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'Good health at low cost' 25 years on - what makes a successful health system?
Date:10/17/2011

health at low cost which sought to shed light on this issue. The report found that Sri Lanka, Costa Rica, China and the Indian state of Kerala achieved levels of health comparable to those seen in wealthier countries, but at significantly lower levels of income, convincingly dispelling the myth that economic growth was a sufficient driver of development and better population health.

To mark the 25th anniversary of the original Good health at low cost report, the LSHTM-led team returned to the original research questions and found that today's study countries have made substantial improvements in health and access to essential services beyond what might be expected on the basis of their income level, including:

  • Thailand has seen steep reductions in maternal mortality between 1960-1990 and the Indian State of Tamil Nadu, has maternal mortality rates which are less than half the Indian national average.
  • Ethiopia has gone from being one of the worst performers in under-5 mortality to outperforming neighbouring Tanzania and Uganda.
  • Bangladesh and Tamil Nadu have among the longest life expectancies for men and women in their regions.
  • Thailand, a country that has achieved all the health MDGs, has now adopted MDG+, a set of targets which go well beyond the internationally agreed goals.
  • Thailand and Kyrgyzstan have achieved universal health care coverage through expansion of health insurance schemes, unique among countries at their income level.

Dr Dina Balabanova, of the London School of Hygiene & Tropical Medicine, says: "Our study shows that the findings of the original 1985 report remain valid. However, strong health systems are becoming more important in improving health than ever before. New challenges, such as increasing urbanisation, a growing private sector and an upsurge in non-communicable diseases, suggest that we need a combination of learning from the past and new thinking if we are to adapt
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Contact: Paula Fentiman
paula.fentiman@lshtm.ac.uk
020-792-72802
London School of Hygiene & Tropical Medicine
Source:Eurekalert

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