The World Bank recognizes a high-income country as one that has a per capita gross national income of $12,000 or more. According to this classification, a little over 80 countries are currently ranked as high-income countries. For this exercise, one of them was selected; Germany. German is a world power with the highest per capita income in the European Union and the lowest unemployment rates in greater Europe. For the middle-income country, one was selected which, according to the World Bank has a per capita gross national income of approximately $1,000 and $12,000. Romania, for instance, has an upper middle-income economy and is close to being classified as a developed country. It enjoys a per capita gross national income of $10,000.
A low-income economy is one that suffers a per capita gross national income of $1,000 or less. Such economies have feeble industrial bases with a population that is mostly engaged in informal employment. For this example Tanzania, an east African country located towards the south of the continent, was used. Health indicators are measured developed to capture the snapshot of the overall status of health in a given community or state. The most commonly used indicators that lend a picture of what is happening in the health sectors of countries are; Maternal and Infant Child Health; Nutrition, Physical Activity and Obesity; Reproductive and Sexual Health; Access to Healthcare Services and Mental Health.
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Maternal and Infant Child Health
According to data provided by UNICEF, Germany experiences a 3.5 number of deaths for children aged five and below, for every 1000 live births. This translates to an under 5 mortality of less than half a percentage point (WHO & Mathers, 2016). This is rather impressive, especially that the population of Germany is 80 million strong. A large percentage of infants also receive the required vaccinations, further indicating a robust healthcare system. Romania, on the other hand, experiences an under-5 mortality rate of 7.8 children under the age of 5 for every 1000 live births, against a population of nearly 20 million. Compare this with Tanzania, which experiences an under-5 mortality rate of 54 children per every 1000 live births, against a population of 53 million. This is indicative of the poor state of Tanzanian healthcare, along with the low levels of literacy in the African nation.
Nutrition, Physical Activity and Obesity
This indicator is related to the early child death statistics since most deaths of infants and toddlers would usually be related to stunted growth, low levels of nutrition and early health care. Looking at the data from Germany, the percentage of new-born children who experience moderate to severe stunting during growth stands at only 1%. Vaccination programs are also well conducted and nutrition well adhered to for children and adults alike. In Romania, the percentage of children getting the necessary vaccines lies at 70%-80%, compared to 95%-100% in Germany. The rate of severe to moderate stunting in Romania stands at 13% while the number of mothers who breastfeed their infants within 1 hour of birth stands at 58% (Vladescu et al., 2016). In Tanzania, this percentage stands at 51%, which translates to slightly more than half of all new-borns being breastfed within an hour of birth. The rate of moderate and severe stunting within the population, however, stands at a high 34% which is rather high, compared to Germany and Romania.
Reproductive and Sexual Health
Germany's advanced healthcare system has ensured that access to contraceptive health and information is widespread. Condoms are available in all pharmacies, while the universal health coverage allows for productive females to get contraception. Abortion services are also available but only on medical or criminal grounds. Romania has a slightly less organized sexual health landscape than Germany. No national sexual health strategy exists, and serious efforts only started in earnest around 1990, after the fall of the Soviet Union. As a result, there is a high percentage of the population, nearly 15%, that does not engage in safe sex and therefore stands at the risk of sexually transmitted infections. In Tanzania, access to sexual and reproductive health stands at extremely low levels. This is demonstrated by the high levels of HIV infection, early teen pregnancies and STI infections throughout the country.
Access to Healthcare Services
100% of the German population has access to universal healthcare insurance that is supported by a robust social welfare system that covers everybody in the society, including the unemployed (Mossialos et al., 2016). Hospitals and medical centres are all uniformly equipped and staffed to provide world-class healthcare services for the whole population. Healthcare in Romania follows the same format as that of Germany, with the government providing universal healthcare alongside other essential services like education and housing. Starting September, every Romanian citizen is entitled to free medical procedures if they bear a health card. In Tanzania, nearly half of the total population lives below the global poverty line of $2 a day. This makes it extremely difficult for universal healthcare to be availed to everybody (Bustreo et al., 2019). Combine this with the country-wide shortage of doctors in Tanzania and access to healthcare in Tanzania is severely impaired.
References
Bustreo, F., Mshinda, H., Hinton, R., Hausmann-Muela, S., & Tanner, M. (2019). Commentary: Primary health care in Tanzania–Leading the way through innovation. EClinicalMedicine , 13 , 12-13.
Mossialos, E., Wenzl, M., Osborn, R., & Sarnak, D. (2016). 2015 international profiles of health care systems . Canadian Agency for Drugs and Technologies in Health.
Vlădescu, C., Scîntee, S. G., Olsavszky, V., Hernández-Quevedo, C., & Sagan, A. (2016). Romania: a health system review. Health systems in transition , (18/4), 1-170.
WHO, U., & Mathers, C. (2016). Global strategy for women's, children's and adolescents' health (2016-2030). Organization .
