Canadian disparities in access to health care by ProQuest


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                                                   Young children remain primary victims of malaria
Canadian disparities in

                                                                hile worldwide access to
access to health care                                           malaria control interventions
                                                                improved through 2006, there

         he health care systems of British         were still a staggering 247 million people
         Columbia and Nova Scotia rate             estimated to have become infected with
         highest in a comparison of med-           the parasite, which continues to kill
ical outcomes, while Newfoundland                  about 900 000 annually, primarily chil-
trailed the provincial pack, according to          dren under the age of 5, according to a
a study by Winnipeg-based Frontier                 new World Health Organization (WHO)
Centre for Public Policy and Europe’s              report (
Health Consumer Powerhouse.                            The disease remained endemic in 109

                                                                                                      Reuters / Corinne Dufka
    But Ontario moves ahead of the pack            countries, including 45 in Africa, on
(box 1) and is the “clear winner” in an            which just 3% of children in need have
overall Canada Health Consumer Index               access to artemisinin-based combination
that rates provincial performance across           therapy, according the WHO’s World
5 sub-disciplines — medical outcomes,              malaria report 2008.
primary care, wait times, patient rights               Some 80% of the malaria cases oc-
and “generosity,” i.e., range of services          curred in 14 African countries and over         Mothers and their malaria-
                                                                                                   infected children await treat-
provided — using 26 indicators, such as            half of those were in Nigeria, the Democ-
                                                                                                   ment at a Kisii district hospital
access to a family doctor, heart infarct           ratic Republic of Congo, Ethiopia, United       400 km west of Nairobi, Kenya.
mortality rates, cancer 5-year survival            Republic of Tanzania and Kenya. Other
rates and childhood vaccinations.                  world hot spots included India, Sudan,
    The four lowest ranked systems                 Myanmar, Bangladesh, Indonesia, Papua New Guinea and Pakistan.
were Newfoundland in tenth, followed                   Despite pockets of progress, Africa still lags in malaria control measures
by Saskatchewan, Quebec and Mani-                  such as mosquito nets, often falling well behind the 80% target sought by the
toba. But authors stress there were                World Health Assembly for 4 interventions by 2010: insecticide-treated nets
only fractional differences between the            for people at risk; appropriate antimalarial drugs for probable and confirmed
bottom 4, who contend “closely for                 malaria cases; indoor residual spraying for infected households; and intermit-
last place.”                                       tent preventive treatment in pregnancy. For example, just 26% of people in
    The 2 public policy think tanks also           37 countries are now 
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