Health Policy and Economics in the Pacific Region
While no two countries are alike, a common feature of many countries in the Pacific region is rising shares of elderly populations, growing numbers of people with chronic non-communicable conditions, emerging health needs and risks linked to climate change, and an economic environment that is challenging.
On the one hand there are growing demands on scarce budgetary resources as health needs increase, and on the other, the future economic environment is an ever-growing concern, as the expiry date for country-specific demographic dividends comes closer and global economic and political conflicts dominate the horizon. Faced with competing resource pressures, ministries of finance are unlikely to loosen their purse strings to support universal health coverage goals in the absence of health sector strategies intended to obtain good value for money.
How might countries in the Pacific region respond to this? Using resources efficiently remains an important health sector priority. Strategies that encourage investments in primary care and health promotion, including by engaging with private providers, or training and reorienting human resources for health towards public health, remain a high priority. Hospitals currently account for a major share of health spending and while remaining an important way to protect against financial risks from illness, can be a source of considerable inefficiency as people bypass primary care to obtain outpatient health services in hospitals, incurring considerable travel costs. In circumstances of limited supplies of specialized human resources for health, understaffed hospitals often serve as a money pit for infrastructure investments, or as providers of social care.
Focusing excessively on hospitals also increases the returns to specialized medical training and consequently the risk of outward migration to more remunerative settings. Public health investments are not enough, however. Economic growth is also needed to support added investments in the health sector, with one key resource often under-looked. Given their much lower work participation rates than men, government investments to encourage productive employment among women has the potential of harnessing enormous economic energy.
Health and economic gains can progress together if supported by public health investments that encourage healthy Pacific populations, lowering caregiving activities among women.
Professor Ajay Mahal is an economist with over 25 years’ experience in health systems and policy research and evaluation. His recent research has focused on evaluation of health system interventions.