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Every country in the South East Asia (SEA)
Region has its primary agenda to provide health
for all to its people, despite its poverty, and
despite carrying the brunt of the world’s burden
of diseases. They have made substantial progress
in making improvement in the average life
expectancy at birth and in the reduction in the
child and infant mortality. Each has developed a
basic health infrastructure for countrywide
coverage, with linkages to community–based
health volunteers. All the countries of the
Region show a continued rise in the human
development index. The Region suffers from
old, new and emerging diseases. Nearly 40% of
global maternal and neonatal deaths, 40% of
tuberculosis, and 41% of all deaths due to
infectious diseases, including diarrhea and
malaria, occur in the Region. The region
accounts for 75% of the global leprosy cases.
HIV/AIDS is assuming epidemic proportions with
devastating results.
The Region has 40% of the world’s poor. A
sizeable number of the people live on income of
less than a dollar a day. The report of the
Commission on Macroeconomics and Health has made
compelling evidence-based arguments stating that
better health is not only an important goal for
the world’s poor but it is also a prerequisite
for an increase in economic growth and social
development for more equitable and functional
societies. The current annual per capita health
expenditure in the Region is US$15 though the
above report has recommended US$ 30-40 per
person per year as adequate.
People out of their own pockets pay more than
70% of the total per capita health expenditure
in the Region. As a result, the poor either have
to shun health care services because the costs
are beyond their means; or they must become more
impoverished by paying out of their pockets. A
vicious cycle of ill- health, low productivity
and poverty; and this is debilitating the
Region.
Existing economic and gender disparities are
major challenges cutting across all other issues
that relate to the Region’s health status.
Although the overall life expectancy has gone
up, there is a wide gap in the life expectancy
of urban and rural populations. The Region’s
maternal mortality ratio (MMR), an indicator of
women’s health, is among the highest in the
world. Unequal development poses a common
challenge for all countries in the Region.
Nepal is a typical example of the Regional
situation where attempts of improvement in the
life of the people are continuously made despite
difficulties such as widespread poverty, social
problems and conflict situation in the country.
With problem as such in the Region there are
a few public health institutions that exist in
the Region to produce human resources that can
provide leadership to help solve the public
health problems. It should be noted that the
health problems in these countries are
continuously changing and there are limited
number of schools of public health that could
produce skilled public health leaders that could
respond to these emerging new public health
issues. |
