Nation at bottom of WHO health delivery ranking

War-torn Sierra Leone comes last among the 191 nations the World Health Organisation has ranked as providing the best overall health care systems for their citizens, the UN said. Oil rich Nigeria is just four places above Sierra Leone, the WHO said in its World Health Report 2000 released on Wednesday. The reports “measures health systems based on a set of performance indicators ranging from responsiveness to costs borne by households”. While France’s health delivery system comes tops in the world, Colombia occupies the masthead in terms of fairness of household contributions to health. In another of its performance index rankings, the WHO places Japan uppermost in the level and distribution of good health. The reports says while private health expenses in industrial countries average around 25 percent because of universal health care (except the United States where it is 56 percent), in India families normally pay 80 percent of their health care cost from their own pocket. The lack of health insurance, it says, means the world’s poor only get poorer because they lack the money to protect themselves against illness. Therefore, WHO recommends that countries cover health care by extending systems of pre-payment such as insurance, taxes or social security.