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World Health Organization ranking of health systems in 2000
Ranking of national health systems
Ranking of national health systems
The World Health Organization (WHO) ranked the health systems of its 191 member states in its World Health Report 2000. It provided a framework and measurement approach to examine and compare aspects of health systems around the world. It developed a series of performance indicators to assess the overall level and distribution of health in the populations, and the responsiveness and financing of health care services. It was the organization's first ever analysis of the world's health systems.
Ranking
| Country | Attainment of goals / Health / Level (DALE) | Attainment of goals / Health / Distribution | Attainment of goals / Health / Overall goal attainment | Health expenditure per capita in international dollars | Performance / On level of health | Performance / Overall health system performance |
|---|---|---|---|---|---|---|
| Afghanistan Afghanistan | 164 | 0 | 183 | 184 | 150 | 173 |
| Albania | 102 | 128 | 86 | 149 | 64 | 55 |
| Algeria | 44 | 63 | 56 | 24 | 45 | 81 |
| Andorra | 10 | 25 | 17 | 23 | 7 | 4 |
| Angola | 165 | 178 | 181 | 164 | 165 | 181 |
| Antigua and Barbuda | 48 | 58 | 71 | 56 | 123 | 86 |
| Argentina Argentina | 39 | 60 | 49 | 34 | 71 | 75 |
| Armenia | 41 | 63 | 81 | 102 | 56 | 104 |
| Australia Australia | 2 | 17 | 12 | 17 | 39 | 32 |
| Austria Austria | 17 | 8 | 10 | 6 | 15 | 9 |
| Azerbaijan | 65 | 99 | 103 | 162 | 60 | 109 |
| Bahamas | 109 | 67 | 64 | 22 | 137 | 98 |
| Bahrain | 61 | 72 | 58 | 48 | 30 | 42 |
| Bangladesh Bangladesh | 140 | 125 | 131 | 144 | 103 | 88 |
| Barbados | 53 | 36 | 38 | 36 | 87 | 46 |
| Belarus | 83 | 46 | 53 | 74 | 116 | 72 |
| Belgium | 16 | 26 | 13 | 15 | 28 | 21 |
| Belize | 94 | 95 | 104 | 88 | 34 | 69 |
| Benin | 157 | 132 | 143 | 171 | 136 | 97 |
| Bhutan | 138 | 158 | 144 | 135 | 73 | 124 |
| Bolivia Bolivia | 133 | 118 | 117 | 101 | 142 | 126 |
| Bosnia-Herzegovina | 56 | 79 | 79 | 105 | 70 | 90 |
| Botswana | 187 | 146 | 168 | 85 | 188 | 169 |
| Brazil Brazil | 111 | 108 | 125 | 54 | 78 | 125 |
| Brunei | 59 | 42 | 37 | 32 | 76 | 40 |
| Bulgaria Bulgaria | 60 | 53 | 74 | 96 | 92 | 102 |
| Burkina Faso | 178 | 137 | 159 | 173 | 162 | 132 |
| Burundi | 179 | 154 | 161 | 186 | 171 | 143 |
| Cambodia Cambodia | 148 | 150 | 166 | 140 | 157 | 174 |
| Cameroon | 156 | 160 | 163 | 131 | 172 | 164 |
| Canada Canada | 12 | 18 | 7 | 10 | 35 | 30 |
| Cape Verde Cape Verde | 118 | 123 | 126 | 150 | 55 | 113 |
| Central African Republic | 175 | 189 | 190 | 178 | 164 | 189 |
| Chad | 161 | 175 | 177 | 175 | 161 | 178 |
| Chile | 32 | 1 | 33 | 44 | 23 | 33 |
| China People's Republic of China | 81 | 101 | 132 | 139 | 61 | 144 |
| Colombia Colombia | 74 | 44 | 41 | 49 | 51 | 22 |
| Comoros Comoros | 146 | 143 | 137 | 165 | 141 | 118 |
| Congo | 150 | 142 | 155 | 122 | 167 | 166 |
| Cook Islands | 67 | 92 | 88 | 61 | 95 | 107 |
| Costa Rica Costa Rica | 40 | 45 | 45 | 50 | 25 | 36 |
| Croatia | 38 | 33 | 36 | 56 | 57 | 43 |
| Cuba Cuba | 33 | 41 | 40 | 118 | 36 | 39 |
| Cyprus Cyprus | 25 | 31 | 28 | 39 | 22 | 24 |
| Czech Republic Czech Republic | 35 | 19 | 30 | 40 | 81 | 48 |
| Democratic Republic of the Congo Democratic Republic of the Congo | 174 | 174 | 179 | 188 | 185 | 188 |
| Denmark | 28 | 21 | 20 | 8 | 65 | 34 |
| Djibouti | 166 | 169 | 170 | 163 | 163 | 157 |
| Dominica | 26 | 35 | 42 | 70 | 59 | 35 |
| Dominican Republic | 79 | 97 | 66 | 92 | 42 | 51 |
| Ecuador | 93 | 133 | 107 | 97 | 96 | 111 |
| Egypt Egypt | 115 | 141 | 110 | 115 | 43 | 63 |
| El Salvador | 87 | 115 | 122 | 83 | 37 | 115 |
| Equatorial Guinea | 152 | 151 | 152 | 129 | 174 | 171 |
| Eritrea Eritrea | 169 | 167 | 176 | 187 | 148 | 158 |
| Estonia Estonia | 69 | 43 | 48 | 60 | 115 | 77 |
| Ethiopia Ethiopia | 182 | 176 | 186 | 189 | 169 | 180 |
| Federated States of Micronesia | 104 | 112 | 111 | 81 | 110 | 123 |
| Fiji | 106 | 71 | 78 | 87 | 124 | 96 |
| FIN Finland | 20 | 27 | 22 | 18 | 44 | 31 |
| France France | 3 | 12 | 6 | 4 | 4 | 1 |
| Gabon | 144 | 136 | 141 | 95 | 143 | 139 |
| Gambia | 143 | 155 | 153 | 158 | 109 | 146 |
| Georgia Georgia | 44 | 61 | 76 | 125 | 84 | 114 |
| Germany Germany | 22 | 20 | 14 | 3 | 41 | 25 |
| Ghana Ghana | 149 | 149 | 139 | 166 | 158 | 135 |
| Greece Greece | 7 | 6 | 23 | 30 | 11 | 14 |
| Grenada | 49 | 82 | 68 | 67 | 49 | 85 |
| Guatemala | 129 | 106 | 113 | 130 | 99 | 78 |
| Guinea | 167 | 166 | 172 | 159 | 160 | 161 |
| Guinea-Bissau | 170 | 177 | 180 | 156 | 156 | 176 |
| Guyana | 98 | 126 | 116 | 109 | 104 | 128 |
| Haiti Haiti | 153 | 152 | 145 | 155 | 139 | 138 |
| Honduras | 92 | 119 | 129 | 100 | 48 | 131 |
| Hungary | 62 | 40 | 43 | 59 | 105 | 66 |
| Iceland Iceland | 19 | 24 | 16 | 14 | 27 | 15 |
| India India | 19 | 13 | 121 | 133 | 118 | 112 |
| Indonesia Indonesia | 103 | 156 | 106 | 154 | 90 | 92 |
| Iran Iran | 96 | 113 | 114 | 94 | 58 | 93 |
| Iraq Iraq | 126 | 130 | 124 | 117 | 75 | 103 |
| Ireland Ireland | 27 | 13 | 25 | 25 | 32 | 19 |
| Israel Israel | 23 | 7 | 24 | 19 | 40 | 28 |
| Italy Italy | 6 | 14 | 11 | 11 | 3 | 2 |
| Ivory Coast | 155 | 181 | 157 | 153 | 133 | 137 |
| Jamaica | 36 | 87 | 69 | 89 | 8 | 53 |
| Japan Japan | 1 | 3 | 1 | 13 | 9 | 10 |
| Jordan Jordan | 101 | 83 | 84 | 98 | 100 | 83 |
| Kazakhstan Kazakhstan | 122 | 52 | 62 | 112 | 135 | 64 |
| Kenya Kenya | 162 | 135 | 142 | 152 | 178 | 140 |
| Kiribati | 125 | 121 | 123 | 103 | 144 | 142 |
| Kuwait | 68 | 54 | 46 | 41 | 68 | 45 |
| Kyrgyzstan Kyrgyzstan | 123 | 122 | 135 | 146 | 134 | 151 |
| Laos Laos | 147 | 147 | 154 | 157 | 155 | 165 |
| Latvia | 82 | 56 | 67 | 77 | 121 | 105 |
| Lebanon | 95 | 88 | 93 | 46 | 97 | 91 |
| Lesotho | 171 | 164 | 173 | 123 | 186 | 183 |
| Liberia | 181 | 191 | 187 | 181 | 176 | 186 |
| Libya Libya | 107 | 102 | 97 | 84 | 94 | 87 |
| Lithuania | 63 | 48 | 52 | 71 | 93 | 73 |
| Luxembourg | 18 | 22 | 5 | 5 | 31 | 16 |
| Macedonia | 64 | 85 | 89 | 106 | 69 | 89 |
| Madagascar | 172 | 168 | 167 | 190 | 173 | 159 |
| Malawi | 189 | 187 | 182 | 161 | 187 | 185 |
| Malaysia Malaysia | 89 | 49 | 55 | 93 | 86 | 49 |
| Maldives | 130 | 134 | 128 | 76 | 147 | 147 |
| Mali Mali | 183 | 180 | 178 | 179 | 170 | 163 |
| Malta | 21 | 38 | 31 | 37 | 2 | 5 |
| Marshall Islands | 121 | 120 | 119 | 80 | 140 | 141 |
| Mauritania Mauritania | 158 | 163 | 169 | 141 | 151 | 162 |
| Mauritius | 78 | 77 | 90 | 69 | 113 | 84 |
| Mexico Mexico | 55 | 65 | 51 | 55 | 63 | 61 |
| Moldova | 88 | 64 | 91 | 108 | 106 | 101 |
| Monaco | 9 | 30 | 18 | 12 | 12 | 13 |
| Mongolia | 131 | 148 | 136 | 145 | 138 | 145 |
| Morocco Morocco | 110 | 111 | 94 | 99 | 17 | 29 |
| Mozambique | 180 | 190 | 185 | 160 | 168 | 184 |
| Myanmar Myanmar | 139 | 162 | 175 | 136 | 129 | 190 |
| Namibia | 177 | 173 | 165 | 66 | 189 | 168 |
| Nauru | 136 | 51 | 75 | 42 | 166 | 98 |
| Nepal Nepal | 142 | 161 | 160 | 170 | 98 | 150 |
| Netherlands Netherlands | 13 | 15 | 8 | 9 | 19 | 17 |
| New Zealand New Zealand | 31 | 16 | 26 | 20 | 80 | 41 |
| Nicaragua | 117 | 96 | 101 | 104 | 74 | 71 |
| Niger | 190 | 184 | 188 | 185 | 177 | 170 |
| Nigeria Nigeria | 163 | 188 | 184 | 176 | 175 | 187 |
| Niue | 85 | 100 | 102 | 127 | 108 | 121 |
| North Korea North Korea | 137 | 145 | 149 | 172 | 153 | 167 |
| Norway | 15 | 4 | 3 | 16 | 18 | 11 |
| Oman Oman | 72 | 59 | 59 | 62 | 1 | 8 |
| Pakistan Pakistan | 124 | 183 | 133 | 142 | 85 | 122 |
| Palau | 112 | 66 | 63 | 47 | 125 | 82 |
| Panama | 47 | 93 | 70 | 53 | 67 | 95 |
| Papua New Guinea | 145 | 157 | 150 | 137 | 146 | 148 |
| Paraguay Paraguay | 71 | 57 | 73 | 91 | 52 | 57 |
| Peru | 105 | 103 | 115 | 78 | 119 | 129 |
| Philippines Philippines | 113 | 50 | 54 | 124 | 126 | 60 |
| Poland Poland | 45 | 5 | 34 | 58 | 89 | 50 |
| Portugal Portugal | 29 | 34 | 32 | 28 | 13 | 12 |
| Qatar Qatar | 66 | 55 | 47 | 27 | 53 | 44 |
| Romania Romania | 80 | 78 | 72 | 107 | 111 | 99 |
| Russia Russia | 91 | 69 | 100 | 75 | 127 | 130 |
| Rwanda | 185 | 185 | 171 | 177 | 181 | 172 |
| Saint Kitts and Nevis | 86 | 91 | 98 | 51 | 122 | 100 |
| Saint Lucia | 54 | 86 | 87 | 86 | 54 | 68 |
| Saint Vincent and the Grenadines | 43 | 89 | 92 | 90 | 38 | 74 |
| Samoa | 97 | 81 | 82 | 121 | 131 | 119 |
| San Marino San Marino | 11 | 9 | 21 | 21 | 5 | 3 |
| Sao Tome and Principe | 132 | 139 | 138 | 167 | 117 | 133 |
| Saudi Arabia Saudi Arabia | 58 | 70 | 61 | 63 | 10 | 26 |
| Senegal Senegal | 151 | 105 | 118 | 143 | 132 | 59 |
| Seychelles | 108 | 73 | 83 | 52 | 83 | 56 |
| Sierra Leone Sierra Leone | 191 | 186 | 191 | 183 | 183 | 191 |
| Singapore Singapore | 30 | 29 | 27 | 38 | 14 | 6 |
| Slovakia | 42 | 39 | 39 | 45 | 88 | 62 |
| Slovenia Slovenia | 34 | 23 | 29 | 29 | 62 | 38 |
| Solomon Islands | 127 | 117 | 108 | 134 | 20 | 80 |
| Somalia | 173 | 179 | 189 | 191 | 154 | 179 |
| South Africa South Africa | 160 | 128 | 151 | 57 | 182 | 175 |
| South Korea South Korea | 51 | 37 | 35 | 31 | 107 | 58 |
| Spain Spain | 5 | 11 | 19 | 24 | 6 | 7 |
| Sri Lanka Sri Lanka | 76 | 80 | 80 | 138 | 66 | 76 |
| Sudan Sudan | 154 | 159 | 148 | 169 | 149 | 134 |
| Suriname | 77 | 94 | 105 | 72 | 77 | 110 |
| Swaziland | 164 | 140 | 164 | 116 | 184 | 177 |
| Sweden | 4 | 28 | 4 | 7 | 21 | 23 |
| Switzerland Switzerland | 8 | 10 | 2 | 2 | 26 | 20 |
| Syria Syria | 114 | 107 | 112 | 119 | 91 | 108 |
| Tajikistan Tajikistan | 120 | 124 | 127 | 126 | 145 | 154 |
| Tanzania Tanzania | 176 | 172 | 158 | 174 | 180 | 156 |
| Thailand Thailand | 99 | 74 | 57 | 64 | 102 | 47 |
| Togo | 159 | 170 | 156 | 180 | 159 | 152 |
| Tonga | 75 | 84 | 85 | 73 | 114 | 116 |
| Trinidad and Tobago Trinidad and Tobago | 57 | 75 | 56 | 65 | 79 | 67 |
| Tunisia | 90 | 114 | 77 | 79 | 46 | 52 |
| Turkey Turkey | 73 | 109 | 96 | 82 | 33 | 70 |
| Turkmenistan Turkmenistan | 128 | 131 | 130 | 128 | 152 | 153 |
| Tuvalu | 119 | 116 | 120 | 151 | 128 | 136 |
| UAE United Arab Emirates | 50 | 62 | 44 | 35 | 16 | 27 |
| Uganda Uganda | 186 | 138 | 162 | 168 | 179 | 149 |
| UK United Kingdom | 14 | 2 | 9 | 26 | 24 | 18 |
| Ukraine Ukraine | 70 | 47 | 60 | 111 | 101 | 79 |
| United States of America United States | 24 | 32 | 15 | 1 | 72 | 37 |
| Uruguay | 37 | 68 | 50 | 33 | 50 | 65 |
| Uzbekistan Uzbekistan | 100 | 144 | 109 | 120 | 112 | 117 |
| Vanuatu | 135 | 127 | 134 | 132 | 120 | 127 |
| Venezuela Venezuela | 52 | 76 | 65 | 68 | 29 | 54 |
| Vietnam Vietnam | 116 | 104 | 140 | 147 | 130 | 160 |
| Yemen Yemen | 141 | 165 | 146 | 182 | 82 | 120 |
| FR Yugoslavia | 46 | 90 | 95 | 113 | 47 | 106 |
| Zambia | 188 | 171 | 174 | 148 | 190 | 182 |
| Zimbabwe | 184 | 98 | 147 | 110 | 191 | 155 |
Methodology
The rankings are based on an index of five factors:
- Health (50%) : disability-adjusted life expectancy
- Overall or average : 25%
- Distribution or equality : 25%
- Responsiveness (25%) : speed of service, protection of privacy, and quality of amenities
- Overall or average : 12.5%
- Distribution or equality : 12.5%
- Fair financial contribution : 25%
Criticism
The WHO rankings are claimed to have been subject to many and varied criticisms since its publication. Concerns raised over the five factors considered, data sets used and comparison methodologies have led health bodies and political commentators in most of the countries on the list to question the efficacy of its results and validity of any conclusions drawn. Such criticisms of a broad endeavour by the WHO to rank all the world's healthcare systems must also however be understood in the context of a predisposition to analytical bias commensurate with an individual nation's demographics, socio-economics and politics. In considering such a disparate global spectrum, ranking criteria, methodology, results and conclusions will always be an area for contention.
In over a decade of discussion and controversy over the WHO Ranking of 2000, there is still no consensus about how an objective world health system ranking should be compiled. Indeed, the 2000 results have proved so controversial that the WHO declined to rank countries in their World Health Reports since 2000, but the debate still rages on. With burgeoning and ageing populations, spiralling costs and the recognition by most national governments that constant vigilance and periodic healthcare reform are necessary, the appetite for a means of measuring national performance in broader world contexts is ever increasing and all the more relevant. With this in mind, and in lieu of any further ranking information from the WHO since 2000, there are many analytical bodies now looking at national healthcare delivery in global contexts and publishing their findings. Bloomberg finds "the U.S. spends the most on health care on a relative cost basis with the worst outcome" and notes Cubans live longer than Americans, but Americans pay more than fourteen times as much for less effective health care. The Commonwealth Fund ranked seven developed countries on health care, the US ranked lowest (AU, CA, DE, NL, NZ, UK, US).
References
References
- "'' World Health Report 2000.''".
- World Health Organization. [http://www.who.int/whr/2000/en/whr00_en.pdf '' World Health Report 2000.''] {{Webarchive. link. (2013-01-17 Geneva, 2000.)
- (7 February 2000). "World Health Organization Assesses the World's Health Systems".
- Tandon, Ajay. "Measuring Overall Health System Performance For 191 Countries". [[World Health Organization]].
- "Most Efficient Health Care: Countries - bloomberg.com".
- "U.S. Ranks Last Among Seven Countries on Health System Performance Based on Measures of Quality, Efficiency, Access, Equity, and Healthy Lives - June 23, 2010".
- "Overall Rankings - commonwealthfund.org".
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