Abstract:
This study is drawn partly from our 2016 report commissioned by the World Health Organization Asia Pacific on Health Systems and Policies. Three countries were selected to explore a range of health system responses among middle-income Asian countries. Malaysia, Sri Lanka, and Thailand are rapidly ageing societies and face an increasing burden from non-communicable diseases (NCDs). Diabetes and stroke were selected as chronic health indicators to trace the effectiveness of NCD health services. For the former, diabetes can be detected through screening and managed at the primary health care requiring referral to tertiary level in the case of common complications (eg kidney, eye, and footcare). For the latter, stroke requires immediate access to a higher level of care and treatment services as well as coordinated follow-up with rehabilitation services after hospital discharge. Strengthening primary health care for preventive and treatment in resource limited settings is essential for cost-effective chronic care management. Changes in population age profiles and their health needs call for age-friendly health services and the training of health professionals. Ensuring integration of social and health services in the management of chronic care will be essential to improve population health outcomes.
Dr Vasoontara Yiengprugsawan is a Fellow based at the ANU Centre for Research on Ageing, Health & Wellbeing (CRAHW). She is currently funded through the ARC Centre of Excellence on Population Ageing Research (ARC CEPAR). Dr Yiengprugsawan has background in economics, international development, and epidemiology. She was previously supported by the UK Wellcome Trust and the Australian National Health and Medical Research Council leading analyses of health-risk transitions among a large cohort of Thai adults (2008-2014). Key contributions have been to advance understanding of social determinants of population health in the context of their cultural traditions and uneven economic development in the Asia-Pacific region.