Proceedings of the 13th Meeting of the
COMCEC Poverty Alleviation Working Group
7
children from poor families. And same for the poor regions of the world. Developing countries
carries the lion share of the maternal death. If you are a pregnant mother from Afghanistan or
Somalia, you have about 48 times higher chance of pregnancy related death compared to a Europe.
The richer regions like Europe or North America have more access to trained and formal healthcare
compared to Africa or Asia. And then there are perils of being women who have always been victim
of illnesses due to socio-cultural and biological reasons coupled with compromised access to
healthcare. Endorsement of MDG has improved the situation to some extent. The major learning
from the implementation of the health-related goals of MDG has taught us that; a. targeted
international effort and coordinated partnership with stakeholders, b. universal and
comprehensive plan and c. effective use of evidence works. Based on wide range of interventions
that aims to improve access to health, Dr. Ahmed presented a summarized picture of four types of
evidences; a. Investing into small or medium scale initiatives, b. Using more and more evidence
(data), c. Ensure intensive participation of all stakeholders and d. financial inclusion-focused
initiatives. These were presented as what type of efforts has worked so far to improve access to
healthcare by the poor and other vulnerable groups.
Then a brief analysis of various dimensions of access to health was presented by globally, OIC
member states (57) and non-OIC member states (160). The OIC and non-OIC states were further
categorized as high, upper middle, lower middle- and low-income groups. The analysis showed that
various health indicators (i.e. life expectancy, maternal and child mortality, HIV incidence and
prevalence, immunization rate, number of health staff, ART coverage, facility birth) as proxy to
demand of healthcare, are low in OIC countries and low-income groups. There was high observed
variation in outcomes and intra-OIC differences with Sub-Saharan Africa being worse off, the
overall higher life expectancy of women than men and maternal mortality rates have fallen, and
high-skilled birth attendance is the key to preventing maternal and infant deaths. The physical
access to healthcare showed high intra-OIC variation, average health staff ratio has increased; Arab
and African OIC groups was better in the past and Asian OIC group has improved and hospital beds
ratio has consistently declined in OIC countries. Considering financial accessibility, healthcare
expenditure per capita has increased over time; Qatar, UAE and Saudi Arabia are the top 3 spenders
with Guinea being in the bottom, Out-of-pocket expenditures have significantly increased; OOP is
lowest in Sub-Saharan Africa and South Asia (in general), Countries with low OOP also show low
expenditure which might mean poor health infrastructure and services, restricted access etc. and
risk of catastrophic expenditure for surgical care is very high particularly in African countries.
Wealth disaggregation showed that Access to health by the poor is particularly small in absolute
terms and relation to richer populations in countries of the African region. Algeria, Jordan,
Kazakhstan, Kyrgyzstan and Turkmenistan are well-covered in terms of access to health care across
all economic groups, including the poor. It was observed in most of the countries that very large
differences and a relatively ‘steady’ increase in access to health services with increasing wealth. In
case of ‘right to information;’ most of the OIC member states had outdated data collection systems,
lack of trained personnel and appropriate technological equipment, lack of legislative and
regulatory framework that facilitates the efficient use of health information systems. There are two
major strategic initiatives across the OIC member state which consider improving access to health;