Rating oil-rich and non-oil-rich countries of the Eastern Mediterranean Regional Office based on selected health indicators using a Combination Approach AHP-TOPSIS

Introduction: to assess development level of a country, various indicators including per capita income, human development, sustainable income, health and so on are used. Among the various development indicators, health indicator is considered as one of the most important indicators in each country, and success of national development plans depends on achieving to goals of this sector. Measurable indicators play effective role in identifying the problems, determining the procedure, and recommending the practical strategies. This objective of the current study is ranking oil-rich and non oil-rich countries in the Eastern Mediterranean region (EMR) of the World Health Organization based on publicly selected health indicators using combined approach of AHP-TOPSIS. Materials and methods: this descriptive study is applied that its population included Eastern Mediterranean region countries. In order to collect information on health indicators, we reviewed firstly all articles and studies conducted on the subject of the research through searching in Internet and investigating these theses and scientific texts published in this area. To prioritize the selected indicators, paired comparison questionnaire was developed and it was completed by 25 experts and specialists. The mentioned indicator was weighted based on AHP technique and using Expert Choice11 software. Then, studied countries were prioritized according to prioritized indicators by using TOPSIS software. Results: the results of prioritization of indicators using the hierarchical analysis technique showed that the indicator of total percentage of health costs of gross domestic product (GDP) from the input indicators category, the indicator of immunization coverage percentage of children who are under one year from process indicators category, and indicator of infants mortality rate (IMR) from outcome indicators category had the highest priority and importance from the experts’ perspective. Results of ranking of countries based on health indicators also showed that counties of Lebanon, Jordan, Bahrain, Qatar, and United Arab Emirates are at the appropriate status, while countries of Somalia, Afghanistan and Pakistan are at the inappropriate status. Conclusion: some of the main causes of inappropriate status of health indicators in mentioned countries include cultural poverty, lack of people's awareness of health issues, inappropriate social context, inadequate health infrastructure, poor resources and unequal distribution of resources, and conflicts among the countries (particularly oil-rich countries). In contrast, health sector's strong infrastructure, promotion of health educations in the society, education and awareness of the population, high economic power of people are considered as the main causes of appropriate status of health indicators in some countries. The necessity of prioritizing the countries to make decision in order to improve the health status should be considered more than ever. Existing facilities and potentials based on priority of countries should be directed toward countries that have inappropriate status in health indicators and higher attention should be paid to these countries compared to other countries. The most important strategies that countries can adopt to improve indicators status in the health area include enhancing the awareness on issues related to health, removing financial barriers in accessing to health, paying attention to intersectoral cooperation, and promoting other sectors for participation. Keywords: health indicator, the Eastern Mediterranean Region (EMR), AHP, TOPSIS.