improving access to quality health services through “high-tech” interventions in lmics
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University of Utah Global Health
Developing a Road Map
Improving Access to Quality
Health Services Through High
-
Tech Interventions in LMICs
Laparoscopy for ll:
A Story of Two Countries
Prince Mahidol Award Conference
Jan 26, 2016
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Colombia- Area: 1,138,910 sq km
- Population: 47.8 Mill (2014)
23.7 Mill (1973)
- GDP/Capita: $ 7,903 (2014)
$ 435 (1973)
- Life expectancy: 73.81 (2014)61.93 (1973)
- TFR: 1.92 (2014)
4.86 (1973)
Source: World Development Indicators, The World Bank
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1973: First Tubal Ligation by Laparoscopy at
Profamilia
Source and Picture: PROFAMILIA Website, accessed Jan 8, 2016
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0
10000
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80000
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Laparoscopy Minilap Total
Transition Project ends
Female Sterilization (Procedure/Total)
Profamilia - Colombia(1972 2010)
Source: Gerencia de Evaluacion e Investigacion, PROFAMILIA
Law 100/93
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Quality- Mortality (Laparoscopy 1979-2010): 2.16/100,000
- Mortality (Minilaparotomy 1979 2010): 2.23/100,000
Costs- Laparoscopy: $ 60 (2010)- Laparotomy: ~ $ 120 (2010)
Fees
- Subsidized recovery charges (BTP): $5 $10- Official price list (after Law 100): $ 200
Source: Gerencia Salud Sexual y Reproductiva, PROFAMILIA
Female Sterilization
Profamilia - Colombia(Various Indicators)
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1,000.00
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Colombia Mongolia
Program to improveaccess to affordablequality surgery inMongolia
Colombia Mongolia
GDP Per Capita Comparison (US $ Nominal)(1960 2014)
Profamilia startsoffering laparoscopy
Source: World Development Indicators, The World Bank
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Mongolia- Area: 1,564,116 sq km
- Population: 2.91 Mill (2014)
2.4 Mill (2000)
- GDP/Capita: $ 4,129 (2014)
$ 474 (2000)
- Life expectancy: 69.06 (2014)62.91 (2000)
- TFR: 2.66 (2014)
2.1 (2000)
Source: World Development Indicators, The World Bank
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49% of the population is nomadic
Source: World Journal of Surgery, Improving Surgical Care in Mongolia: A Model for Sustainable Development , 2012
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Identified Needs in Mongolia
2005
Source: World Journal of Surgery, Improving Surgical Care in Mongolia: A Model for Sustainable Development , 2012
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Regional Diagnostic Treatment
Referral Centers Mongolia
Source: World Journal of Surgery, Improving Surgical Care in Mongolia: A Model for Sustainable Development , 2012
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Cholecystectomies in MongoliaTotal Procedures and Types(2005 2013)
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Cholecystectomies in Mongolia
Laparoscopy Vs. Open(2005 2013)
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ConclusionsPrograms in Colombia and Mongolia started sophisticated surgical
programs at points in which their economies were less developed than they
are today.
Profamilia (private sector) could develop sustainable programs after years ofdonor dependency (useful for public sector as well).
More developed surgical technologies favored access expansion and quality
improvement.
Relatively sophisticated solutions can present quality advantages but alsosignificant cost reductions, even for LMICs.
New technologies can offer important advantages in the quest for UHC