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The rural bite in population pyramids: what are the implications for responsiveness of health systems in middle income countries?

Jahan, Nowrozy Kamar; Allotey, Pascale; Arunachalam, Dharma; Yasin, Shajahan; Soyiri, Ireneous N.; Davey, Tamzyn M.; Reidpath, Daniel D.


Nowrozy Kamar Jahan

Pascale Allotey

Dharma Arunachalam

Shajahan Yasin

Tamzyn M. Davey

Daniel D. Reidpath



Health services can only be responsive if they are designed to service the needs of the population at hand. In many low and middle income countries, the rate of urbanisation can leave the profile of the rural population quite different from the urban population. As a consequence, the kinds of services required for an urban population may be quite different from that required for a rural population. This is examined using data from the South East Asia Community Observatory in rural Malaysia and contrasting it with the national Malaysia population profile.

Census data were collected from 10,373 household and the sex and age of household members was recorded. Approximate Malaysian national age and sex profiles were downloaded from the US Census Bureau. The population pyramids, and the dependency and support ratios for the whole population and the SEACO sub-district population are compared.

Based on the population profiles and the dependency ratios, the rural sub-district shows need for health services in the under 14 age group similar to that required nationally. In the older age group, however, the rural sub-district shows twice the need for services as the national data indicate.

The health services needs of an older population will tend towards chronic conditions, rather than the typically acute conditions of childhood. The relatively greater number of older people in the rural population suggest a very different health services mix need. Community based population monitoring provides critical information to inform health systems.

Journal Article Type Article
Publication Date Jun 20, 2014
Journal BMC Public Health
Print ISSN 1471-2458
Electronic ISSN 1471-2458
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 14
Issue Suppl 2
Pages S8
APA6 Citation Jahan, N. K., Allotey, P., Arunachalam, D., Yasin, S., Soyiri, I. N., Davey, T. M., & Reidpath, D. D. (2014). The rural bite in population pyramids: what are the implications for responsiveness of health systems in middle income countries?. BMC public health, 14(Suppl 2), S8.
Keywords Middle income country; Dependency ratio; High fertility rate; Urban migration; Demographic surveillance system
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Copyright Statement
© Jahan et al; licensee BioMed Central Ltd. 2014

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