Access to health in the developped and developing world

Exclusively written for the Sting by Mr Aluko Oluzabusayo Daniel, student of medicine and surgery at Lagos University Teaching Hospital in Nigeria. Mr Aluko is affiliated to the International Federation of Medical Students Association (IFMSA). The idea that complete access to optimum health care is reserved only for the financially stable in the society or that inequality in health care access should exist for various social reasons first of all should not harmonize with our thoughts and policies against that should be formulated and implemented globally. To think that the only means by which people will be get access to adequate health care is determined by their income, education, ethnicity, occupation or place of residence is absurd and should not stand in our world today. This is because the highest attainable standard of health is a fundamental right of any human being (including refugees and internally displaced persons) wherever they may find themselves. Economical stability as a result of technological advancement, level of industrialisation, widespread infrastructure, per capita income and general standard of living makes it obvious as to who is getting more affordable access to health care and where. In the United States, only 5.3% of persons failed to obtain needed medical care due to costs in the past year. This is a stat the government is still trying to improve by formulating and implementing key programs like the “Patient Protection and Affordable Care Act” to give Americans access to affordable and quality healthcare and insurance. However, a program like the National Health Insurance Scheme (NHIS) introduced in Nigeria since its inception has enrolled only 5% of the working population. The NHIS was introduced to warrant accessibility to healthcare for Nigerians. Questions should be asked. Questions like why governments of most developing nations pay little attention to the healthcare sector which is evident in their budget allocation, how we could increase and measure access to safe, effective healthcare and reduce disparities in health care access for diverse populations (including racial and ethnic minorities as well as older adults) and how we could improve access to palliative and emergency healthcare services. You see, the issue with healthcare in most developed nations is inequality in access, as it appears that a non citizen or basically someone who is not under a particular scheme isn’t given equal or affordable healthcare services like General Practitioner consultations.  However, in most developing nations, the issues are so diverse that they are bordered by so many topic barriers. Availability of health care and the financial ability of people to access the good quality available care are usually directly proportional.  Firstly, if healthcare services are sufficiently available for use, then the opportunity to procure healthcare services exists right? Obviously! However, in a situation when there’s no availability in the first place or the services are scarce due to ineptitude on the side of the suppliers, situations affected by the topic of burden won’t be helped. Also, there are over 400 million people in the developing world without the financial access to basic healthcare. This is a real problem and measures should be taken by their governments to deliver health insurance to them as well as increase the affordability of these services. Also, there seems to be a dearth of the availability of the healthcare workforce in the developing world and most especially in primary health care. This shouldn’t be surprising because people trained there just tend to look for places where they can be better appreciated for the services they can offer. Well, you can call that “Brain Drain”. Imagine a government that refuses to pay the salaries of its doctors, and when they complain by taking part in an industrial legal action, decides to lay them off! Primary health care on the other hand is so important that it’s regarded as the first point of contact of individuals to healthcare and shouldn’t be taken for granted. The primary health care is known for its role in limiting the spread of communicable diseases and spread of health education in the developing world especially. Therefore, encouragement of medical graduates and exclusive training of individuals as health extension workers to work at this level should be heavily funded by governments. Current efforts to revitalise primary health care worldwide should go concurrently with attention paid to the social determinants of health. Without going much deeper, technology has been a neglected factor in the developing world unlike the developed world. What technology does makes it easier for patients to get access to the information they really need as regarding to their health, helps strengthen communication between doctors and patients thereby helping them stay healthy. This is also a form of health care access and should be explored from all angles. Furthermore, laboratory and clinical investigations would be done with ease in these regions if only modern medical facilities like the electrocardiogram (ECG), Magnet Resonance Imaging (MRI) machines, Computed Tomography Scanning and so on were available as well as uninterrupted power supply to make them work because modern medicine relies on the clinical laboratory as a key component of health care. “Now our job, our duty, our responsibility to ensure the safety and security of our citizens cannot be complete unless we guarantee health care security for all” –Thomas Vilsack