Page 29 - GHES-2-3

Global Health Economics and
Sustainability

REVIEW ARTICLE
Sustainability of specialized healthcare in upper-

middle-income economies: Innovations despite
constraints

1,2
Amza Ali *
1 Department of Medicine, Kingston Public Hospital, Kingston, Jamaica
2 Department of Medicine, University Hospital of the West Indies, Kingston, Jamaica

Abstract

Countries such as Jamaica have had to be largely self-reliant in funding their health-
care systems. The success of an early and sustained focus on primary healthcare,
coupled with a change in the disease profile from infectious concerns to chronic
non-communicable diseases associated with aging, has resulted in a marked rise in
healthcare costs. Rapid technological advances in the diagnosis and treatment of
This article will be published as
part of a two-article series. The first many specialized conditions have further increased the cost of care. Funding these
article can be found at health-care costs sustainably is a challenge for Jamaica and other similarly developed
https://doi.org/10.36922/ghes.2709 economies due to competing demands for scarce funds. In addition to government
Academic editor: health-care allocations, sources of sustainable funding from local public-private
Mihajlo Jakovljevic M.D. Ph.D. MAE partnerships, through mechanisms such as philanthropy, may help address, at least
*Corresponding author: in part, this chronic problem. This review examines strategies to create a framework
Amza Ali for such funding, as well as proposes specific practical steps for their achievement.
(amzaalimd@gmail.com) The author’s motivation to participate in the process of change stems from the
Citation: Ali, A. (2024). stubbornly persistent inequalities of healthcare that people and health-care workers
Sustainability of specialized in Jamaica – and similar lower- and middle-income countries – routinely cope with.
healthcare in upper-middle-income
economies: Innovations despite These inequalities must be addressed to truly achieve greater health egalitarianism,
constraints. Global Health Econ social stability, and ultimately, the developed country status they aspire to. The need
Sustain, 2(3):2717. to think innovatively to achieve this goal is self-evident, given the current inability of
https://doi.org/10.36922/ghes.2717
governments to achieve this goal.
Received: January 11, 2024
Accepted: April 3, 2024 Keywords: Healthcare; Small island economies; Philanthropy; Social capital; Inequality;
Published Online: August 19, 2024 Social entrepreneurialism; Innovation; Policy
Copyright: © 2024 Author(s).
This is an Open-Access article
distributed under the terms of the
Creative Commons Attribution 1. Introduction
License, permitting distribution,
and reproduction in any medium, In this review, the second article in a two-article series, the issue of how upper-middle-
provided the original work is
properly cited. income countries such as Jamaica, a small island state of three million people, can
Publisher’s Note: AccScience potentially afford to fund increasingly expensive specialized healthcare at a time of rapid
Publishing remains neutral with technological change is explored. The first article of this series focused on understanding
regard to jurisdictional claims in
published maps and institutional how Jamaica’s history of colonialism and slavery has impacted the provision of health
affiliations. care in the past and its possible impact on current healthcare in this society, which

Volume 2 Issue 3 (2024) 1 https://doi.org/10.36922/ghes.2717