Читать книгу The Political Economy of the BRICS Countries - Группа авторов - Страница 77

While summary statistics are available that indicate what percentage of population is covered, these are slightly misleading as indicators of UHC coverage because these include different programs and schemes, many of which may not be what the country needs or aligned to the philosophy of UHC. Instead, we use access to quality services for primary health care needs of the population along with a set of recommended indicators for monitoring progress towards UHC, but mainly to understand access to primary care across countries. Health MDG-related UHC indicators or tracer indicators (Marten et al., 2014) include demand for family planning met by modern methods, antenatal care visits, skilled attendants at birth, immunization coverage, improved water and sanitation, access to antiretroviral (ARV) therapy, and TB treatment. Further, Sustainable Development Goal 3.8 specifically mentions the importance of access to “safe, effective, quality and affordable essential medicines and vaccines for all”, making access to medicines an important indicator as well (Wirtz et al., 2016).

However, in the absence of data on all the indicators, we select the ones with data for all the five countries and construct an index based on these indicators given in the last column (Table 3).

The country with the best access to basic services is Brazil, followed by China and Russia, respectively. South Africa and India trail behind, with India being at the bottom of the ranking for these indicators. The most alarming status is that of sanitation in India. Only 40% of Indians have access to improved sanitation. In fact, while India is certainly an outlier in this respect, other BRICS countries too are noticeably short of universal access to improved sanitation. This is applicable to tuberculosis case detection rate as well.

Table 3:Access to primary and preventive care in BRICS.

Notes: The family planning indicators are for the years 2006 (Brazil), 2001 (China), 2008 (India), 2011 (Russia), and 2004 (South Africa). The skilled birth attendance indicators is for the years 2013 (Brazil and India), 2014 (China), 2008 (Russia), and 2004 (South Africa). The source for both is World Health Statistics, WHO. The index for a country is an average of its normalized score in each indicator. The process of normalization is (X−X_min)/(X_max−X_min), where X is the indicator.