The Association between Development and Health Economics Indices of World Countries and Health Ministers' Fields of Study

Health ministers need to have strategic thinking, political and ‎organizational skills, work experience in the health system, a comprehensive ‎vision of health, and no conflicts of interest. One way to evaluate these characteristics is to ‎determine the ministers’ fields of study and expertise. This study was conducted to ‎answer whether there is any association between world countries’ indices of development and health economics and health ministers' fields of study in 2021.

In this descriptive-analytical study, the data of development and ‎health economics indices of 185 countries and their health ministers’ fields of study and sex were extracted in August 2021. The indices included per capita income, sociodemographic index (SDI), ‎healthcare access and quality (HAQ) index, universal health coverage (UHC) effective coverage index, life ‎expectancy at birth, the share of current health expenditure from the gross domestic product, the share ‎of government expenditure from ‎current health expenditure, and the share of out-of-pocket expenditure from current health ‎expenditure. The health ministers’ fields of study were categorized into six groups including clinical fields, non-clinical health-related fields, law and politics, business and economics, management, and other fields.

The information about the health ministers of 185 countries was found, 76.6% ‎of whom were male and around 45% had studied in clinical fields. In high-income and high-SDI countries, the percentage of health ministers studied politics or law, and also those studied business or economics was significantly higher than that in other ‎countries. Conversely, in low- and middle- income and SDI countries, the percentage of ministers studied in clinical and health-related fields was higher than that in other countries. This pattern was similarly observed in other indices.

This study showed that in countries with higher levels of development and health economics indices, more health ministers had studied politics, law, business, and economics than in other countries. Conversely, in countries with lower levels of the indices, more health ministers had studied in clinical and health-related fields than in other countries. These results do not implicate that non-physician health ministers have improved life expectancy and welfare. Because the main determinants of life expectancy and welfare are the development of knowledge, technology, and the implementation of them. In developing countries, because of the insufficiency of these determinants, governments assume that physicians are more efficient health ministers. Nevertheless, specialist physicians are trained to provide care for diseases, and improving their abilities to manage the health system and to maintain and promote healthy communities is not included in their curriculum.