Human Capital Role of Education and Health in Human Development (II)

The World Health Organisation displays the definition of health on its webpage as, ‘A state of complete physical, mental and social well-being and not merely the absence of disease and infirmity.’ Developing countries of the world face a crippling disease burden more than the developed countries especially regarding infectious diseases. Every year more than 12 million children under the age of 5 die in developing countries due to diseases that could be prevented by spending a very small amount of money per child. It has been claimed rightfully that their real underlying disease is poverty.

Health issues and problems are at the worst in sub-Saharan Africa. Water there is scarce and if there is any, that is contaminated. Infant mortality is around 100 deaths per 1,000 live births in this region and in some countries such as Niger and Sierra Leone, it is nearly 200 per 1,000. WHO studies reveal that five conditions, namely acute respiratory infections, diarrhoea, measles, malaria and malnutrition account for 70% of deaths among children less than 5 years of age.

The devastating effects of poor healthcare on child mortality are clear enough. A pertinent questions arises here, do poor health conditions in the developing part of the world also harm the productivity of people? Research shows that the answer to this question is yes. Studies around the globe vividly depict that healthier people tend to earn higher wages and, therefore, lead a better life as compared to unhealthy adults. It is not just the reverse causality that higher wages are used in part to purchase better health. A study in Bangladesh found that the higher productivity of healthier workers allows them to get better paying jobs. It can easily be concluded that health and nutrition do increase productivity, with the greatest improvements for those who are initially least educated and poorest. Health, therefore, has to be kept as a policy priority for economic development because not only is health a major goal in itself, it has a significant impact on income levels also.

Turning our attention towards health systems policy, we see that health system of any country comprises all the activities whose primary purpose is to promote, restore or maintain health. Health systems include the components of public health departments, hospitals and clinics and offices of doctors and paramedics.

Besides this formal system there is an informal network which includes traditional healers who may practice with the use of somewhat effective herbal remedies or other methods such as acupuncture but who also may practice techniques for which there is no evidence of effectiveness beyond the placebo effect.

  Some developing countries such as China and Sri Lanka have been far more successful than others in achieving health goals. In 2000, the WHO released its first detailed report comparing health systems around the world. Great variability was found in the performance of health systems at each income level. Singapore was ranked 6th, Morocco 29th, Colombia 22nd, Chile 33rd and Costa Rica 36th. All of these countries were ranked higher than the United States. Thus, it was concluded that much can be done with relatively modest levels of income. Any health system may be evaluated against five performance indicators: (1) the overall level of health of the population; (2) health inequalities within the population; (3) health-system responsiveness (a combination of patient satisfaction and system performance); (4) the distribution of responsiveness within the population (how well people of varying economic status find that they are served by the health systems); and (5) the distribution, or fairness, of health system’s financial burden within the population.

Formal public health measures play a very vital role in developing countries. Non-governmental organisations sometimes complement the ministries of health in extending vaccines to remote rural areas. But like educational systems, public health operations often favour the wealthy and well connected and, therefore, health systems usually use the public funds inappropriately. Subsidies tend to focus on expensive curative measures for older and generally richer patients such as those with heart disease or cancer who are influential enough to get into the relevant hospitals. Cost-effective preventative health campaigns and basic medical care for those not attended by any medical professionals are generally ignored or underfunded. Doctors getting their medical training with the help of public money often choose to practise a specialty in rich areas of the major cities or immigrate to developed countries of the world.

Besides having a direct positive effect on national health standards, basic health is also quite effective in reducing poverty levels of a population. Although both parents may be employed, if parents are too weak, unhealthy and unskilled to be productive enough to support their family, the children have to work. This will leave them without education and so when they grow up they also send their children to work. Thus, the bad equilibrium of child-labour may extend across many generations as a family is locked into a vicious cycle of poverty.

Governments have to play an effective role in health systems for at least three important reasons. Firstly, health is central to poverty reduction. Secondly, households spend too little on health because they may neglect externalities. Thirdly, the market would invest too little in health infrastructure and research and development and technology transfer to developing countries, due to market failures. The WHO has concluded, ‘The careful and responsible management of the well-being of the population’ stewardship’ is the very essence of good government. The health of people is always a national priority: Government’s responsibility for it is continuous and permanent.’