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01.12.2014 | Research | Ausgabe 1/2014 Open Access

Conflict and Health 1/2014

Expansion of health facilities in Iraq a decade after the US-led invasion, 2003–2012

Zeitschrift:
Conflict and Health > Ausgabe 1/2014
Autoren:
Valeria Cetorelli, Nazar P Shabila
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1752-1505-8-16) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

VC and NPS conceptualised and designed the study. VC carried out the data analysis. VC and NPS prepared the manuscript. Both authors read and approved the final manuscript.

Abstract

Background

In the last few decades, Iraq’s health care capacity has been severely undermined by the effects of different wars, international sanctions, sectarian violence and political instability. In the aftermath of the 2003 US-led invasion, the Ministry of Health has set plans to expand health service delivery, by reorienting the public sector towards primary health care and attributing a larger role to the private sector for hospital care. Quantitative assessments of the post-2003 health policy outcomes have remained scant. This paper addresses this gap focusing on a key outcome indicator that is the expansion of health facilities.

Methods

The analysis is based on data on health facilities provided by the World Health Organisation and Iraq’s Ministry of Health. For each governorate, we calculated the change in the absolute number of facilities by type from early 2003 to the end of 2012. To account for population growth, we computed the change in the number of facilities per 100,000 population. We compared trends in the autonomous northern Kurdistan region, which has been relatively stable from 2003 onwards, and in the rest of Iraq (centre/south), where fragile institutions and persistent sectarian strife have posed major challenges to health system recovery.

Results

The countrywide number of primary health care centres per 100,000 population rose from 5.5 in 2003 to 7.4 in 2012. The extent of improvement varied significantly within the country, with an average increase of 4.3 primary health care centres per 100,000 population in the Kurdistan region versus an average increase of only 1.4 in central/southern Iraq. The average number of public hospitals per 100,000 population rose from 1.3 to 1.5 in Kurdistan, whereas it remained at 0.6 in centre/south. The average number of private hospitals per 100,000 population rose from 0.2 to 0.6 in Kurdistan, whereas it declined from 0.3 to 0.2 in centre/south.

Conclusions

The expansion of both public and private health facilities in the Kurdistan region appears encouraging, but still much should be done to reach the standards of neighbouring countries. The slow pace of improvement in the rest of Iraq is largely attributable to the dire security situation and should be a cause for major concern.
Zusatzmaterial
Additional file 1: Table S1: Estimated population of Iraq according to governorates in 2003 and 2012. (DOCX 14 KB)
13031_2014_135_MOESM1_ESM.docx
Literatur
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