“Health for All” in a Least-Developed Country: BACKGROUND

The United Nations has classified countries into “least developed”, “developing”, “transitional-economy” and “developed” based on their stage of economic and social development (Table l). This classification is based on such characteristics as gross domestic product per capita, the augmented physical quality­of-life index and the economic diversification index. Gross domestic product is the total value of all goods and services that are produced by a nation in a specified amount of time. The augmented quality-of-life index was determined by using measures of life expectancy at birth, per-capita caloric intake, school enrollment and level of adult literacy. The economic diversification index reflects the percentage of manufacturing included in the gross domestic product, the percentage of the population employed in industry versus agriculture, per-capita electricity consumption and the export concentration ratio. Thus, the UN country classification is based on measures of economic activity, education, health and worker productivity, all of which are closely related.

Table 1. Country Development Classification as Defined by the United Nations

Least- Developing Transitional Developed
Developed (Excluding Least-Developed)
Afghanistan Algeria                   Macedonia Albania Andorra
Angola Antigua and Barbuda Malaysia Armenia Australia
Bangladesh Argentina                Malta Azerbaijan Austria
Benin Bahamas                Marshall Islands Belarus Belgium
Bhutan Bahrain                   Mauritius Bulgaria Canada
Burkina Faso Barbados                Mexico Czech Republic Denmark
Burundi Belize                     Micronesia, Federated Estonia Finland
Cambodia Bolivia                    States of Georgia France
Cape Verde Bosnia-Herzegovina     Mongolia Hungary Germany
Central African Rep. Botswana                Morocco Kazakhstan Greece
Chad Brazil                      Namibia Kyrgyzstan Iceland
Comoros Brunei                    Nauru Latvia Ireland
Congo Cameroon               Nicaragua Lithuania Italy
Djibouti Chile                      Nigeria Moldova Japan
Equatorial Guinea China, People’s         Niue Poland Luxembourg
Eritrea Republic                  Oman Romania Monaco
Ethiopia Colombia                Pakistan Russian Federation Netherlands
Gambia Cook Islands             Palau Slovakia New Zealand
Guinea Costa Rica               Panama Tajikistan Norway
Guinea-Bissau Cote d’lvoire            Papua New Guinea Turkmenistan Portugal
Haiti Croatia                   Paraguay Ukraine San Marino
Kiribati Cuba                     Peru Uzbekistan Spain
Laos Cyprus                    Philippines Sweden
Lesotho Dominica                Qatar Switzerland
Liberia Dominican Republic    St. Kitts and Nevis United Kingdom
Madagascar Ecuador                  St. Vincent/Grenadines United States
Malawi Egypt                     Saudi Arabia
Maldives El Salvador              Senegal
Mali Fiji                         Seychelles
Mauritania Gabon                   Singapore
Mozambique Ghana                   Slovenia
Myanmar Grenada                 South Africa
Nepal Guatemala              Sri Lanka
Niger Guyana                  Suriname
Rwanda Honduras                Swaziland
Samoa India                      Syrian Arab Republic
Sao Tome and Principe Indonesia                Thailand
Sierra Leone Iran                       Tonga
Solomon Islands Iraq                      Trinidad and Tobago
Somalia Israel                     Tunisia
Sudan Jamaica                 Turkey
Tanzania Jordan                   United Arab Emirates
Togo Kenya                    Uruguay
Tuvalu North Korea             Venezuela
Uganda South Korea             Vietnam
Vanuatu Kuwait                    Yugoslavia
Yemen Lebanon                 Zimbabwe
Zambia Libya
* Reproduced with permission from The World Health Report 1998: Life in the 21st Century-Organization, 1998. —A Vision for All. Geneva: World Health

Lesotho (formerly Basutoland), a least-developed country, was constituted a native state under British protection by a treaty signed with the native Chief Moshoeshoe in 1843, who had forged alliances with peoples displaced by the ravaging wars initiated by Shaka Zulu. It was annexed to Cape Colony in 1871, but in 1884 it was restored to the direct control of the Crown. The colony of Basutoland became the independent nation, the Kingdom of Lesotho, on October 4,1966, with King Moshoeshoe II as sovereign.
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Lesotho, an enclave within South Africa and described as the “Mountain Kingdom” or “Kingdom in the Sky,” lies outside the tropics (lying between latitude 28° and 30° south of the equator, and longitude 27° and 30° east of Greenwich). It thus enjoys a temperate climate with well-marked seasons of summer, autumn, winter and spring. It is a mountainous country with a land size of 30,355 km2 and the lowest land at about 1,400 m above sea level and peak of 3,055 m. It has a population of about 2.1 million, a population density of about 75 per km2, and it is divided into 10 administrative districts. Only 9% of the land is arable—down from 13% in 1960 because of erosion and overgrazing. By virtue of its temperate climate, it is almost entirely free from tropical diseases that are major problems in most of sub-Saharan African countries. Online UK Pharmacy

The natural resources of this nation are limited to its people, water and the largely untapped tourism and mining industries. In spite of its lean resources, Lesotho is rated above many other sub-Saharan African countries in terms of human development indicators (HDI)—access to safe drinking water of 48%, access to a healthcare facility of 80%, adult literacy of 78%, and life expectancy at birth of 56 years (female) and 53 years (male). However, like most other sub-Saharan African countries, the health and social welfare profiles portend a low level of development. It has an annual population growth rate of 2.54%; fertility rate of 5.2%; crude death rate of 12/1,000; crude birth rate of 38/1,000; neonatal mortality rate of 62/1,000; infant mortality of 80/1000; perinatal mortality of4.8/1,000; and maternal mortality of 36/1,ООО. It has a doctor/population ratio of 1:11,764. Viagra Super Active

The government recognizes and adopts the principles and objectives of the WHO’s Global Health for All (HFA) with the primary healthcare as an approach to implementing such. This is enunciated by the Alma Ata declaration 9. The Kingdom of Lesotho is one of the few countries in Africa that has enjoyed an uninterrupted, stable and democratic governance. The government adopted the principles and objective of HFA through an act of its parliament.

The specific objectives and aims of this approach are: to ensure every citizen’s right to good healthcare regardless of status, nature of illness or residence; people, both individually and collectively, should have a role and responsibility to promote, live and maintain healthy habits (Bamako Initiative). The vulnerable groups of the society deserve special attention. Health and socioeconomic development are inseparable, the people constitute the central focus of this development, and easy accessibility to health facilities should be guaranteed to all. Consequently, the integrated health system of Lesothoembraces the elements of preventive, rehabilitative and curative services. An evaluation of the situa­tion shows that Lesotho had made appreciable progress over the years since the 1970s.
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Category: Health

Tags: developing countries, healthcare delivery, healthcare financing, Lesotho

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