This fifth edition of Health at a Glance Asia/Pacific presents a set of key indicators of health status, the determinants of health, health care resources and utilisation, health care expenditure and financing and quality of care across 27 Asia-Pacific countries and territories. It also provides a series of dashboards to compare performance across countries, and a thematic analysis on health inequalities. Drawing on a wide range of data sources, it builds on the format used in previous editions of Health at a Glance, and gives readers a better understanding of the factors that affect the health of populations and the performance of health systems in these countries and territories. Each of the indicators is presented in a user-friendly format, consisting of charts illustrating variations across countries and over time, brief descriptive analyses highlighting the major findings conveyed by the data, and a methodological box on the definition of the indicator and any limitations in data comparability. An annex provides additional information on the demographic context in which health systems operate.
Health at a Glance: Asia/Pacific 2018
Abstract
Executive Summary
Health at a Glance: Asia/Pacific 2018 presents key indicators on equity, health status, determinants of health, health care resources and utilisation, health expenditure and financing, and quality of care for 27 Asia-Pacific countries and territories. The report provides a concise overview of the progress of countries towards achieving universal health coverage for their population.
Life expectancy increased by almost 6 years since 2000, but maternal mortality is still twice the Sustainable Development Goal target in lower-middle and low income countries in the region
Life expectancy at birth across lower-middle and low income Asia-Pacific countries reached 70 years in 2016. Upper-middle and high income Asia-Pacific countries gained – on average – 3.6 years and OECD countries 3 years during the same period.
The infant mortality rate has fallen dramatically in particular across the lower-middle and low income Asia-Pacific countries since 2000, with many countries experiencing declines of greater than 50%. At an average of 30 deaths per 1 000 live births in 2016, infant mortality in lower-middle and low income Asia-Pacific countries is still eight times the high income Asia-Pacific countries and OECD rate, and two and a half time the SDG target of 12 deaths per 1 000 live births.
Between 2000 and 2015, the average maternal mortality rate across lower-middle and low income Asia-Pacific countries was cut by more than half, but it is still high at 140 deaths per 100 000 live births, twice the SDG target of 70 deaths per 100 000 live births.
The share of the population aged over 65 years and over 80 will more than double in the next four decades, with faster growth in middle and low income countries
In high income Asia-Pacific countries, the share of population aged over 65 years is expected to double to reach – on average – 27.6% in 2050, whereas the share of population aged over 80 years is expected to triple between 2015-2050 to reach 10.2%.
In upper-middle income and lower-middle low income Asia-Pacific countries, the share of population over 65 and over 80 will be two and half and four times the current share, and reach 23.9% and 14.5% (over 65) and 7.9% and 3.5% (over 80) respectively.
Less than two third of rural dwellers access basic sanitation
Although access to basic drinking water for rural dwellers has improved steadily since 2010 and reached 81% of rural populations in 2015 compared to 94.1% in urban dwellings, improving sanitation in rural areas is more problematic.
In the region, on average, only less than two third of rural dwellers had access to basic sanitation in 2015 compared to 80% in urban dwellings. In Papua New Guinea and Solomon Islands less than one person in five living in rural areas have access to basic sanitation for adequate excreta disposal.
Undernutrition remains prevalent, but more than one third of adults are overweight in Asia-Pacific
Stunting of children under age 5 – which reflects both maternal and child undernutrition – affects – on average – about one quarter of children in Asia-Pacific.
More than one third of adults are overweight in Asia-Pacific, and one in ten persons is obese. Overweight also affects 5% of children under age 5 and more than 20% of adolescent in the Asia-Pacific region. Between 2010 and 2016, the rates of obesity in Asia-Pacific have risen by 33% among adults and 58% among adolescents.
Almost half of health spending comes from payments made by households in lower-middle and low income countries
Lower-middle and low income Asia-Pacific countries spend – after adjusting for differences in prices across countries – just below USD 200 per person per year on health, against USD 670 and USD 3 450 in upper-middle income and high income Asia-Pacific countries respectively. This amounts to over 4.3% of gross domestic product, on average, in middle and low income Asia-Pacific countries, compared to over 7.3% in high income Asia-Pacific countries in 2015. On average, high income countries reported an increase of 0.8 percentage points from 2010-2015, twice the increase reported by middle and low income countries at 0.4 percentage points.
The share of public spending in total health spending increased in all Asia-Pacific countries from 2010 to 2015, but it is much lower in lower-middle and low income Asia-Pacific countries compared to upper-middle and high income Asia-Pacific countries: 41.9% compared to 62% and 72.3%, respectively.
On average, household out-of-pocket expenditure (that is, payments made directly by households for health services and goods) accounted for 48.2% of total health expenditure in lower-middle and low income Asia-Pacific countries in 2015, an increase of one percentage point from 2010, signalling that significant gaps in providing health coverage remain in the region.
Spending on pharmaceuticals accounted for almost one third of all health expenditure on average across lower-middle and low income Asia-Pacific countries in 2015, whereas it accounted for 28% and 15% of health spending in upper-middle and high income Asia-Pacific countries respectively. Most of the spending on pharmaceuticals across lower-middle and low income Asia-Pacific countries is paid for by households out of pockets.
