Classifications of health care systems: Do existing typologies reflect the particularities of the Global South?

Abstract

Typologies are a useful and widely employed instrument in comparative research, including the study of health care systems. This study analyses the effectiveness of extant classifications in representing health care systems globally, examining whether existing literature adequately helps to understand health care systems of the Global South. To this end, the study highlights key elements of health care systems in the Global South, in particular limited resources, segmentation and the involvement of non-domestic/international actors. In a further step, we conduct a systematic literature review of typological scholarship on health care systems, in which 42 classifications are identified and analysed regarding regional coverage, methods, as well as the criteria and categories they include. The results point to major limitations: First, there is a general lack of representation and systematic classification of health care systems of the Global South. Second, there is a bias as criteria for classification are developed inductively based upon health care systems of the Global North. Consequently, existing typologies mostly fail to take into account the particularities of the countries beyond high-income economies. The study concludes by putting forth recommendations for developing a more comprehensive, globally applicable typological framework.