8 Countries with the Worst Healthcare Systems 2024

The quality and accessibility of healthcare can vary dramatically around the world. Whilst many countries have made significant advancements in their medical provision, other regions continue to struggle with inadequate systems that don’t meet the needs of their population. Understanding these disparities is crucial for encouraging a global dialogue on health equality and the urgent need for reform.

In this blog, we explore the countries that are thought to be among the worst healthcare systems in the world, using data from CEOWorld, which ranked 110 countries. Scores were based on various factors, including Medical Infrastructure and Professionals, Medicine Availability and Cost, and Government Readiness, contributing to an overall Health Care Index.

El Salvador has the lowest Health Index Score of 18.6, ranking this country as having the worst healthcare. El Salvador has the second-lowest score overall for Government Readiness and the third-lowest score for Medicine Availability and Cost.

It has one of the highest death rates in Central America, at 59 per 1,000, reflecting the poor healthcare provision. Among potentially premature deaths, the rate for preventable causes was 200 per 100,000 people, 46% higher than the regional average.

There are many factors that contribute to El Salvador’s poor-quality healthcare. This includes underfunding, which results in a lack of essential medical supplies and insufficient infrastructure, as well as shortages of medical professionals. The country experiences high levels of poverty and there is significant inequality across the region, particularly between rural and urban areas, which exacerbates health issues.

Honduras has the second worst healthcare according to this ranking, with a Health Index Score of 19.6. It has the fourth-lowest score of Medicine Availability and Cost, and the third-lowest score for Government Readiness.

Honduras faces similar challenges to other developing countries, including underfunding, inequality, workforce shortages, and social and economic factors that put a strain on the system. It’s reported that Honduras has around 0.37 physicians per 1,000 people, far below what is needed – the average for OECD countries is 3.0. Preventable deaths are also high in Honduras. Most recent data shows that the rate of preventable deaths was 381.2 per 100,000 people, 68% higher than the average rate for the Region of Americas.

Nepal has the third worst healthcare according to this ranking, with an overall Health Index Score of 21.4. it has the fourth-lowest score for Government Readiness and the fifth-lowest score for Medicine Availability.

Nepal faces similar issues around underfunding and insufficient infrastructure as many of the other countries on this list. Healthcare can be difficult to access, particularly in the remote, difficult-to-access rural villages located in mountainous terrain. Reports show that less than 17% of healthcare facilities provide basic diagnostic testing and only 5% can conduct caesarean sections. Only 41% of all facilities had the equipment required for providing basic quality services.

Paraguay has the fourth worst healthcare system, with an overall Health Index Score of 21.9. It had the fifth-lowest score of Government Readiness and was in the bottom 10 for both other categories.

Healthcare in Paraguay is severely underfunded. Only around 4% of GDP is spent on healthcare, which is one of the lowest in Latin America. In addition, healthcare in Paraguay is highly fragmented, split between public, private and social security providers. This has led to inefficiencies and inequalities, with people facing many bureaucratic barriers to access the care they need.

Bolivia has the fifth worst healthcare system, with an overall Healthcare Index Score of 22.3. Whilst steps have been taken since 2019 to improve and reform the healthcare provision in the country, it still faces many challenges.

Bolivia aims to provide universal healthcare, through the Unified Health System. However, this is severely underfunded, receiving only $200 million instead of the $1 billion that is required. As such, there is a major lack of supplies and facilities, meaning many people are unable to access the healthcare they need.

Sri Lanka has the sixth worst healthcare system, with an overall Health Index Score of 22.5. The healthcare in Sri Lanka has been praised for its universal coverage, but has been facing challenges in recent years, partly due to the economic crisis the country is experiencing.

The economic situation has resulted in a severe shortage of essential medicines and supplies, with hospitals in rural areas being impacted the most. It’s estimated that at least 1,000 medical specialists have left the country, and stocks of 150 essential medications have run out at certain points throughout the last year. This has seen delays in critical treatments due to a lack of resources.

Pakistan has the seventh worst healthcare system, with an overall Health Index Score of 22.7. Underfunding is a key part of why Pakistan’s healthcare is of low quality, with the country only spending around 1.1% of its GDP to health provision.

The leading causes of death in Pakistan include heart disease, stroke, and diabetes, which are exacerbated by poor diet, lack of awareness, and inadequate access to preventative healthcare. Rural areas suffer severely from a lack of accessibility as well as a shortage of healthcare professionals.

Libya has the eighth worst healthcare system, with an overall Health Index Score of 25.2. Years of political instability and conflict have resulted in a fragmented system that is unable to provide the services needed.

The WHO has reported that up to 90% of primary health care centres were closed in some areas, and one-third of all health facilities in the south and east of Libya were not functioning. 73% of facilities in the south and 47% in the east were only partially functioning. It’s said that the situation is worse in more isolated areas. Around 80% of all healthcare facilities lack essential staff, contributing to the poor provision.

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