The pressures placed on national healthcare systems by the recent demographic and epidemiological transitions are amplified by the growing demands of an increasingly educated and affluent population for high-quality healthcare. Many traditional health practices persist alongside the use of new medical technologies and pharmaceutical products, presenting regulatory problems in terms of safety and quality.
Countries in Southeast Asia and their health system reforms can thus be categorized according to the stages of development of their healthcare systems. A typology of common issues, challenges and priorities are generated for the diverse mix of health systems at different stages of socioeconomic development.
The 1990s began with the opening up of socialist states and rapid growth among market economies in the region. Before the East Asian financial crisis in 1997–98 and the recent global economic recession, an expanding middle class in the urban populations of the larger cities pushed their demand for high-quality care into a booming private sector. As a result, market forces have turned many aspects of healthcare into a new industry in countries such as Singapore, Malaysia and Thailand, contributing to labour-force distortions for the production and distribution of health workers both within and across countries.