EXECUTIVE SUMMARY

Ill-health is one of the major challenges for human well-being. In the last century, much progresses

have been made; however, profound inequalities in health remain between different regions of the

world, geographical locations within countries and subpopulation groups identified different socio-

economic characteristics. These differences relate to health outcomes as much as to coverage of and

access of health services. Good health and economic prosperity are mutually supportive, and equitable

health status forms one of the foundations of social justice. It is one of the essential parts of all

development initiatives.

This report presents and analysis of the current status and trends regarding access to health services

in the world and within the OIC and suggests strategies to improve the performance of and access to

health services within the OIC member states with a specific emphasis on the poor.

The findings of our study show that there is a high demand for health care services in the OIC countries,

more so than in non-OIC countries, and the demands are increasing. OIC countries are characterised

by lower life expectancy, higher maternal mortality rate and higher under-five mortality rates than

non-OIC countries for lower middle-income countries. However, OIC countries are less affected by

tuberculosis and HIV than non-OIC countries for the upper middle-income group.

Physical and financial accessibility of healthcare service tends to be lower in OIC countries than in non-

OIC countries. Availability of nurses and midwives is much lower in low income OIC countries than in

low income non-OIC countries, whereas OIC countries invest less in health as a proportion of their GDP

and expose their citizens to higher out-of-pocket expenses (OOP) than non-OIC countries. This is true

for all income groups. Furthermore, physical health accessibility indicators in OIC countries have not

improved as fast as in non-OIC countries.

There are high levels of variation in health indicators across OIC countries, often illustrating

geographic clusters or country groups which share similar levels. In general, OIC countries of the

African group are trailing behind the Arab and Asian groups throughout the 20-year period considered

in the study. Great progress has been made in relation to maternal and child health, for example,

maternal mortality rates have steadily declined for OIC countries and for the three groups of countries

within the OIC over the 20- year period studied.

As much as service coverage differs across regions and countries, its distribution across different

wealth quintiles varies substantially across the countries. Access to health by the poor is particularly

limited in absolute terms and in relation to richer populations in countries of the African region.

There exist very stark differences in the level of access to health for the poor and the non-poor in many

OIC countries. Generally, in countries where healthcare service coverage is high, health inequity tends

to be lower than in countries where service coverage is more limited. We also find very dramatic

differences between the poor and the non-poor in terms of access to safe drinking and improved

sanitation in many OIC countries.

A number of learnings emerge from the case studies, showing the importance of

(1)

structured learning and understanding access barriers to health by the population, and the

poor in particular, in order to design programmes and initiatives where needs are matched by

service provision efficiently

(2)

building and supporting leadership and fostering long-term engagement throughout levels of

responsibility – including the highest levels