Health and health-care systems in southeast Asia: diversity and transitions

Abstract

Southeast Asia is a region of enormous social, economic, and political diversity, both across and within countries, shaped by its history, geography, and position as a major crossroad of trade and the movement of goods and services. These factors have not only contributed to the disparate health status of the region's diverse populations, but also to the diverse nature of its health systems, which are at varying stages of evolution. Rapid but inequitable socioeconomic development, coupled with differing rates of demographic and epidemiological transitions, have accentuated health disparities and posed great public health challenges for national health systems, particularly the control of emerging infectious diseases and the rise of non-communicable diseases within ageing populations. While novel forms of health care are evolving in the region, such as corporatised public health-care systems (government owned, but operating according to corporate principles and with private-sector participation) and financing mechanisms to achieve universal coverage, there are key lessons for health reforms and decentralisation. New challenges have emerged with rising trade in health services, migration of the health workforce, and medical tourism. Juxtaposed between the emerging giant economies of China and India, countries of the region are attempting to forge a common regional identity, despite their diversity, to seek mutually acceptable and effective solutions to key regional health challenges. In this first paper in the Lancet Series on health in southeast Asia, we present an overview of key demographic and epidemiological changes in the region, explore challenges facing health systems, and draw attention to the potential for regional collaboration in health.

Soft-tissue Sarcomas in the Asia-Pacific Region: A Systematic Review

“…Patients with STS require tailored and multidisciplinary treatment and management; however, this approach, and the resources needed to study and publish treatment practices, may be lacking in parts of the Asia-Pacific region. Further, differences in healthcare systems throughout the region (Chongsuvivatwong et al, 2011) may have contributed to the variability in reported outcomes. Overall, these findings emphasise the need for a comprehensive assessment of STS treatment, management, and outcomes in the Asia Pacific and are a critical first step towards developing clinical and research collaborations in the region.…”

“…Among the included studies, survival outcomes and recurrence, when reported, differed and few reported safety outcomes. The treatment and management of STS requires a multidisciplinary approach; however, healthcare systems within and among Asia-Pacific countries are in various states of evolution (Chongsuvivatwong et al, 2011). This may have adverse consequences for patients by limiting the availability of, or access to, facilities that detect, diagnose, and treat STS.…”

Family Process with Breast Cancer Patient in Indonesia

“…In the other hand health insurance for long way treatment needed. Chongsuvivatwong et al (2011) state that health-related insurance implemented in Indonesia with decentralization system (Swadana) in implementation still needs stabilization because of the lack of supporting infrastructure. While a lack of understanding in national health insurance coverage may contribute to treatment inadequacy (Obrist et al, 2014).…”

Trade and investment liberalization and Asia¿s noncommunicable disease epidemic: a synthesis of data and existing literature

“…In China for example, the market is monopolised by the stateowned enterprise China National Tobacco Corporation [50], which had a 96.9% market share in 2012 [43]. Justifications for this policy contradiction usually centre on poverty alleviation, although this view has been discredited [31,49]. These observations discount the combined role of trade liberalization and transnational tobacco corporations (TTCs) as consumption drivers in these countries.…”