Abstract
This article deals with the issues of health services for poor consumers in Third World countries. The health services in these countries have been modelled on the systems available in developed countries and meet the needs of the affluent sections of the population who control government policy. But these services are beyond the reach of the poor. There are wide disparities between the health indicators of the rich and poor consumers in the Third World. To provide adequate health services to the poor, there should be a re-allocation of resources away from high technology and hospital based curative services to preventive and promotive health services. It is often argued that low income countries cannot expect to improve the health of all their inhabitants without first increasing productivity. Evidence from selected Third World countries indicates, however, that visible improvements in the health status of the poor are quite feasible with low per capita GNPs if there is the political will to implement progressive policies in health and certain non-health sectors. The latter include policies on land reform and education, particularly education of women.
Zusammenfassung
Der Aufsatz befaßt sich mit Problemen von Gesundheitsdiensten für arme Konsumenten von Drittweltländern. Die gesundheitliche Versorgung der Bevölkerung ist dort nach Vorbildern von Industrieländern eingerrichtet worden. Sie kommt den Bedürfnissen der wohlhabenden Oberschicht entgegen, die die Regierungspolitik kontrollieren. Die dieserart angebotenen Gesundheitsdienstleistungen sind jedoch für die Armen unerreichbar und unerschwinglich. Es zeichnen sich erhebliche Unterschiede in den Gesundheitsindikatoren zwischen den wohlhabenden und den armen Verbrauchern in Ländern der Dritten Welt ab. Um wirklich die Armen gesundheitlich zu versorgen, müßte eine Umverteilung der Resourcen weg von Hochtechnologie und stationärer Behandlung und hin zu präventiven und unterstützend-helfenden Maßnahmen erfolgen. Es wird oft behauptet, daß Länder mit geringem Volkseinkommen den Gesundheitsstand ihrer Bevölkerung nicht wesentlich verbessern können, bevor sie nicht erst ihre Produktivität steigern. Beweismaterial von Drittweltländern zeigt jedoch an, daß erkennbare Verbesserungen des Gesundheitszustandes der Armen in Ländern mit geringem Volkseinkommen möglich sind, wenn der politische Wille besteht, fortschrittliche Politiken in Gesundheitsdientsen und einigen verwandten Nichtgesundheitssektoren umzusetzen. Zu letzteren gehören Bodenreform und Erziehung, vor allem für Frauen.
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Kumariah Balasubramaniam is pharmaceutical advisor to IOCU (International Organization of Consumers Unions), P.O. Box 1045, 10830 Penang, Malaysia.
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Balasubramaniam, K. Issues of health services for the consumer in Third World countries. J Consum Policy 12, 309–331 (1989). https://doi.org/10.1007/BF00412138
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DOI: https://doi.org/10.1007/BF00412138