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The black markets, which themselves are caused by malfunctioning health systems, and low income of health workers, further undermine those systems.

Health ministries fail to enforce regulations that they themselves have created or are supposed to implement in the public interest.

Government’s money is often spent on high cost hospital services that disproportionately serve the more affluent urban sector. Unfortunately, expensive diagnostic and treatment services consume funds that could instead provide essential and cost-effective public health and clinical services

Too many hospital beds have been built and too much medical equipment has been purchased, increasing pressures on medical inflation and leaving beds and equipment underutilized.

The rising costs of hospital-based medical care leave little for essential clinical and public health services for the public at large

No concept of health insurance from the government. Private insurance that is available to only a small and affluent minority.

The impact of failures in health systems is most severe on the poor, who are driven deeper into poverty by lack of financial protection against ill- health

Without a health insurance safety net, many families have to pay more than 100 percent of their income for health care when hit with sudden emergencies. In other words, illness forces them into debt.

The poor are treated with less respect, given less choice of service providers and offered lower- quality amenities.

The poor pay a higher percentage of their income on health care than the rich.

Inequality and denial of an individual's basic rights to health