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By Economic & Social Commission for Asia & the Pacific

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Extra resources for Achieving the Health Millennium Development Goals in Asia and the Pacific: Policies and Actions Within Health Systems and Beyond (Asia-Pacific MDG Study Series)

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Afghanistan, Bangladesh, CHAPTER 3 Obstacles to Achieving the Health-Related MDGs Bhutan, Indonesia and Papua New Guinea have the lowest density of health professionals in the region, with only 4 to 6 health workers per 10,000 people, half the average in sub-Saharan Africa (World Bank, 2005a; WHO, 2005g). 3). In Afghanistan, Bangladesh and Nepal, less than 14 per cent of births are attended by skilled personnel (WHO, 2005i). 3. Deliveries attended by skilled personnel 1990 51 East and North-East Asiaa 79 38 South-East Asia 30 36 42 46 40 South and South-West Asiab Sub-Saharan Africa North Africa 2004 68 Latin America and Caribbean 71 72 81 0 20 40 60 80 100 Deliveries (percentage) attended by skilled health personnel Source: United Nations, The Millennium Development Goals Report, 2006 (New York, United Nations, 2006).

Management Systems International, 2002). The elimination of corruption and introduction of good governance practices in health systems is paramount in the efforts to achieve the Millennium Development Goals. Corruption has clear negative effects on the efficiency, effectiveness and equity of health systems. Corruption not 35 Achieving the Health Millennium Development Goals in Asia and the Pacific Policies and Actions within Health Systems and Beyond Introduction of good governance practices in health systems is paramount to the achievement of the MDGs only lowers quality and access to services, especially for the poor, but also increases the operational costs of health systems (Utstein Group, 2005).

INEQUITABLE ALLOCATIONS OF HEALTH BUDGETS Spending on health does not automatically translate into accelerated progress towards achieving the health-related MDGs. Equally important to the ability, effectiveness and efficiency of health systems to provide services is the way in which investments are targeted. A highly inequitable distribution of public investments in health exists in many developing countries in the ESCAP region. Resources are heavily concentrated in urban areas and on secondary and tertiary care, often at the expense of even the most essential health care in rural areas.

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