Transformational trends confounding the South Asian health systems

Already overwhelmed by the burden of communicable diseases, the health systems in South Asia face six global and regional transformational trends, which pose opportunities, challenges and threats. These six trends discussed in the paper are: (i) economic growth and globalization: (ii) technological changes; (iii) labor market changes; (iv) private sector growth; (v) demographic changes; and (vi) epidemiological changes. These trends have created dual challenges for the health systems in South Asia: (i) to achieve the Millennium Development Goals (MDGs) relating to child and maternal health, and communicable diseases and (ii) to deal with the emerging challenges posed by the six transformational trends. The paper suggests and proposes the use of the transformational trends framework to investigate the various opportunities and challenges, and to design effective policy responses. The capacities and resources of the governments in the region are already stretched by legacy challenges posed by communicable diseases. Hence, effective responses to new challenges will need flexible and innovative approaches including partnership with private sector, civil society, and regional cooperation. The opportunities from the trends are more likely to benefit the richer sections of the society. Therefore, pro-poor measures are necessary to ensure inclusive development. (C) 2008 Elsevier Ireland Ltd. All rights reserved.