operate.
  5. Medicine: Medicine can be unusually expensive in the Maldives. Importing pharmaceuticals is often costly, as the Maldives is a fairly remote island nation. Furthermore, an analysis from 2014 found that price controls on medicine did not experience enforcement. Some pharmaceuticals cost patients more than 100% of their importation costs.
  6. Disease: Noncommunicable diseases such as respiratory diseases, cancer, diabetes and cardiovascular diseases cause the most deaths in the Maldives. Noncommunicable diseases such as these cause almost 80% of deaths in the country according to a 2018 WHO report.
  7. Life Expectancy: The Maldives has an above-average life expectancy. The life expectancy in the Maldives was 78.6 years in 2019, while the world average the same year was 72.6.

Healthcare in the Maldives is rapidly improving, with the country having an above-average life expectancy and basic health services on all inhabited islands. However, some areas of the nation struggle to receive essential medical supplies and medicine can be expensive. Overall, these seven facts about healthcare in the Maldives show that the country is making progress a priority and heading towards promising results.

– Kayleigh Crabb
Photo: Pixabay

Healthcare in Poland
Poland is an eastern European country between Belarus and Ukraine. As a member of the European Union, Poland enjoys many benefits and privileges. Many consider the eastern European country’s economy one of the most developed in Eastern Europe. Meanwhile, its Human Development Index (HDI) score is around .872, which is very high. Additionally, Poland has a successful universal healthcare system, although it has experienced challenges. Here is some information about healthcare in Poland.

Universal Healthcare

Nearly all European countries have free and universal healthcare, and Poland is no exception. The country offers a free public healthcare system in which every Polish and E.U. resident has the right to accessible healthcare, supported by the National Health Fund. The organization’s funding consists of a mandatory contribution from every Polish citizen: an 8.5% deduction from individual income. These deductions are the main source of funding for public and free health insurance. However, Poland does offer private health insurance as well. As of 2017, 91% of Poland’s population has insurance.

Flaws in Polish Healthcare 

Although Poland’s healthcare coverage is impressive, organizational problems, politics, underfunding and outdated technology still plague the system. The percentage of the population that has insurance is high, at 91%, but this is still lower than in many other European countries. Poland’s organizational structure is also incredibly understaffed in physicians, and especially specialists. Under the current Polish government, funding for the National Health Fund is also converting into a federal budget funding system, further complicating the bureaucracy of Polish healthcare. 

Income Inequality and Health

Another problem that plagues healthcare in Poland is the disparity of health between high income- and low-income groups. According to Poland’s 2017 health profile, 71% of high-income citizens report that they are in good health while only 53% of low-income citizens state the same. This 18 point difference is sizeable, considering Poland’s population. Poland’s life expectancy rate is also lower than most European countries, ranking 24th in the E.U. at around 77.5 years. With the improvement of its healthcare system, Poland has the potential to increase its life expectancy and decrease the health gap.

Poland’s healthcare system is effective in providing basic primary care to its residents. One can attribute this to both the improved treatment for cardiovascular disease– the leading cause of death in Poland–and the centralization of Poland’s healthcare system since 1999. However, the nation must prioritize the improvement of its organizational structure and funding system to continue to benefit its citizens.

Poland’s healthcare system is keeping most citizens healthy, but there are further improvements necessary in order for the current system to increase efficiency and reach beyond-average higher standards of health. Healthcare in Poland may not currently live up to the standards of other western European countries, but it has the potential to improve its healthcare structure to compete with and possibly surpass them in the future, considering its relative economic stability. In pursuit of this goal, Poland is taking steps to improve its healthcare system. The Polish Ministry of Health has begun using electronic prescriptions and other e-health technologies to improve coordination between hospitals, physicians and patients. The Ministry is also working on plans to further increase the number of physicians and specialists available in the public sector. Such reforms are essential to remaining competitive with other European countries.

Sadat Tashin
Photo: Flickr

Kazakhstan’s Healthcare System
In the midst of a global health crisis, easy access to healthcare is more important than ever. Unfortunately, most people in Kazakhstan were already struggling with limited healthcare funding, high levels of chronic disease and restricted access to care prior to the COVID-19 pandemic. While the country’s daily new COVID-19 case numbers approached 2,000 in early July 2020, social reforms and organizations like the World Bank have worked to combat this crisis and improve healthcare in Kazakhstan.

Background

Kazakhstan is a country in Central Asia that Russia, China, the Caspian Sea and a number of former Soviet republics border. Once a member of the former Soviet Union, the world around Kazakhstan has shaped both it and its culture. The exploitation of its natural resources and the migration of surrounding peoples into the country have influenced its development and geography. A new movement to reinstate traditional Kazakh culture has resulted in various reforms in both its society and government, including reforms in healthcare.

Health and Kazakhstan’s Population

Poor diet, pollution and inadequate healthcare negatively affect the health of Kazakhstan’s population. Compared with the countries surrounding it, Kazakhstan’s infant mortality rate is one of the highest at 17.9 deaths per 1,000 live births. Additionally, Kazakhstan’s average life expectancy is at 72 years. Moreover, access to healthcare in rural areas has limitations. According to IntegratedCare4People, a website that the World Health Organization manages, the northern, rural region of Kostanay has 266 physicians per 100,000 people, while the rest of the country has, on average, 388 physicians per 100,000 people.

The Current Healthcare System

In the past, the healthcare system has failed to focus on the significance of chronic diseases, such as diabetes and cancer, and blood pressure issues, focusing more on transmissible diseases. Recently, the government has expanded primary-care services (generalized care aiming to improve the life expectancy of a population) to combat the growing chronic disease mortality. The ultimate goal of Kazakhstan’s reforms is to transition to a universal healthcare system with greater cost transparency and a better quality of life. Over the years, the government has steadily increased healthcare funding and reduced the influence of private insurance.

The Shift Toward Universal Healthcare

The newest reform, the Compulsory Social and Medical Insurance (CSMI) program, which went into effect in January 2020, aims to create a single-payer healthcare system. The intent is for public insurance to pay for certain medical expenses and regulate healthcare quality. The goal of the program is to reduce out-of-pocket expenses (the cost of care that patients are responsible for), which made up 45.14% of Kazakhstan’s total health spending in 2014. However, despite steady growth in funding, healthcare financing in Kazakhstan is still very limited. Health spending makes up 3.1% of the GDP, in comparison with the global average of 9.89%, as of 2017. With an average yearly income of $26,300 per capita, Kazakhstan cannot achieve widespread public insurance without stimulating its economy.

The World Bank and Kazakhstan

In 2019, economic expansion caused wages in Kazakhstan to increase by 8.9% and poverty to decrease to 8.5%. Though the quick spread of COVID-19 in the country will likely backtrack some of these achievements, the World Bank has set up the Country Partnership Framework, a strategy for increasing economic support for Kazakhstan from 2020 until 2025. The goals of this framework are to expand economic diversity, minimize the healthcare gap between rural and urban areas, decrease carbon usage and increase energy efficiency. Part of the World Bank’s work in Kazakhstan includes offering grants to businesses to improve health and economic outcomes. The World Bank has sponsored and commercialized inventions like X-matrix (a wound dressing for burns) and invested in agricultural technology to boost Kazakhstan’s economy.

Healthcare in Kazakhstan is majorly dependent on its economy. While government funding for healthcare is far behind similar countries, the steady growth of business and investment will allow it to slowly increase. The effects of COVID-19 in Kazakhstan are meeting with productive and long-term funding from organizations like the World Bank. With steady growth and progress, Kazakhstan’s healthcare system and overall health should be able to improve over time.

Ann Marie Vanderveen
Photo: Pixabay

Healthcare in BoliviaBolivia has historically struggled with high levels of poverty and providing quality healthcare to those in need of it. However, in the past decade, healthcare in Bolivia has created promising developments that have facilitated lower levels of extreme poverty, child mortality and rampant diseases.

Bolivia’s Unified Health System

In 2019, Bolivia’s then-president Evo Morales implemented the Unified Health System. The free health care system promised to cover almost 6 million uninsured people, a significant percentage of Bolivia’s 11 million citizens. It provides access to services such as doctor visits and medication and covers the treatment of illnesses like Parkinson’s, child cancer, diabetes and more.

To aid citizens in receiving care, an instructional app was made to provide the necessary information. For example, it helped with locating healthcare centers and identifying what treatments would be covered under the Unified Health System.

The Unified Health System saw immediate success, with more than 35,000 patients receiving healthcare treatment in the first five days of its implementation. This program builds off the success of the 2013 “My Health” program that allowed citizens with the most need to have access to free healthcare.

Developments such as these have accounted for the threefold increase in the Bolivian healthcare budget since the mid-2000s. Fortunately, this increased dedication to public health has paid off. The changes have increased the overall health of the population and decreased child malnutrition rates by 50%.

Increasing Access to Healthcare

Even when citizens have a right to free healthcare, there are additional boundaries that may prevent them from getting the help they need. Bolivia’s rural areas tend to be much more burdened with poverty than urban areas. Additionally, there are usually fewer health clinics that are easily accessible in rural areas.

In response, the government built 2,710 clinics to increase access to healthcare in Bolivia. It was estimated that this provided 25% of the most vulnerable population with access to medical assistance. The government also placed increased effort on preventatively addressing medical issues, many of these focusing on women and children.

Similarly, the government introduced the Bono Madre Niño-Niña Juana Azurduy program to promote safe motherhood. It supplied cash transfers to mothers who frequently received health checkups during pregnancy and the first two years of their child’s life. This endeavor partnered with the Zero Malnutrition Multisectoral Program, which helped fight malnutrition in children under five. Programs such as these helped increase the survival rate of infants and decrease the risk of child malnutrition.

The Challenges of the Unified Health System

The Unified Health System did show promise for making long term improvements for healthcare in Bolivia. However, the government did not allocate enough money to make this goal sustainable and achievable. Doctors expressed the need for a budget of around $1 billion (USD), much greater than the $200 million they received. Because of the lack of funds, there are not enough supplies or facilities available to provide the healthcare that so many Bolivians need.

Continuing to Improve Healthcare in Bolivia

To combat some of the shortcomings, various organizations help to support Bolivian healthcare systems. Here are some examples.

  • Because the need is greatest in rural areas, NGOs such as Global Links have stepped in to provide materials and support to these areas. They have also provided a significant amount of equipment for people with disabilities. These efforts have reached an estimated 200,000 people in areas that were previously underserved.

  • Mano a Mano, a nonprofit focusing on serving Bolivia, ships excess medical supplies from Minnesota to Bolivia. This supports existing healthcare clinics by providing free supplies to serve patients.

  • Another solution is found in new mobile healthcare centers. By relocating these centers to reach patients in need, this solution combats limited funding and medical equipment. The mobile centers have been built to contain fully functional MRIs, and their portability has allowed an increase of more than 50% in patients served.

Healthcare in Bolivia has made impressive strides to improve citizens’ quality of life. Experts have praised the idea of the Unified Health System, calling it a “model for Latin America.” To continue the good work that this program can provide, more money needs to be dedicated to supporting it. In doing so, more clinics can be built, more doctors can be hired and more equipment can be purchased.

– Hannah Allbery
Photo: Flickr