The World Health Organization (WHO) ranked the health systems of its 191 member states in its World Health Report 2000. It provided a framework and measurement approach to examine and compare aspects of health systems around the world.World Health Organization. World Health Report 2000. Geneva, 2000. It developed a series of performance indicators to assess the overall level and distribution of health in the populations, and the responsiveness and financing of health care services. It was the organization's first ever analysis of the world's health systems.

Ranking

Country Attainment of goals / Health / Level (DALE) Attainment of goals / Health / Distribution Attainment of goals / Health / Overall goal attainment Health expenditure per capita in international dollars Performance / On level of health Performance / Overall health system performance Afghanistan 164 0 183 184 150 173 102 128 86 149 64 55 44 63 56 24 45 81 10 25 17 23 7 4 165 178 181 164 165 181 48 58 71 56 123 86 Argentina 39 60 49 34 71 75 41 63 81 102 56 104 Australia 2 17 12 17 39 32 Austria 17 8 10 6 15 9 65 99 103 162 60 109 109 67 64 22 137 98 61 72 58 48 30 42 Bangladesh 140 125 131 144 103 88 53 36 38 36 87 46 83 46 53 74 116 72 16 26 13 15 28 21 94 95 104 88 34 69 157 132 143 171 136 97 138 158 144 135 73 124 Bolivia 133 118 117 101 142 126 56 79 79 105 70 90 187 146 168 85 188 169 Brazil 111 108 125 54 78 125 59 42 37 32 76 40 Bulgaria 60 53 74 96 92 102 178 137 159 173 162 132 179 154 161 186 171 143 Cambodia 148 150 166 140 157 174 156 160 163 131 172 164 Canada 12 18 7 10 35 30 Cape Verde 118 123 126 150 55 113 175 189 190 178 164 189 161 175 177 175 161 178 32 1 33 44 23 33 People's Republic of China 81 101 132 139 61 144 Colombia 74 44 41 49 51 22 Comoros 146 143 137 165 141 118 150 142 155 122 167 166 67 92 88 61 95 107 Costa Rica 40 45 45 50 25 36 38 33 36 56 57 43 Cuba 33 41 40 118 36 39 Cyprus 25 31 28 39 22 24 Czech Republic 35 19 30 40 81 48 Democratic Republic of the Congo 174 174 179 188 185 188 28 21 20 8 65 34 166 169 170 163 163 157 26 35 42 70 59 35 79 97 66 92 42 51 93 133 107 97 96 111 Egypt 115 141 110 115 43 63 87 115 122 83 37 115 152 151 152 129 174 171 Eritrea 169 167 176 187 148 158 Estonia 69 43 48 60 115 77 Ethiopia 182 176 186 189 169 180 104 112 111 81 110 123 106 71 78 87 124 96 Finland 20 27 22 18 44 31 France 3 12 6 4 4 1 144 136 141 95 143 139 143 155 153 158 109 146 Georgia 44 61 76 125 84 114 Germany 22 20 14 3 41 25 Ghana 149 149 139 166 158 135 Greece 7 6 23 30 11 14 49 82 68 67 49 85 129 106 113 130 99 78 167 166 172 159 160 161 170 177 180 156 156 176 98 126 116 109 104 128 Haiti 153 152 145 155 139 138 92 119 129 100 48 131 62 40 43 59 105 66 Iceland 19 24 16 14 27 15 India 19 13 121 133 118 112 Indonesia 103 156 106 154 90 92 Iran 96 113 114 94 58 93 Iraq 126 130 124 117 75 103 Ireland 27 13 25 25 32 19 Israel 23 7 24 19 40 28 Italy 6 14 11 11 3 2 155 181 157 153 133 137 36 87 69 89 8 53 Japan 1 3 1 13 9 10 Jordan 101 83 84 98 100 83 Kazakhstan 122 52 62 112 135 64 Kenya 162 135 142 152 178 140 125 121 123 103 144 142 68 54 46 41 68 45 Kyrgyzstan 123 122 135 146 134 151 Laos 147 147 154 157 155 165 82 56 67 77 121 105 95 88 93 46 97 91 171 164 173 123 186 183 181 191 187 181 176 186 Libya 107 102 97 84 94 87 63 48 52 71 93 73 18 22 5 5 31 16 64 85 89 106 69 89 172 168 167 190 173 159 189 187 182 161 187 185 Malaysia 89 49 55 93 86 49 130 134 128 76 147 147 Mali 183 180 178 179 170 163 21 38 31 37 2 5 121 120 119 80 140 141 Mauritania 158 163 169 141 151 162 78 77 90 69 113 84 Mexico 55 65 51 55 63 61 88 64 91 108 106 101 9 30 18 12 12 13 131 148 136 145 138 145 Morocco 110 111 94 99 17 29 180 190 185 160 168 184 Myanmar 139 162 175 136 129 190 177 173 165 66 189 168 136 51 75 42 166 98 Nepal 142 161 160 170 98 150 Netherlands 13 15 8 9 19 17 New Zealand 31 16 26 20 80 41 117 96 101 104 74 71 190 184 188 185 177 170 Nigeria 163 188 184 176 175 187 85 100 102 127 108 121 North Korea 137 145 149 172 153 167 15 4 3 16 18 11 Oman 72 59 59 62 1 8 Pakistan 124 183 133 142 85 122 112 66 63 47 125 82 47 93 70 53 67 95 145 157 150 137 146 148 Paraguay 71 57 73 91 52 57 105 103 115 78 119 129 Philippines 113 50 54 124 126 60 Poland 45 5 34 58 89 50 Portugal 29 34 32 28 13 12 Qatar 66 55 47 27 53 44 Romania 80 78 72 107 111 99 Russia 91 69 100 75 127 130 185 185 171 177 181 172 86 91 98 51 122 100 54 86 87 86 54 68 43 89 92 90 38 74 97 81 82 121 131 119 San Marino 11 9 21 21 5 3 132 139 138 167 117 133 Saudi Arabia 58 70 61 63 10 26 Senegal 151 105 118 143 132 59 108 73 83 52 83 56 Sierra Leone 191 186 191 183 183 191 Singapore 30 29 27 38 14 6 42 39 39 45 88 62 Slovenia 34 23 29 29 62 38 127 117 108 134 20 80 173 179 189 191 154 179 South Africa 160 128 151 57 182 175 South Korea 51 37 35 31 107 58 Spain 5 11 19 24 6 7 Sri Lanka 76 80 80 138 66 76 Sudan 154 159 148 169 149 134 77 94 105 72 77 110 164 140 164 116 184 177 4 28 4 7 21 23 Switzerland 8 10 2 2 26 20 Syria 114 107 112 119 91 108 Tajikistan 120 124 127 126 145 154 Tanzania 176 172 158 174 180 156 Thailand 99 74 57 64 102 47 159 170 156 180 159 152 75 84 85 73 114 116 Trinidad and Tobago 57 75 56 65 79 67 90 114 77 79 46 52 Turkey 73 109 96 82 33 70 Turkmenistan 128 131 130 128 152 153 119 116 120 151 128 136 United Arab Emirates 50 62 44 35 16 27 Uganda 186 138 162 168 179 149 United Kingdom 14 2 9 26 24 18 Ukraine 70 47 60 111 101 79 United States 24 32 15 1 72 37 37 68 50 33 50 65 Uzbekistan 100 144 109 120 112 117 135 127 134 132 120 127 Venezuela 52 76 65 68 29 54 Vietnam 116 104 140 147 130 160 Yemen 141 165 146 182 82 120 46 90 95 113 47 106 188 171 174 148 190 182 184 98 147 110 191 155

Methodology The rankings are based on an index of five factors: Health (50%) : disability-adjusted life expectancy Overall or average : 25% Distribution or equality : 25% Responsiveness (25%) : speed of service, protection of privacy, and quality of amenities Overall or average : 12.5% Distribution or equality : 12.5% Fair financial contribution : 25%

Criticism

The WHO rankings are claimed to have been subject to many and varied criticisms since its publication. Concerns raised over the five factors considered, data sets used and comparison methodologies have led health bodies and political commentators in most of the countries on the list to question the efficacy of its results and validity of any conclusions drawn. Such criticisms of a broad endeavour by the WHO to rank all the world's healthcare systems must also however be understood in the context of a predisposition to analytical bias commensurate with an individual nation's demographics, socio-economics and politics. In considering such a disparate global spectrum, ranking criteria, methodology, results and conclusions will always be an area for contention.

In over a decade of discussion and controversy over the WHO Ranking of 2000, there is still no consensus about how an objective world health system ranking should be compiled. Indeed, the 2000 results have proved so controversial that the WHO declined to rank countries in their World Health Reports since 2000, but the debate still rages on. With burgeoning and ageing populations, spiralling costs and the recognition by most national governments that constant vigilance and periodic healthcare reform are necessary, the appetite for a means of measuring national performance in broader world contexts is ever increasing and all the more relevant. With this in mind, and in lieu of any further ranking information from the WHO since 2000, there are many analytical bodies now looking at national healthcare delivery in global contexts and publishing their findings. Bloomberg finds "the U.S. spends the most on health care on a relative cost basis with the worst outcome" and notes Cubans live longer than Americans, but Americans pay more than fourteen times as much for less effective health care. The Commonwealth Fund ranked seven developed countries on health care, the US ranked lowest (AU, CA, DE, NL, NZ, UK, US).

See also Health systems – explains in some depth the concept of healthcare and its delivery on national and international scales International comparisons of health systems – a section of the above article specifically about international comparisons Healthcare subjects – a list of subjects detailing the complexities behind global healthcare delivery List of countries by quality of healthcare

References

External links The World Health Organization's ranking of the world's health systems, by Rank