improving access to quality health services through “high-tech” interventions in lmics

7/25/2019 Improving Access to Quality Health Services Through High-Tech Interventions in LMICs

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University of Utah Global Health

Developing a Road Map

Improving Access to Quality

Health Services Through High

-

Tech Interventions in LMICs

Laparoscopy for ll:

A Story of Two Countries

Prince Mahidol Award Conference

Jan 26, 2016


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Colombia- Area: 1,138,910 sq km

- Population: 47.8 Mill (2014)

23.7 Mill (1973)

- GDP/Capita: $ 7,903 (2014)

$ 435 (1973)

- Life expectancy: 73.81 (2014)61.93 (1973)

- TFR: 1.92 (2014)

4.86 (1973)

Source: World Development Indicators, The World Bank


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1973: First Tubal Ligation by Laparoscopy at

Profamilia

Source and Picture: PROFAMILIA Website, accessed Jan 8, 2016


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0

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Laparoscopy Minilap Total

Transition Project ends

Female Sterilization (Procedure/Total)

Profamilia - Colombia(1972 2010)

Source: Gerencia de Evaluacion e Investigacion, PROFAMILIA

Law 100/93


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Quality- Mortality (Laparoscopy 1979-2010): 2.16/100,000

- Mortality (Minilaparotomy 1979 2010): 2.23/100,000

Costs- Laparoscopy: $ 60 (2010)- Laparotomy: ~ $ 120 (2010)

Fees

- Subsidized recovery charges (BTP): $5 $10- Official price list (after Law 100): $ 200

Source: Gerencia Salud Sexual y Reproductiva, PROFAMILIA

Female Sterilization

Profamilia - Colombia(Various Indicators)


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Colombia Mongolia

Program to improveaccess to affordablequality surgery inMongolia

Colombia Mongolia

GDP Per Capita Comparison (US $ Nominal)(1960 2014)

Profamilia startsoffering laparoscopy



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Mongolia- Area: 1,564,116 sq km

- Population: 2.91 Mill (2014)

2.4 Mill (2000)

- GDP/Capita: $ 4,129 (2014)

$ 474 (2000)

- Life expectancy: 69.06 (2014)62.91 (2000)

- TFR: 2.66 (2014)

2.1 (2000)



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49% of the population is nomadic

Source: World Journal of Surgery, Improving Surgical Care in Mongolia: A Model for Sustainable Development , 2012


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Identified Needs in Mongolia

2005



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Regional Diagnostic Treatment

Referral Centers Mongolia



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Cholecystectomies in MongoliaTotal Procedures and Types(2005 2013)


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Cholecystectomies in Mongolia

Laparoscopy Vs. Open(2005 2013)


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ConclusionsPrograms in Colombia and Mongolia started sophisticated surgical

programs at points in which their economies were less developed than they

are today.

Profamilia (private sector) could develop sustainable programs after years ofdonor dependency (useful for public sector as well).

More developed surgical technologies favored access expansion and quality

improvement.

Relatively sophisticated solutions can present quality advantages but alsosignificant cost reductions, even for LMICs.

New technologies can offer important advantages in the quest for UHC

improving access to quality health services through “high-tech” interventions in lmics

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