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7 Key Facts About Healthcare in Colombia

Healthcare in ColombiaColombia’s healthcare system is not perfect but it also far from inadequate. Located in the northernmost part of South America, Colombia has estimable healthcare provision for the country’s people. With both public and private insurance plans, reputable facilities and well-equipped healthcare providers, Colombia sets an example of what sufficient healthcare looks like in a developing country. To understand this better, it is necessary to know some key facts about healthcare in Colombia.

7 Facts About Healthcare in Colombia

  1. Healthcare in Colombia ranked 22nd out of 191 healthcare systems in overall efficiency, according to the World Health Organization. For perspective, the United States, Australia, Canada and Germany ranked 37th, 32nd, 30th and 25th respectively.
  2. Colombia’s healthcare system covers more than 95% of its population.
  3. Indigenous people are considered a high-risk population due to insufficient access to healthcare in indigenous communities in Colombia. Specifically, they are more vulnerable to COVID-19 due to this lack of healthcare access and significant tourist activities in indigenous regions increase the risk of spread. Robinson López, Colombian leader and coordinator for Coordinadora de las Organizaciones Indígenas de la Cuenca Amazónica (COICA), said in March 2020 that tourism in indigenous territories in Latin America should stop immediately to curb the spread of COVID-19.
  4. There are inequities in the utilization of reproductive healthcare by ethnic women in Colombia, according to a study. Self-identified indigenous women and African-descendant women in the study had considerably less likelihood of having an adequate amount of prenatal and postpartum care.
  5. The Juanfe Foundation is a Colombian-based organization that promotes the physical, emotional and mental health of vulnerable and impoverished adolescent mothers and their children. So far, the organization has supported more than 250,000 people. The Juan Felipe Medical Center served 204,063 individuals — 20% of the population in Cartagena, Colombia. The organization also saved the lives of 4,449 infants through its Crib Sponsoring Program.
  6. In 2019, four of the top 10 hospitals in Latin America were in Colombia and 23 of the top 55, according to América Economía.
  7. Colombia secured nine million doses of the COVID-19 vaccine from Johnson & Johnson in December 2020. Combined with the doses it will receive from Pfizer, AstraZeneca Plc, COVAX and other finalizing deals, Colombia will be able to vaccinate 35 million people within its population of 49.65 million, striding toward herd immunity.

Recognizing Colombia’s Healthcare System

Simultaneously recognizing the current inequities and challenges alongside the positives in Colombia’s healthcare system is the true key to understanding it and the individuals depending on it overall. Despite attention-worthy deficits, healthcare in Colombia stands out in Latin America and in the world as high quality, widespread and respectable. The country’s healthcare is contributing to the well-being of many and the future ahead looks promising.

– Claire Kirchner
Photo: Flickr

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Top 10 Facts About Life Expectancy in Japan

Life Expectancy in JapanYear after year, Japan consistently ranks as one of the top countries for life expectancy. These top 10 facts about life expectancy in Japan is a reflection of economic developments that occurred since World War II.

Top 10 Facts About Life Expectancy in Japan

  1. Japan ranks second in the world for life expectancy, with the average Japanese citizen living to 85.0 years. The life expectancy for the average female in Japan is 88.1 years and 81.9 years for males. There has been a fairly consistent difference in the life expectancy between women and men in Japan. Currently, women are expected to live around 6.2 years longer than men. Prior to 1990, the country had not even made the list of the top 100 countries with the highest life expectancies.
  2. The fertility rate in 1955 for Japan was 3.0 live births per women, which has decreased to 1.4 in 2020. A decrease may appear worrisome but there is a clear correlation between fertility rates and wealth. Poorer nations tend to have high fertility rates which continues a cycle of poverty but intermediate levels of fertility tend to represent an economically stable, wealthy country.
  3. Infant mortality and overall child mortality rates have greatly decreased since the 1950s. In 1950, the infant mortality rate was roughly 47 deaths per 1,000 births and the number of deaths for children under 5 was 72 per 1,000 births. As of 2020, the infant mortality rate and deaths for children under the age 5 is 1.6 and 2.2 per 1,000 births, respectively. These statistics display growth that has contributed to a higher life expectancy in Japan.
  4. Diet and lifestyle are major contributors as well. Japanese people tend to enjoy well-balanced, nutritious meals that consist of vegetables, fruits, fish and high-grain based foods. This diet is low in saturated fats and includes mainly natural, unprocessed foods. In addition, the country has succeeded in promoting a healthy and active lifestyle. Even in their old age, many Japanese seniors continue to exercise regularly.
  5. Rapid economic growth was seen in the country in the 1960s and the Japanese Government made great efforts to invest in the country’s healthcare system. In 1961 the country adopted universal health insurance for their citizens which included vaccination programs and medical treatments that greatly decreased both adult and child mortality rates.
  6. Increased economic prosperity is a contributing factor. After World War II, Japan experienced an extremely rapid growth in its economy. Increased economic prosperity led to medical technology advancements, universal healthcare access, improved diets and lifestyles, decrease in disease and deaths, improvements in education and lower mortality rates. Economic prosperity and life expectancy rates are related, as seen in Japan.
  7. A smaller poverty gap can also account for life expectancy in Japan. In the 1970s, Japan had a smaller income and wealth gap in the population compared to many other developed countries and it has been proven that a higher inequality in wealth correlates to higher mortality rates.
  8. Successful health education and a well-established health culture is what Japan is known for. Majority of citizens engage in regular physician check-ups and receive vaccinations and immunizations. Furthermore, Japanese people are encouraged to reduce their salt intake and red meat consumption, advice the people take seriously.
  9. Practice of good hygiene is another factor in explaining the high life expectancy in Japan. Common practices such as handwashing and cleanliness is normal in Japan but the country also has sufficient access to clean, safe water and sewage systems as well.
  10. Decreased cerebrovascular diseases. Historically, Japan has always had low rates of ischemic heart disease and cancer compared to other developed, high GDP countries. However, Japan had one of the highest rates for cerebrovascular disease from the 1970s-1980s. Thanks to health developments, Japan has greatly decreased their rates of cerebrovascular diseases within the past 20 years.

– Bolorzul Dorjsuren
Photo: Flickr

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Commendable Healthcare in Monaco

Healthcare in MonacoWith nearly 40,000 people, Monaco is one of five European micro-states and is located on the northern coast of the Mediterranean Sea. According to the Organisation for Economic Co-operation and Development (OECD), Monaco has one of the best global healthcare schemes. The World Health Organization established that an individual born in 2003 can expect to have, on average, the longest lifespan in Europe. The country also has the third-highest proportion of doctors for its population in Europe.

Healthcare Education in Monaco

Leaders in Monaco believe that prevention and screening are essential to maintaining health and it is customary for young people to access comprehensive health education. This education aims to promote high-quality lifestyles and prevent early-risk behavior, such as tobacco use, drug addictions and sexually transmitted diseases.

Caisses Sociales de Monaco (CSM)

The Caisses Sociales de Monaco (CSM) is the official agency responsible for supervising Monaco’s public health service. Public healthcare automatically covers all citizens and long-term residents who contribute to the agency. French and Italian citizens may also access public health facilities in Monaco upon evidence of regular contributions to their home country’s state healthcare scheme. Foreign visitors can receive health treatment at all public hospitals and clinics. However, without state insurance contributions, travelers and expatriates will be forced to pay for all healthcare expenses accrued from treatment.

Public Healthcare Coverage

Public healthcare insurance operates through reimbursements, so an individual who plans on using coverage provided by the CSM will be required to make up-front payments and then claim costs back. After joining the public healthcare system, an individual receives a card that provides access to medical and dental care. The card contains administrative information necessary to refund medical care.

The public healthcare system provides coverage for inpatient and outpatient hospitalization, prescribed medications, treatment by specialists, pregnancy and childbirth and rehabilitation. Some prescription drugs are also reimbursed through the CSM and emergency care is available to everyone at Princess Grace Hospital, one of three public hospitals. The hospital will be reconstructed to strengthen the complementary nature of all the hospitals in Monoco.

Out-of-Pocket Healthcare Costs

Out-of-pocket healthcare costs in Monaco are high and if the CSM fails to provide sufficient coverage, an individual may supplement with private insurance. Private health insurance is a tool for individuals who want to cover medical services and fees not paid for by the public healthcare system. Doctors fund privately-paid equipment and staff through private contributions. According to an article from Hello Monaco, most Monaco citizens take out extra private insurance to cover ancillary services and unpaid rates.

A Commendable Healthcare System in Monaco

Every resident in Monaco is eligible for public health insurance but private health insurance remains an option for those interested in more coverage. Healthcare in Monaco earned outstanding reviews from the OECD and officials continue to seek improvements by reconstructing medical buildings and providing health education for young people.

– Rachel Durling
Photo: Flickr

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Five Facts About Healthcare in Austria

Healthcare in AustriaAustria is known for having one of the most generous and greatest healthcare systems across the world. Healthcare needs are readily accessible to Austrian citizens at little to no cost. The vast majority of the Austrian population has access to healthcare, as long as an individual is not willingly choosing to be unemployed.

Healthcare in Austria

  1. Two-tiered system: In the first tier of Austria’s two-tiered healthcare system, healthcare covers 99% of the population, of which 75% is typically funded through public taxes. However, citizens can also pay to have supplementary healthcare, which allows individuals to see private practitioners. As of 2010, it is estimated that 130,000 individuals chose to pay for private healthcare.
  2. Life-long private providers: For those who choose to pay for private or supplementary healthcare, insurance companies are not allowed to have restrictions within contracts, nor are they allowed to terminate an individual’s healthcare without permission. The private healthcare services can only be terminated by the individual, allowing the user to have access to life-long healthcare services.
  3. High accessibility to hospitals and pharmaceuticals: Despite the decline in hospital bed availability around the world, Austria has 271 hospitals containing more than 64, 000 beds and around 45,000 doctors, classing the country as having one of the highest bed/patient ratios in Europe. Along with the availability of hospitals and other health centers, the cost of pharmaceutical drugs in Austria is low. In 2012, Austria’s pharmaceutical costs were an estimated 18.6% lower than the rest of Europe.
  4. Public healthcare covers four areas: Within the Austrian healthcare system, there are four specific areas in which those who choose to have public healthcare, rather than private healthcare, can be covered: illness, maternity, precautionary and therapeutic aid. Each of these categories requires certain criteria for the individual to be categorized into one of the four areas.
  5. Tourists have access to healthcare: For those visiting Austria with a European Health Insurance Card, access to public healthcare is enabled. While this does not cover any private healthcare, it does cover basic doctor’s visits, dental services and even emergency hospital visits. This allows tourists or students who may need emergency medical assistance to access healthcare at a reduced fee.

Through this dynamic healthcare plan, Austria is able to provide healthcare and benefits for its citizens. Whether it be a simple checkup or something more extensive, Austria’s public healthcare system alleviates healthcare burdens for its people. Even for those who pay for a private healthcare plan, the cost of medical expenses is far less than many places around the world, as it is estimated to only cost $243 a month. Whether it be private or public healthcare, Austria’s two-tiered system has found itself among the highest-ranking healthcare systems in the world.

– Olivia Eaker
Photo: Flickr

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How Does Corruption in Healthcare Disproportionately Impact those in Poverty?

corruption in healthcare
The healthcare sector in several countries around the world is commonly referred to as being among the most corrupt sectors. A 2013 Transparency International Study reported that more than 50% of citizens viewed their country’s health sector as corrupt in 42 out of 109 countries surveyed. The World Bank has regarded corruption in healthcare as a major barrier to achieving social and economic development.

Corruption and Poverty

Informal payments are a very specific form of corruption prevalent in weak health care systems around the world. Informal payments refer to under-the-table payments to receive services that are otherwise free or which are requested in addition to officially sanctioned required payments.  They are prevalent in the healthcare sector of many countries globally. For example, in Azerbaijan, informal payments account for 73.9% of all medical spending. This form of corruption often arises due to inadequate healthcare management, including inadequate public spending, resource deprivation, governance and human resource constraints and scarcity of providers.

Informal payments negatively affect healthcare at the individual and governmental levels. Due to the secrecy that often shrouds the transaction of informal payments, these payments are often made in cash and do not contribute to the collection of taxes. This translates into less money available to be reinvested in the healthcare system.

Further, informal payments are often regressive in nature, meaning that low-income individuals often tend to pay a larger proportion of their income respective to high-income individuals.  One study in sub-Saharan Africa identified informal payments as being highly prevalent among the poorest segments of society.

Informal payments represent severe barriers to accessing care for those living in poverty. In some cases, informal payments can push low-income individuals to borrow money often with high-interest rates. This indebtedness can lead to financial ruin for low-income families and can potentially push them into the poverty trap.  More concerning is the potentially deadly impact of patients to delay or forego medical care due to the inability to cover the expected informal payments.  Further, the informal nature of these payments makes exemptions to protect those in poverty increasingly difficult to enforce.

The Impact of COVID-19

The COVID-19 crisis can lead to further barriers to accessing care and may bring an increase in the prevalence of informal payments. Overwhelmed, weak health care systems around the world with resource and provider scarcity may push those seeking treatment to use informal payments as a means of accessing better care and at other times may be required to make up for inadequate funding. It is known that informal payments are tied to these scarcities. These factors are increasingly relevant in COVID-19 responses around the world.

There is a high risk of the prevalence of informal payments increasing in reaction to the pandemic. For those who cannot afford the cost of informal payments, the catastrophic virus may cause families to take on a high-rate of debt, pushing low-income families further into poverty. If individuals choose to forego testing or treatment for the virus due to a lack of financial ability to cover informal payments it could impact the response to fighting COVID-19 by accelerating the spread of the disease.  With the number of people living in extreme poverty projected to rise by 71 million due to the economic shocks brought on by the pandemic, there is an urgent need to address the issue of informal payments and broader corruption in the healthcare sector.

How to Take Action

According to the Carnegie Endowment, the spread of coronavirus, with corruption acting as a catalyst, poses a serious threat to U.S. interests and foreign policy objectives. There are a number of ways the U.S. can address the problem of corruption and the prevalence of informal payments around the world through the U.S. Global Coronavirus Response. The Countering Russian and Other Overseas Kleptocracy (CROOK) Act aims to address corruption through rapid action. The act has been introduced in the Senate after passing the House of Foreign Affairs Committee and shares bipartisan support. USAID in partnership with the State Department is addressing the corruption-coronavirus nexus by supporting transparent emergency procurement mechanisms and providing support to anti-corruption law enforcement.

Due to the discrete nature of informal payments and the provider-patient relationship, the U.S. influence is limited in combating informal payments. In low-income countries with weak healthcare systems, the most effective means of mitigating the impact of informal payments on those impacted by COVID-19 is prevention. The United States can help curb the spread of COVID-19 around the world by providing adequate funding for global health security in the next emergency supplemental COVID-19 response.

– Leah Bordlee
Photo: Flickr

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Healthcare in Czechia Finds Success

Healthcare in CzechiaAccording to the European Consumer Health Care Index of 2019, the Czech Republic’s healthcare system is ranked 14th out of the European Union countries. The European Consumer Health Care Index attempts to provide a ranking based on the perspective of the consumer. Some measures used to determine this perspective include “patient rights and information, access to care, treatment outcomes, range and reach of services provided, and prevention.” In fact, according to the Index, healthcare in Czechia is more successful than initially expected, considering the small amount spent per capita.

Healthcare in Czechia

The Czech Republic spends around 7% of its GDP on healthcare. Other funding comes from employees and employers who pay toward the healthcare system. Anyone who works for a Czech employer has health insurance. The Czech Republic government makes contributions on behalf of the unemployed, so coverage is essentially universal.

Aside from employee-funded and government-funded public healthcare options, the Czech Republic also offers an option for private insurance. The differences between the public and private healthcare systems can be significant. For instance, common problems with the public system include very long wait times for patients, tired and overworked doctors and a lack of English-speaking doctors. These are common issues in public healthcare systems, to which some countries have responded by offering a more expensive but private option, as the Czech Republic does.

Coverage for All

When comparing healthcare in Czechia with other Central and Eastern European (CEE) countries, the Czech Republic stands out as a “star performer.” Its high ranking is attributed to healthcare accessibility, cost-effectiveness and lack of corruption.

The idea of universal healthcare in the Czech Republic dates back to the 18th century, when the Austro-Hungarian Emperor Joseph II built hospitals and organized ways for everyone to have healthcare. By 1900, most European countries had state-subsidized healthcare. The Czech Republic, which was then part of Czechoslovakia, had one of the best healthcare systems in Europe even then.

In an article published by StarTribune, author Bonnie Blodgett explores what she considers to be the most important aspect of Czech healthcare: the idea of “self-administration.” Blodgett dates this back to the year 1989, when the Czech Republic government began to emphasize a bottom-up, instead of top-down, decision-making process.

A prime example of “self-administration” in Czech healthcare, aside from the ability to choose public or private, is doctors’ incentives to practice medicine. In the United States, being a doctor is a well-paying job. As Blodgett points out, some Americans may enter medicine with a primary interest in the financial incentives. This is not the case in the Czech Republic. Instead, doctors and nurses enter the profession to make sick people healthy. This is incentivized by the government, which gives and withholds money based on medical results.

Problems with the Czech System

The system of “self-administration” is not perfect. Many Czech doctors and physicians have threatened to leave the Czech Republic to work in a different European country that will pay them higher wages. Additionally, some critics of the Czech system worry that the government’s insistence on keeping public healthcare as affordable as possible risks turning healthcare in Czechia into a two-tier system. Interestingly, Blodgett points out that many Americans travel to Prague to undergo surgery because of how inexpensive the procedures are compared to in the United States.

Despite potential problems for the Czech Republic’s healthcare system, the country’s determination to keep healthcare affordable and accessible for all citizens is commendable. For now, the Czech Republic remains one of the most affordable and well-ranked healthcare systems in Europe.

– Lara Smith
Photo: Flickr

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Maternal Instinct: Indian Women Take on a Corrupt Medical System


A group of 40 volunteers is cracking down on the corrupt medical system in India and taking a stand against the country’s soaring rate of maternal deaths.

Prenatal care at government-run medical facilities is supposed to be free of charge, but as Monika Singh discovered, not every woman is aware of this, and some doctors are more than willing to exploit their ignorance.

“Why are you charging for medicine? It’s supposed to be free for pregnant women in a government hospital,” challenged Singh when a doctor tried to make an ill mother-to-be pay for her medicine.

Armed with Nokia phones and a list of codes, Singh and fellow volunteers routinely visit a number of villages, interviewing expecting and new mothers and families. Using simple numeric codes, interviewees can text the volunteer’s details of their pregnancy and related care. For example, texting the number 25 means no ambulance was available when needed.

Cases of women being turned away from hospitals, women being extorted and forced to bribe their way to treatment, and even cases of women dying on the way to the hospital after being denied treatment at multiple clinics are just a few of the examples of the rampant corruption of the Indian medical system.

An estimated 50,000 women in India die each year from pregnancy-related causes, accounting for 17 percent of global maternal deaths each year. While there are countries with much higher rates of maternal death, the sheer volume of annual maternal deaths is unprecedented.

Aside from malnutrition and a lack of enforcement of laws meant to protect expecting mothers, many women say they are too afraid to pursue their rights, even when they know them. “They don’t have the courage to pursue their rights proactively. That’s the challenge,” said Singh. But the presence of volunteers is encouraging more women to speak out about the injustices they have faced.

Improvements have been seen, however, since Singh and her fellow volunteers took to the streets. Working with the End Maternal Mortality Now (EndMMNow) scheme, the volunteers say it is now the doctors who are afraid of them, not the other way around.

“The workers fear these volunteers. They’re afraid they will report a case about them, so now they do their jobs properly,” said Arpana Choudhury, who follows up on reported cases.

The EndMMNow program compiles the reports that they receive to create an interactive map, clearly showing areas needing the most urgent attention, hoping that a clear depiction of the need for reform will prompt much-needed government attention.

– Gina Lehner

Sources: The Guardian, WHO
Photo: Flickr