Contents List of Figures Figure 1. The PHC reforms necessary to refocus health systems vi Figure 3. 1 The effect on uptake of contraception of the towards health for all reorganization of work schedules of rural health centres in Niger Figure 3. 2 Lost opportunities for prevention of mother-to-child Figure 1.1 Selected best p 2 transmission of HIV(MTCT)in cote d'Ivoire: only a tiny fraction of five mortality by at least 80%, by regions, 1975-2006 he expected transmissions are actually Figure 1.2 Factors explaining mortality reduction in Portugal 3 Figure 3.3 More comprehensive health centres have better in reducing under-five mortality, Figure 3. 4 Inappropriate investigations prescribed for simulated 53 975 and 2006. in selected countries with similar rates in 1975 Figure 1. 4 GDP per capita and life expectancy at birth in 169 Figure 3. 5 Primary care as a hub of coordination: networking ountries. 1975 and 2005 within the community served and with outside partners Figure 1. 5 Trends in GDP per capita and life expectancy at birth 5 countries grouped by the 1975 GDP, 1975-2005 Figure 4.1 Deaths attrib Figure 1. 6 Countries grouped according to their total health expenditure in 2005 (international S) Figure 4.2 Annual pharmaceutical spending and number Figure 1.7 Africa' s children are at more risk of dying from traffic 7 of prescriptions dispensed in New Zealand since the accidents than European children: child road-traffic deaths per Pharmaceutical Management Agency was convened in 1993 100 000 population Figure 4.3 Percentage of births and deaths recorded in countries Figure 1. 8 The shift towards noncommunicable diseases and with complete civil registration systems, by WHo region accidents as causes of death Figure 1.9 Within-country inequalities in health and health care 10 Figure 4.4 Essential public-health functions that 30 national public-health institutions view as being part of their portfolio Figure 1.10 How health systems are diverted from PHC core 11 Figure 1.11 Percentage of the population citing health as their 15 Figure 5.1 Percentage of GDP used for health, 2005 ain concern before other issues, such as financial problems, Figure 5.2 Health expenditure in China: withdrawal of the State in the 1980s and 1990s and recent re-engagement Figure 1.12 The professionalization of birthing care: percentage 7 Figure 5.3 Transforming information systems into instruments 87 of births assisted by professional and other carers in selected for PHc reform areas, 2000 and 2005 with projections to 2015 Figure 5.4 Mutual reinforcement between innovation in the field Figure 1. 13 The social values that drive PHC and the corresponding sets of reforms Figure 5.5 A growing market: technical cooperation as part of Official Development Aid for Health. Yearly aid fiows in 2005, Figure 5.6 Re-emerging national leadership in health: the shift Figure 2.2 Three ways of moving towards universal coverag in donor funding towards integrated health systems support, and its impact on the Democratic Republic of the Congo's 2004 PHC Figure 2.3 Impact of abolishing user fees on outpatient attendance in Kisoro district, Uganda: outpatient attendance 1998-2002 Figure 2.4 Different patterns of exclusion: massive deprivation Figure 6. 1 Contribution of general gov in some countries, marginalization of the poor in others. Births and private out-of-pocket expenditure to the yearly growth attended by medically trained personnel (percentage), by income in total health expenditure per capita, percentage, weighter averages group Figure 2. 5 Under-five mortality in rural and urban areas, the 29 Figure 6.2 Projected per capita health expenditure in 2015, slamic Republic of Iran, 1980-2000 apid-growth health economies (weighted averages itputs in the midst of 31 Figure 6.3 Projected per capita health expenditure in 2015, low disaster: Rutshuru, the Democratic Republic of the Congo expenditure, low-growth health economies (weighted averages Figure 6. 4 The progressive extension of coverage by community- 107 owned, community-operated health centres in Mali, 1998-2007v Contents Figure 1. The PHC reforms necessary to refocus health systems towards health for all xvi Figure 1.1 Selected best performing countries in reducing under- fi ve mortality by at least 80%, by regions, 1975–2006 2 Figure 1.2 Factors explaining mortality reduction in Portugal, 1960–2008 3 Figure 1.3 Variable progress in reducing under-fi ve mortality, 1975 and 2006, in selected countries with similar rates in 1975 3 Figure 1.4 GDP per capita and life expectancy at birth in 169 countries, 1975 and 2005 4 Figure 1.5 Trends in GDP per capita and life expectancy at birth in 133 countries grouped by the 1975 GDP, 1975−2005 5 Figure 1.6 Countries grouped according to their total health expenditure in 2005 (international $) 6 Figure 1.7 Africa’s children are at more risk of dying from traffi c accidents than European children: child road-traffi c deaths per 100 000 population 7 Figure 1.8 The shift towards noncommunicable diseases and accidents as causes of death 8 Figure 1.9 Within-country inequalities in health and health care 10 Figure 1.10 How health systems are diverted from PHC core values 11 Figure 1.11 Percentage of the population citing health as their main concern before other issues, such as fi nancial problems, housing or crime 15 Figure 1.12 The professionalization of birthing care: percentage of births assisted by professional and other carers in selected areas, 2000 and 2005 with projections to 2015 17 Figure 1.13 The social values that drive PHC and the corresponding sets of reforms 18 Figure 2.1 Catastrophic expenditure related to out-of-pocket payment at the point of service 24 Figure 2.2 Three ways of moving towards universal coverage 26 Figure 2.3 Impact of abolishing user fees on outpatient attendance in Kisoro district, Uganda: outpatient attendance 1998–2002 27 Figure 2.4 Different patterns of exclusion: massive deprivation in some countries, marginalization of the poor in others. Births attended by medically trained personnel (percentage), by income group 28 Figure 2.5 Under-fi ve mortality in rural and urban areas, the Islamic Republic of Iran, 1980–2000 29 Figure 2.6 Improving health-care outputs in the midst of disaster: Rutshuru, the Democratic Republic of the Congo, 1985–2004 31 Figure 3.1 The effect on uptake of contraception of the reorganization of work schedules of rural health centres in Niger 42 Figure 3.2 Lost opportunities for prevention of mother-to-child transmission of HIV (MTCT) in Côte d’Ivoire: only a tiny fraction of the expected transmissions are actually prevented 45 Figure 3.3 More comprehensive health centres have better vaccination coverage 49 Figure 3.4 Inappropriate investigations prescribed for simulated patients presenting with a minor stomach complaint in Thailand 53 Figure 3.5 Primary care as a hub of coordination: networking within the community served and with outside partners 55 Figure 4.1 Deaths attributable to unsafe abortion per 100 000 live births, by legal grounds for abortions 65 Figure 4.2 Annual pharmaceutical spending and number of prescriptions dispensed in New Zealand since the Pharmaceutical Management Agency was convened in 1993 66 Figure 4.3 Percentage of births and deaths recorded in countries with complete civil registration systems, by WHO region, 1975–2004 74 Figure 4.4 Essential public-health functions that 30 national public-health institutions view as being part of their portfolio 75 Figure 5.1 Percentage of GDP used for health, 2005 82 Figure 5.2 Health expenditure in China: withdrawal of the State in the 1980s and 1990s and recent re-engagement 84 Figure 5.3 Transforming information systems into instruments for PHC reform 87 Figure 5.4 Mutual reinforcement between innovation in the fi eld and policy development in the health reform process 89 Figure 5.5 A growing market: technical cooperation as part of Offi cial Development Aid for Health. Yearly aid fl ows in 2005, defl ator adjusted 91 Figure 5.6 Re-emerging national leadership in health: the shift in donor funding towards integrated health systems support, and its impact on the Democratic Republic of the Congo’s 2004 PHC strategy 94 Figure 6.1 Contribution of general government, private pre-paid and private out-of-pocket expenditure to the yearly growth in total health expenditure per capita, percentage, weighted averages 101 Figure 6.2 Projected per capita health expenditure in 2015, rapid-growth health economies (weighted averages) 103 Figure 6.3 Projected per capita health expenditure in 2015, low expenditure, low-growth health economies (weighted averages) 105 Figure 6.4 The progressive extension of coverage by community￾owned, community–operated health centres in Mali, 1998–2007 107 List of Figures