Health For All Revisited - Part 1

A right approach to health sector reform. In a disorganized and exceedingly bureaucratic health system, it is tempting for the ill-informed policymaker to engage in the "band-aid" approach to achieve quick fixes that appease both the public and legislators in times of crisis. We have discussed numerous examples of this in the past. Furthermore, providers, who have been reluctant to engage in significant attempts to reform the system, except when dealing with matters of remuneration, remain disconnected from the policy-making arena. Indeed, in an environment lacking exposure to even basic education in principles of public policy, management, and economics related to health, understanding the sector as a whole, beyond ones restricted clinical domain, remains a daunting endeavor. For this reason, we will expose a series of articles addressing key concepts in health sector reform using the framework adopted by experts representing institutions such as Harvard University, the World Health Organization (WHO), and the World Bank, among others.

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Losing Perspective

Kuwait and the neighboring GCC countries have unique social structures. Despite high growth rates, there seems to be an unrelenting need to import skilled manpower and foreign expertise. Expatriates constitute about 80% of the labor force and form an estimated 65% of the population. This tells you that the majority of expatriates are in the working age group, while Kuwaitis are distributed more evenly across the age spectrum.

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86 Restaurants in 16 km

The World Health Organization lists Kuwait as the 8th fattest country in the world with a 74.2% prevalence of overweight individuals, behind Nauru (94.5%), Federated States of Micronesia (91.1%), Cook Islands (90.9%), Tonga (90.8%), Niue (81.7%), Samoa (80.4%) and Palau (78.4%). This small group of Pacific Island countries has a genetic propensity for larger muscular physiques, and abdominal fatness has long been considered a symbol of wealth and prosperity for Pacific Islanders. Second to this cluster of small Pacific Islands is Kuwait. We are heavier than the Americans and report the highest rate of obesity of all Gulf Arab countries. We have the highest prevalence of hypertension and elevated cholesterol levels in all the Gulf region and we rank 5th for the global prevalence of diabetes behind Nauru, UAE, Saudi Arabia and Bahrain. Small-scale national studies report that only 2 - 5% of our population is physically active despite the fact that International Diabetes Federation tells us that up to 80% of type 2 diabetes is preventable by adopting a healthy diet and increasing physical activity.

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Tunnel vision

In 2001, a Pakistani woman was publicly gang-raped and later forced to walk the streets of her village unclothed, exposed to the rest of the villagers. This atrocity was perpetrated by individuals who claim to be faithful Muslims and who begin their sermons with the mention of God and the prophet Mohammad, PBUH. The first question that jumped to mind was how a group of people could approve of such a horrendous crime. You would assume that your social network would guide you back in track when deviating from a righteous path. However, the reality is that it is easier to commit an immoral act collectively where the responsibility is diluted in the masses and the appearance of diminished individual accountability often prevails.

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