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Policy implications of health changes in rapidly developing countries: the case of Malaysia.

Abstract：

:Malaysia offers an instructive case study of health care changes in a rapidly developing country. The pace of improvements in life expectancy and maternal and child health has been even more rapid than that in the US in the 1st half of the 20th century. Life expectancy at birth increased from 57 years in 1957 to 69 years in 1976, whereas comparable levels in the US were reached in 1915 and 1941. Infant and child mortality declined in 1947-76, and deaths from the major infectious diseases (including tuberculosis and malaria) were markedly reduced. It is not possible to point to a single intervention or program that can be credited with these advances, although public health changes, a considerable increase in the provision of personal health services, health education, the development of vaccines and antibiotics, and social changes such as increased literacy and family planning no doubt contributed. Improvements in child health have been counterbalanced, however, by increases in mortality and morbidity from chronic diseases and trauma. Age-specific rates of cardiovascular and cerebrovascular disease nearly doubled between 1967-76. The distribution of risk factors in the population and environmental correlates must be determined before interventions to reduce the rate of cardiovascular disease can be planned. It is unclear whether emphasis should be placed on primary prevention, or on improving medical care, or both. It is important for developing countries such as Malaysia to seek the most cost-effective approach given the relatively modest resource base. A preventive strategy would provide for more equitable distribution of care and not penalize rural areas with fewer technical resources. Although a growing demand for specialty care has paralleled the increasing affluence of the population, the limited availability of hospital beds and health manpower will probably prevent a move toward high technology, curative care. As rapidly developing countries seek alternate, cost-effective solutions to health problems common to industrialized nations, they may generate useful lessons for the medical sector in the developed world.

journal_name

J Public Health Policy

journal_title

Journal of public health policy

authors

Harlan WR,Harlan LC,Oii WL

subject

Has Abstract

pub_date

1984-12-01 00:00:00

pages

563-72

issue

eissn

0197-5897

issn

1745-655X

journal_volume

pub_type

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Policy implications of health changes in rapidly developing countries: the case of Malaysia.