Universal health care is a broad concept that has been implemented in several ways. The common denominator for all such programs is some form of government action aimed at extending access to health care as widely as possible and setting minimum standards.
Here is the list of the countries with worst health-care system and the least healthy population.
Somalia’s public healthcare system was largely destroyed during the ensuing civil war. As with other previously nationalized sectors, informal providers have filled the vacuum and replaced the former government monopoly over healthcare, with access to facilities witnessing a significant increase. Many new healthcare centers, clinics, hospitals and pharmacies have in the process been established through home-grown Somali initiatives. The cost of medical consultations and treatment in these facilities is low, at $5.72 per visit in health centers (with a population coverage of 95%), and between $1.89–$3.97 per outpatient visit and $7.83–$13.95 per bed day in primary through tertiary hospitals.
Comparing the 2005–2010 period with the half-decade just prior to the outbreak of the conflict (1985–1990), life expectancy actually increased from an average of 47 years for men and women to 48.2 years for men and 51.0 years for women.
According to a 2005 World Health Organization estimate, about 97.9% of Somalia’s women and girls have undergone female circumcision, a pre-marital custom mainly endemic to Northeast Africa and parts of the Near East that has its ultimate origins in Ancient Egypt.
Angola lies in the yellow fever endemic zone. Cholera incidence is high. Only a small fraction of the population receives even rudimentary medical attention. As of 2004, the ratio of physicians per population was estimated at 7.7 per 100,000 people. In 2005, average life expectancy was estimated at only 38.43 years, one of the lowest in the world. That year infant mortality was estimated at 187.49 per 1,000 live births, the highest in the world. The incidence of tuberculosis in 1999 was 271 per 100,000 people. Immunization rates for one-year-old children in 1999 were estimated at 22% for diphtheria, pertussis, and tetanus and 46% for measles. Malnutrition affected an estimated 53% of children under five years of age as of 1999. From 1975 to 1992, there were 300,000 civil war-related deaths. The overall death rate was estimated at 24 per 1,000 in 2002. The HIV/AIDS prevalence was 3.90 per 100 adults in 2003. As of 2011, there were approximately 240,000 people living with HIV/AIDS in the country. There were an estimated 21,000 deaths from AIDS in 2003. In 2011, 38% of the population had access to safe drinking water and 44% had adequate sanitation.
As of 2010, the life expectancy is 60 years for males and 65 years for females, a major improvement since 1999 when the average life expectancy was 49.8 and 46.8 respectively. The Royal Cambodian Government plans to increase the quality of healthcare in the country by raising awareness of HIV/AIDS, malaria, and other diseases.
Cambodia’s infant mortality rate has decreased from 115 per 1000 live births in 1993 to 54 in 2009. In the same period, the under-five mortality rate decreased from 181 to 115 per 1000 live births. In the province with worst health indicators, Ratanakiri, 22.9% of children die before age five.
Republic of Burundi, is a landlocked country in the Great Lakes region of Eastern Africa bordered by Rwanda to the north, Tanzania to the east and south, and the Democratic Republic of the Congo to the west. There is less health care in Burundi than in most other countries. Life expectancy at birth is estimated at 48.5 years. (2005) A large proportion of the population is undernourished. There were 3 physicians per 100,000 persons in the early 2000s. The HIV/AIDS prevalence has been about 4.2 % in 2007.
6. Burkina Faso
Average life expectancy at birth in 2004 was estimated at 52 for females and 50 for males. The median age of its inhabitants is 16.7. The estimated population growth rate is 3.109%. Central government spending on health was 3 % in 2001. As of 2009, it was estimated that there were as few as 10 physicians per 100,000 people. In addition there were only 41 nurses, and 13 midwives per 100,000 people. Demographic and Health Surveys has completed three surveys in Burkina Faso since 1993 and is currently in the process of performing another.
According to the World Health Organization in 2005 an estimated 72.5% of Burkina Faso’s girls and women have suffered female genital mutilation (term used to describe traditional or religious procedures on a minor).
The quality of healthcare is low, with one in five children dying before their fifth birthday, often from malaria. There is a shortage of staff, and some medicines are in short supply or unavailable. 87% have access to healthcare but there are only two doctors and two paramedics per 100,000 people. The government is seeking to improve the situation as part of the Vision 2020 development programme. In 2008, the government spent 9.7% of national expenditure on healthcare, compared with 3.2% in 1996. It also set up training institutes including the Kigali Health Institute (KHI) and started a social service scheme. HIV/AIDS seroprevalence is declining due to government policies; the rate is estimated at 3%.
Health expenditure per capita was 42 US$ (PPP) in 2004. In the early 21st century there were 3 physicians per 100,000 people in the country. Infant mortality was at 100 per 1,000 births in 2011. HIV prevalence among 15 to 49 year olds exceeds 10%.
According to the Human Development Index, Afghanistan is the second least developed country in the world. Every half hour, an average of one woman dies from pregnancy-related complications, another dies of tuberculosis and 14 children die, largely from preventable causes. Before the start of the wars in 1978, the nation had an improving health system and a semi-modernized health care system in cities like Kabul. Ibn Sina Hospital and Ali Abad Hospital in Kabul were two of the leading health care institutions in Central Asia at the time. Following the Soviet invasion and the civil war that followed, the health care system was limited only to urban areas and was eventually destroyed. The Taliban government made some improvements in the late 1990s, but health care was not available for women during their six year rule. Afghanistan has one of the highest incidences of people with disabilities in the world. There are an estimated one million disabled or handicapped people in the country. An estimated 80,000 citizens of the country have lost limbs, mainly as a result of landmines. The nation’s health care system began to improve dramatically since 2002, which is due to international support on the vaccination of children, training of medical staff. According to USAID, infant mortality rate has dropped by 33 percent and approximately 64 percent of the total population now has access to some form of health care. Most Afghans live within one hour travel to a health facility.
2. Sierra Leone
This country has a very high infant mortality and a very low life expectancy (44 years). The maternal death rates are also the highest in the world, at 2,000 deaths per 100,000 live births. The country suffers from epidemic outbreaks of diseases including yellow fever, cholera, lassa fever and meningitis. The prevalence of HIV/AIDS in the population is 1.6 percent, higher than the world average of 1 percent but lower than the average of 6.1 percent in Sub-Saharan Africa.
According to the head of the World Bank‘s Global HIV/AIDS Program, Ethiopia has only 1 medical doctor per 100,000 people. However, the World Health Organization in its 2006 World Health Report gives a figure of 1936 physicians (for 2003), which comes to about 2.5 per 100,000. Globalization is said to affect the country, with many educated professionals leaving Ethiopia for a better economic opportunity in the West.
Ethiopia’s main health problems are said to be communicable diseases caused by poor sanitation and malnutrition. These problems are exacerbated by the shortage of trained manpower and health facilities.
There are 119 hospitals (12 in Addis Ababa alone) and 412 health centers in Ethiopia. Ethiopia has a very low average life expectancy of 42 years. Infant mortality rates are relatively very high, as over 10% of infants die during or shortly after childbirth, (although this is a dramatic decrease from 16% in 1965) while birth-related complications such as obstetric fistula affect many of the nation’s women. HIV is also prevalent in the country. The other major health problem in Ethiopia is spread of Acquired Immune Deficiency Syndrome (AIDS). AIDS has mainly affected poor communities and women, due to lack of health education, empowerment, awareness and lack of social well being.