Health in Commonwealth Asia

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  • The quality of the healthcare system in Commonwealth Asia, including proportion of public expenditure on health and number of qualified health personnel, varies significantly between member states. Singapore has the highest number of doctors, nurses and midwives of Asian member states, with 183 doctors and 590 nurses and midwives per 100,000 people (2009). Maldives and Brunei Darussalam also have well-staffed health care systems, with more than 100 doctors and 400 nurses per 100,000 people. However, Bangladesh has only 30 doctors and 27 nurses and midwives, the lowest in Commonwealth Asia (2007). Maldives has the highest proportion of public expenditure on health of Asian member states, at 5% of its GDP which equates to US$331 per capita. Singapore has the highest public spending per capita on health in Commonwealth Asia and sixth highest in the Commonwealth as a whole, at US$1,501 per person – although the proportion of public expenditure on health is only 2% of its GDP (2009). Commonwealth Asia also has some of the least funded public healthcare systems; Bangladesh, Pakistan and India have the lowest proportion of public expenditure on health in the Commonwealth, along with Kenya and Sierra Leone, with only 1% of GDP being spent on healthcare. Four member states of Commonwealth Asia spend less than $100 per person on health every year – at $18 per capita spent on health, Bangladesh is the lowest in the Commonwealth (2009).
  • The prevalence of daily smoking in the adult population in Commonwealth Asia is relatively low compared to Pacific member states, but higher than the Commonwealth Americas and Africa, as a whole. Maldives has the highest rate of smoking of the Asian member states, with more than one in five adults smoking on a daily basis. Sri Lanka has the lowest rate at 10.6% of adults (2008).
  • Commonwealth Asia had the lowest prevalence of HIV/AIDS among those aged 15-49 of all member states with available information. All Asian member states have a prevalence of HIV/AIDS less than 1% (2009).
  • India and Bangladesh have the lowest prevalence of being overweight and obese in the Commonwealth, with only 11% of the adult population classified as overweight and less than 2% as obese in India, and less than 8% of adults classified as overweight and 1% obese in Bangladesh (2008). Malaysia has the highest prevalence in Commonwealth Asia, with 44% of the adult population classified as overweight and 14% as obese. Overall, Asian member states have the lowest levels of obesity in the Commonwealth, along with some member states of Commonwealth Africa (2008).
  • The prevalence of risk factors for non-communicable diseases, such as raised blood pressure, cholesterol and blood glucose, is low throughout Asian member states, especially in comparison to the Commonwealth Pacific and Africa. Sri Lanka has the highest prevalence of raised blood pressure (hypertension) in Commonwealth Asia, at 39% of the adult population. India has the lowest rate of hypertension with only 32.5% (2008). Singapore has a high prevalence of raised cholesterol at 60% of the adult population, the third highest in the Commonwealth. However, Pakistan and India have rates of 30% or less (2008). Out of the seven Asian member states with available information on prevalence of raised blood glucose, a key indicator in the presence of diabetes, only Pakistan, Malaysia and India have rates of 10% or higher, while Maldives has the third lowest prevalence in the Commonwealth with only 6.2% of its adult population having raised blood glucose (2008).
  • Pakistan has the highest rate of infant mortality in Commonwealth Asia, with 70 deaths per 1,000 live births, the fifth highest in the Commonwealth. Pakistan also has the highest rate of under-five mortality of the Asian member states, with 87 deaths per 1,000 live births (2010). However, Singapore has the lowest rate of child mortality in the Commonwealth, with an infant mortality rate of 2 deaths per 1,000 live births and an under-five mortality rate of 3 deaths (2010).
  • Of Asian member states, India has the highest reported maternal mortality ratio, with 250 government-reported deaths of mothers per 100,000 live births from 2006 to 2010; however, the adjusted maternal mortality ratio of India, which takes into account government figures, World Bank and UN agency estimates, drops to 230 deaths. According to these adjusted figures, Bangladesh has the highest maternal mortality ratio of 340 deaths per 100,000 live births (2008). Singapore has the second lowest World Bank/UN agency adjusted ratio in the Commonwealth, with 9 deaths per 100,000 live births in 2008.
  • A comparison of Singapore and Bangladesh illustrates the significantly different levels of development in Commonwealth Asia. Singapore has the third highest income per capita in the Commonwealth at $40,070 per person while Bangladesh has the 8th lowest, at $700 (2010). Singapore and Brunei Darussalam are the only member states of Commonwealth Asia that are classified as high-income economies by the World Bank, the rest of the Asian member states are middle-income economies with average incomes of less than $10,000 per capita (2010). In terms of human development, Singapore and Brunei are in the top 40 countries on the UN’s 2011 Human Development Index, ranking 26 and 33 out of 187 countries, respectively. Singapore ranks fourth highest in the Commonwealth and Brunei is the sixth highest on the index. However, both Pakistan and Bangladesh are given a ‘low human development’ classification, ranking 145 and 146 on the Human Development Index (2011). Singapore has the highest life expectancy of Asian member states at 81 years, which is the second highest in the Commonwealth, along with Canada and New Zealand (2010). Bangladesh, India and Pakistan have life expectancies of less than 70 years, with Pakistan the lowest in Commonwealth Asia at 65 years (2010).