Health is a basic necessity of life and birth right of every individual. Thus arises the need for an efficient health care system. A health care system is an organisation or institution of people that are responsible for delivering health care services to the target population. There are more than 200 countries on this planet, and each country organises its health care services differently.

 In the last 60 years, health care systems have become more advanced than ever in the history of mankind. A good healthcare system ensures that quality healthcare reaches every strata of the population. This requires big financial strength1, good policy making and equally good governance to ensure right implementation of policies and an efficient work force. The WHO ranks after rating the healthcare services of different countries. This rating is an index of factors which are as follows:

1-Health-disability adjusted life expectancy – DALY

2- Responsiveness-speed and efficiency of healthcare availability.

3- Fair financial distribution.

Accordingly, healthcare systems are rated as best and worst. Here are the 5 countries with the worst healthcare systems:

1-Zambia-The population of this country is a mere 14 million. The average life expectancy is barely 50 years, as the leading cause of death are preventable, diarrhoeal diseases due to lack of clean drinking water facilities.

2-Mozambique-The population of this country is 23.9 million. Malaria is the leading killer2 of children causing more than 25% of deaths each year in children under the age of 5. HIV/AIDS is the major concern in the adult population. An estimated 670,000 children have lost either one of their parents to this disease.

3-Liberia-The population of this country is around 4 million and general life expectancy just 57 years. Malaria is a major problem here too, and due to lack of health care services, more than 43% of children below 5 years of age do not receive any treatment.

4-Central African Republic-This country is ridden with poverty and poor healthcare. The average life expectancy is at the lowest at just 47 years of age. Sanitation and lack of clean water are the major problems of this country and diarrhoea is a leading cause of death.

5-Myanmar-This is the only non-African country with poor healthcare. This country spent their lowest GDP on health and gets lowest international aid for health per capita. The average life expectancy is 50 years, with 25% of the population below 15 years of age.

In contrast, let’s look at the 5 countries with best health care systems:

1-France-This country has one of the best health care services, because of the universal healthcare system adopted by them, where people contribute in proportion to their income. Hence, the government is able to reimburse 70% of the medical bills of its citizens. France recorded the lowest percentage of deaths avoidable by providing basic health care services.

2-Italy-In Italy, the general life expectancy is a whopping 80.5 years of age. Most citizens have no private insurance plan as their country is able to cover for most of their health care needs.

3-Japan-The average life expectancy is the world’s highest at 86 years, owing to their advanced medical care facilities. In spite of spending lowest on health care, their infant mortality rate is as low as 3 in 1000.They have the best recovery rate from major illnesses in the entire world.

4-Spain–  In Spain, the average life expectancy of women is 85 years, which indicates the quality of health care facilities. The health care system ensures no upfront expenditure for the patients except that of paying medical bills of a portion of prescription drugs. Both public and private healthcare services are extremely efficient.

5-Portugal-The general life expectancy is 80 years, indicting how efficiently health care services are provided. Its infant mortality rate is as low as 3 in 1000.The state of Portugal pays a part of cost of medicines, many other drugs required for treating are totally subsidised4.

Thus, its clearly visible that there is a huge gap between health care services provided by different health care systems in different countries. While some countries boast of best health care systems others, underdeveloped countries face acute shortage of rudimentary health care services that can save millions of lives.

Contributed by Dr. Rachita Narsaria, MD


1-World health organisation.

2-Mosambique.Our Africa.


4-The Angloinfo.