World Health Organization ranking of health systems in 2000

The World Health Organization (WHO) ranked the health systems of its 191 member states in its World Health Report[1] 2000. It provided a framework and measurement approach to examine and compare aspects of health systems around the world.[2] It developed a series of performance indicators to assess the overall level and distribution of health in the populations, and the responsiveness and financing of health care services. It was the organization's first ever analysis of the world's health systems.[3]

Ranking

Country Attainment of goals / Health / Level (DALE) Attainment of goals / Health / Distribution Attainment of goals / Health / Overall goal attainment Health expenditure per capita in international dollars Performance / On level of health Performance / Overall health system performance
Afghanistan168182183184150173
 Albania102129861496455
 Algeria84110991144581
 Andorra1025172374
 Angola165178181164165181
Antigua and Barbuda4858714312386
Argentina396049347175
 Armenia41638110256104
Australia21712173932
Austria178106159
 Azerbaijan659910316260109
 Bahamas10967642213794
 Bahrain617258483042
Bangladesh14012513114410388
 Barbados533638368746
 Belarus8346537411672
 Belgium162613152821
 Belize9495104883469
 Benin15713214317113697
 Bhutan13815814413573124
Bolivia133118117101142126
 Bosnia-Herzegovina5679791057090
 Botswana18714616885188169
Brazil1111081255478125
 Brunei594237327640
Bulgaria6053749692102
 Burkina Faso178137159173162132
 Burundi179154161186171143
Cambodia148150166140157174
 Cameroon156160163131172164
Canada12187103530
Cape Verde11812312615055113
 Central African Republic175189190178164189
 Chad161175177175161178
 Chile32133442333
People's Republic of China8110113213961144
Colombia744441495122
Comoros146143137165141118
 Congo150142155122167166
 Cook Islands6792886195107
Costa Rica404545502536
 Croatia383336565743
Cuba3341401183639
Cyprus253128392224
Czech Republic351930408148
Democratic Republic of the Congo174174179188185188
 Denmark28212086534
 Djibouti166169170163163157
 Dominica263542705935
 Dominican Republic799766924251
 Ecuador931331079796111
Egypt1151411101154363
 El Salvador871151228337115
 Equatorial Guinea152151152129174171
Eritrea169167176187148158
Estonia6943486011577
Ethiopia182176186189169180
 Federated States of Micronesia10411211181110123
 Fiji10671788712496
Finland202722184431
France3126441
 Gabon14413614195143139
 Gambia143155153158109146
Georgia44617612584114
Germany22201434125
Ghana149149139166158135
Greece7623301114
 Grenada498268674985
 Guatemala1291061131309978
 Guinea167166172159160161
 Guinea-Bissau170177180156156176
 Guyana98126116109104128
Haiti153152145155139138
 Honduras9211912910048131
 Hungary6240435910566
Iceland192416142715
India134153121133118112
Indonesia1031561061549092
Iran96113114945893
Iraq12613012411775103
Ireland271325253219
Israel23724194028
 Italy614111132
 Ivory Coast155181157153133137
 Jamaica36876989853
Japan5137353110758
Jordan10183849810083
Kazakhstan122526211213564
Kenya162135142152178140
 Kiribati125121123103144142
 Kuwait685446416845
Kyrgyzstan123122135146134151
Laos147147154157155165
 Latvia82566777121105
 Lebanon958893469791
 Lesotho171164173123186183
 Liberia181191187181176186
Libya10710297849487
 Lithuania634852719373
 Luxembourg1822553116
 Macedonia6485891066989
 Madagascar172168167190173159
 Malawi189187182161187185
Malaysia894955938649
 Maldives13013412876147147
Mali183180178179170163
 Malta2138313725
 Marshall Islands12112011980140141
Mauritania158163169141151162
 Mauritius7877906911384
Mexico556551556361
 Moldova886491108106101
 Monaco93018121213
 Mongolia131148136145138145
Morocco11011194991729
 Mozambique180190185160168184
Myanmar139162175136129190
 Namibia17717316566189168
 Nauru13651754216698
Nepal14216116017098150
Netherlands1315891917
New Zealand311626208041
 Nicaragua117961011047471
 Niger190184188185177170
Nigeria163188184176175187
 Niue85100102127108121
North Korea137145149172153167
 Norway1543161811
Oman7259596218
Pakistan12418313314285122
 Palau11266634712582
 Panama479370536795
 Papua New Guinea145157150137146148
Paraguay715773915257
 Peru10510311578119129
Philippines113505412412660
Poland45534588950
Portugal293432281312
Qatar665547275344
Romania80787210711199
Russia916910075127130
 Rwanda185185171177181172
 Saint Kitts and Nevis86919851122100
 Saint Lucia548687865468
 Saint Vincent and the Grenadines438992903874
 Samoa978182121131119
San Marino119212153
 Sao Tome and Principe132139138167117133
Saudi Arabia587061631026
Senegal15110511814313259
 Seychelles1087383528356
Sierra Leone191186191183183191
Singapore30292738146
 Slovakia423939458862
Slovenia342329296238
 Solomon Islands1271171081342080
 Somalia173179189191154179
South Africa16012815157182175
South Korea13113910
Spain511192467
Sri Lanka7680801386676
Sudan154159148169149134
 Suriname77941057277110
 Swaziland164140164116184177
 Sweden428472123
Switzerland810222620
Syria11410711211991108
Tajikistan120124127126145154
Tanzania176172158174180156
Thailand9974576410247
 Togo159170156180159152
 Tonga75848573114116
Trinidad and Tobago577556657967
 Tunisia9011477794652
Turkey7310996823370
Turkmenistan128131130128152153
 Tuvalu119116120151128136
United Arab Emirates506244351627
Uganda186138162168179149
United Kingdom1429262418
Ukraine70476011110179
United States24321517237
 Uruguay376850335065
Uzbekistan100144109120112117
 Vanuatu135127134132120127
Venezuela527665682954
Vietnam116104140147130160
Yemen14116514618282120
 Yugoslavia46909511347106
 Zambia188171174148190182
 Zimbabwe18498147110191155

Methodology

The rankings are based on an index of five factors:[2]

  • Health (50%) : disability-adjusted life expectancy
    • Overall or average : 15%
    • Distribution or equality : 35%
  • Responsiveness (25%) : speed of service, protection of privacy, and quality of amenities
    • Overall or average : 12.5%
    • Distribution or equality : 12.5%
  • Fair financial contribution : 25%

Criticism

The WHO rankings have been subject to many and varied criticisms since its publication. Concerns raised over the five factors considered, data sets used and comparison methodologies have led health bodies and political commentators in most of the countries on the list to question the efficacy of its results and validity of any conclusions drawn. Such criticisms of a broad endeavour by the WHO to rank all the world's healthcare systems must also however be understood in the context of a predisposition to analytical bias commensurate with an individual nation's demographics, socio-economics and politics. In considering such a disparate global spectrum, ranking criteria, methodology, results and conclusions will always be an area for contention.

In over a decade of discussion and controversy over the WHO Ranking of 2000, there is still no consensus about how an objective world health system ranking should be compiled. Indeed, the 2000 results have proved so controversial that the WHO declined to rank countries in their World Health Reports since 2000, but the debate still rages on. With burgeoning and ageing populations, spiralling costs and the recognition by most national governments that constant vigilance and periodic healthcare reform are necessary, the appetite for a means of measuring national performance in broader world contexts is ever increasing and all the more relevant. With this in mind, and in lieu of any further ranking information from the WHO since 2000, there are many analytical bodies now looking at national healthcare delivery in global contexts and publishing their findings. Bloomberg finds "the U.S. spends the most on health care on a relative cost basis with the worst outcome"[4] and notes Cubans live longer than Americans, but Americans pay more than fourteen times as much for less effective health care. The Commonwealth Fund ranked seven developed countries on health care, the US ranked lowest[5](AU, CA, DE, NL, NZ, UK , US[6]).

See also

References

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