Aligning Policy Options with Burden and Capacity(cont...)

To support these findings, several other standard indicators were used, of

(i) health system infrastructure (physicians/10,000 population, hospital beds/10,000 population, out-of-pocket expenditures for health as a proportion of total health expenditures (THE)

(ii) service delivery (prenatal care services and vaccine coverage)

(iii) outcome indicators (such as life expectancy). Various combinations of these indicators to create a capacity index revealed similar trends (data not shown) as with these established financing and governance indictors.

Figure A4.1 Country standing based on standardized public expenditures as a percent of THE and effectiveness and regulatory quality index compared with the country NCD burden, South Asia

Sources: WHO Global Burden of Disease 2004; Kaufmann 2008; and World Development Indicators 2010.

These categories of burden and capacity can help with prioritization of initial efforts. The aim here is not to rigorously categorize countries, but rather, to provide a range of strategies for different countries at different levels of development to adapt these strategies to their needs and capacity levels. Exceptions may occur. One example is Afghanistan (lower burden and lower capacity) in its success with tobacco policy and signing the Framework Convention on Tobacco Control, although global implementation remains a major challenge. This is also an example of how global (and regional) approaches can enhance individual country capacity.