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Princess Juliana Airport (SXM), Airport Road, Simpson Bay, Sint Maarten

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BACKGROUND

The Japanese healthcare system provides universal health coverage through both a fee-for-service system under governmental control and a free-access system.1 The free-access system allows private facilities to establish hospitals or clinics if they meet the requirements of the Medical Care Act, a Japanese law covering the healthcare system.1 Patients can seek treatment at whatever public or private medical facility they prefer, with no difference in cost.1 There is no strict gatekeeper system by primary care physicians1 so patients are not always required to have a regular primary care doctor.1

Under this system, Japan has maintained top-class global health indicators, including life expectancy at birth and infant mortality.1 However, the debt-to-gross domestic product (GDP) ratio of the government currently exceeds 200%, and is expected to continue rising.2 Japan's debt-to-GDP ratio is the highest among the Organisation for Economic Co-operation and Development (OECD) countries,3 and a large proportion of that debt comes from social security expenditures.2

As a result, the costs associated with social security need to be reduced.2 Healthcare expenditures increased by 3.1% in 2011, about one-third of which was attributed to the ageing population and about two-thirds to the costs of advanced medical care.2 As expenditures per capita on national health care have been increasing annually, this raises the question of whether Japanese people are receiving appropriate care.

The World Health Organization and the Ministry of Health, Labour and Welfare (MHLW) in Japan point out that the lack of gatekeepers to advanced medical facilities is associated with an increased number of inpatients, a disproportionate burden on healthcare workers, and a reduction in efficiency and quality of care.1

They also add that the lack of primary care doctors leads to an insufficient supply in providing appropriate medical care.1 Considering these circumstances, the MHLW has indicated the importance of primary care physicians for dealing with the rapidly ageing population and reduce healthcare expenditures.4

THE NEW CATEGORY OF SPECIALIST

In Japan, physicians trained in an internal medicine-based residency programme have continued to play a principal role in the primary care setting.5 The Japan Primary Care Association (established in 2010) provides continuous professional development and has become the recognised certifying body for primary care physicians.6 It had 11 401 members as of 31 May 2014, including 10 227 physicians, 65 dentists, 627 pharmacists, 336 other health professionals, and 146 medical students.6 Moreover, as of 30 September 2015, there were 500 certified family physicians, 3386 certified instructors, 310 residency programmes, and 126 board-certified primary care pharmacists.6

From 2017, the system of an independent third-party organisation will be established and 'board-certified GPs' will become the new category of specialist.4 The GP board will include the following six competencies: Person-centered care - Comprehensive care, Integrated care; Interprofessional work; Community orientation; Professionalism; and System-based practice.7

LOOKING AHEAD

A final decision has yet to be reached on the formal English-language term for board-certified GPs. The Japanese board-certified GP consists of a combination of 'hospitalist' - a doctor primarily engaged in inpatient care at hospitals - and 'family physician' - a doctor specialising in outpatient care as a regular primary care doctor at a clinic.7 Thus, the concept of a board-certified GP in Japan is not necessarily synonymous with that of a GP in the UK. For example, hospitalists need to see many patients without advanced or serious disease due to the free-access system mentioned previously (that is, hospitalists are also doing the job of a family physician).

The MHLW promotes differentiation of function in outpatient care by increasing medical remuneration to those who play a role as a consistent primary care doctor to strengthen the primary care system. The MHLW also imposes the special charge for patients who visit hospitals containing over 500 beds or advanced treatment hospitals without a referral letter from a primary care physician.8

Whether the new system and board will lead to improvements in the Japanese healthcare system has become the subject of considerable discussion.

REFERENCES

Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners

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Current trends in Japanese health care: establishing a system for board-certificated GPs

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The Japanese healthcare system provides universal health coverage through both a fee-for-service system under governmental control and a free-access system.1 The free-access system allows private facilities to establish hospitals or clinics if they meet the requirements of the Medical Care Act, a Japanese law covering the healthcare system.1 Patients can

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International Trade Administration | Trade.gov

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Overview

The state is the primary healthcare provider in Morocco, with 85 percent of supply provided by public hospitals and 15 percent by private centers. However, spending remains unbalanced. In 2022, the public system accounted for only 40 percent of health care spending, while the private sector accounted for 60 percent. There are six university hospitals, in Rabat, Casablanca, Fez, Oujda, Marrakech and Tangier. The country also counts 159 public hospitals and 14,300+ physicians in the public sector and a separate military healthcare system with six hospitals and a medical center. The Moroccan government has several multi-year plans to strengthen the current healthcare system through the development of new hospitals, increasing the number of doctors and nurses in training, and opening the market to private investment. To accelerate the sector's reformation, the government allocated $2.8 billion to the healthcare sector in 2023 marking an increase compared to 2022.

The private sector healthcare market includes more than 400 private clinics, heavily concentrated in the Casablanca-Settat and Rabat- Salé-Kénitra regions, with 14,500+ physicians and a capacity of 14,500+ beds.

Since the start of the COVID-19 pandemic, Morocco has received over $4 billion in aid from domestic and international sources to bolster its healthcare infrastructure and curb the spread of COVID-19. Eighty-one hospitals, including military field hospitals, and 32 consultation centers have been upgraded and equipped across different cities to care for COVID-19 patients.

COVID-19's long-term impact on the healthcare system in Morocco is difficult to predict, but the budget for recovery efforts and investment in human resources are expected to increase. Upgrading public hospitals is a national priority, as well as public-private partnerships to support healthcare infrastructure and scientific research. Morocco is vigorously seeking to develop self-sufficiency/local manufacturing of drugs, vaccines, and PPE such as masks, gloves, gowns, overshoes, and head coverings.

The universal health coverage system is one of the main reforms introduced in the health sector. It aims to offer subsidized healthcare to all Moroccans regardless of their income. Still under development, the system is expected to be fully implemented by 2025.

The Ministry of Health is introducing a slew of new laws to reform the sector:

Law 07-22 on the creation of a High Authority of Health

Law 08-22 on the creation of territorial health groups

Law 09-22 on human resources in the health sector

Law 10-22 on the creation of the Moroccan Agency for Drugs and Health Products

Law 11-22 on the creation of the Moroccan Agency of Blood and Derivatives

Leading Sub-Sectors

In May 2018, the Ministry of Health introduced the National Healthcare Plan 2025 with a budget of about $2.5 billion in investments including $1.5 billion for the improvement of hospital capacity and $1 billion for the reinforcement of various national health and disease-control programs. Leading sub-sectors include:

COVID-19 Test Kits

Ventilators and respirators

ICU Equipment

Magnetic resonance imaging and ultra-sonic scanning equipment

X-Ray equipment

Cancer Treatment

Hospital infrastructure

Hospital management

Specialty hospitals (wellbeing, oncology, pediatric, nephrology,..)

Emergency aid (equipment and services)

Monitoring and electro-diagnostic equipment

Computerized tomography equipment

ICT (E-medicine, equipment, and related software).

Opportunities

Hospital Infrastructure

To bolster the country's healthcare system, Morocco plans to build eight new regional teaching hospitals, 29 urgent-care hospitals, and four university hospitals over the next decade. Within the Al Hoceima, Rabat, and Agadir regions the government plans to add 3,354 hospital beds with a total spend of $1.1 billion. In addition, the government plans to rehabilitate and remodel 21 regional (CHR) and provincial (CHP) hospital centers to add a further 3,254 beds with a total budget of $440 million.

Medical Equipment

The Moroccan medical device market is estimated at $236 million, with $191 million in imports in 2021. China, Germany, and the United States supply the majority of the equipment, with increasing competition from Italy, Turkey, and South Korea. The Moroccan government plans to develop emergency and mobile hospital units, for which the Ministry of Health will issue multiple tenders over the next five years. Notably, the government has prohibited the import or sale of second-hand or refurbished medical devices and equipment per a February 2017 law, to improve equipment quality.

Cancer Treatment

The Lalla Salma Foundation for the Prevention and Treatment of Cancer was founded in 2005. This non-governmental organization has improved the quality of cancer management and access to cancer care for Moroccan patients. Currently, Morocco has 24 cancer centers - 12 public and 12 private - that treat over 60,000 new cases annually. Within the Ministry of Health's plans, Cancer treatment equipment has been identified as a priority investment area.

Resources

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This is a best prospect industry sector for this country. Includes a market overview and trade data.

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Everyone living and working in Spain can register for free public healthcare. Although the country has (almost) universal medical coverage, many local and expat residents will supplement it with private health insurance ( seguro de salud privado). This provides them with better and faster access to treatment, plus extra coverage for additional care, such as dentistry or mental healthcare.

Continue reading to learn which health insurance works best for your situation:

The healthcare system and health insurance

The Spanish healthcare system is one of the best in the world. In 2022, Spain's National Health System ( Sistema Nacional de Salud - SNS) ranked sixth out of 95 countries on the Health Care Index. And in Europe, it comes in third, behind only Denmark and France.

The nonprofit think tank Foundation for Research on Equal Opportunity (FREOPP) gives Spain just a moderate score. Although the healthcare system is effective and offers almost universal coverage for all residents, it is lacking on some fronts. For example, there is not enough access to mental healthcare, and children are only fully covered up to the age of 15.

It is common for expats and Spanish residents to supplement their coverage with private health insurance. The added insurance offers easier and better access to medical care such as dentistry or mental healthcare.

Over 70% of the public healthcare system ( asistencia sanitaria pública) is financed by social security contributions paid by residents. This is reportedly around 11% of the GDP.

Who needs health insurance in Spain?

If you're living and working in Spain - either salaried or self-employed - you'll be covered by public healthcare through your social security payments. Because of that, other people can also get free medical care, including:

Minor children under the age of 15

Students under the age of 26

Recipients of certain state benefits

Retirees with a state pension

Spouses and partners of those registered for social security, including those who are separated or recently divorced

If you are staying in Spain for a short time or are not on the above list, you might need to take out private health insurance.

EU/EFTA nationals

Expats who contribute to state healthcare in another EU or EFTA country can access free healthcare in Spain with their European Health Insurance Card (EHIC).

It's important to note that some national health insurers will only cover the costs of your healthcare in another EU country for a limited period of time. If that is the case, you must register with the SNS and get a Spanish Health Card ( Tarjeta Sanitaria Individual - TSI), or take out private medical insurance.

If you are staying for less than two years or retiring in Spain while collecting a state pension elsewhere, you must fill out an S1 form. This entitles you to healthcare during your residence in the country. This includes students on an exchange program, trainees, and researchers.

Non-EU/EFTA nationals

Expats from outside the EU/EFTA region can access Spanish healthcare using the travel insurance that they've taken out as part of their visa application.

However, if you're planning to relocate to Spain for a longer period of time, you must register with the SNS or take out private health insurance.

What happens if I am not covered by health insurance?

Those not covered by health insurance (e.g., undocumented migrants) can access the healthcare system but are likely to pay up to 100% of any costs of medical procedures. They must pay also at least 40% of the costs of any medication prescribed to them.

What is covered by Spanish health insurance?

Prescription medication

Partially

The SNS covers 40-60% of the cost, depending on your earnings. Retirees only pay 10% of their medication fees.

Sexual and reproductive health
Partially

If you have a prescription from a family doctor, your costs are partially covered. Treatment without a prescription is not covered.

Insurance for fertility treatments differs by region of Spain, so it's good to check with your doctor first.

Alternative medicines and complementary therapies

No

Treatment abroad

Maybe

The SNS only covers emergency medical costs in EU member states.

Prescription medication

The SNS covers 40-60% of the cost of prescription drugs, depending on your earnings. The higher your income, the less the government will cover. Pensioners and retirees only have to pay 10% of their medication fees.

While undocumented migrants don't pay for the public healthcare system, they can access basic medical care. If they're also prescribed medication, they are required to pay at least 40% of the costs.

Mental healthcare

Public medical insurance covers referrals to a mental healthcare professional by a primary care physician. That said, unfortunately, the public mental health sector is extremely underresourced. Spain has altogether six clinical psychologists for every 100,000 residents (2022). This is much lower than the EU average of 38 per 100,000 inhabitants.

It's important to note that mental healthcare is usually easier to access with private insurance. The waiting times are reduced, and you'll likely get more freedom of choice.

Dentistry and dental care

The SNS does not cover basic dentistry, so the individual must pay for the costs of treatment. Thankfully, dentist ( dentista) fees are relatively inexpensive and the general quality of care is of a high standard.

Private health insurance can halve the costs, with dental add-ons costing as low as €10-20 per month. If you need specialized dental care in a hospital (e.g., after an accident), public healthcare will cover it.

Sexual and reproductive health

While public healthcare includes some sexual health treatments, it does not cover everything. The basic rule of thumb is that if your treatment is prescribed, it'll be covered and if it's not prescribed, it's not.

For example, hormonal contraception ( anticonceptivos) like the pill ( píldora anticonceptiva) and IUDs ( DIU) require a prescription and are partially covered by public health insurance. Condoms and emergency Contraception like Plan B ( la píladora del dia despues) are available without a prescription; these are not covered by the healthcare system.

With a referral from a family doctor, you can get free testing for STDs/STIs (Infecciones de Transmisión Sexual- ITS) at a public health clinic. These are also available for sexual health information and advice.

Abortion is legal in Spain, and public healthcare covers the cost in 70% of cases. You can terminate a pregnancy up to 14 weeks, or up to 22 weeks if it poses a serious health risk for you or the fetus. Abortion beyond those 22 weeks is only possible when the fetus is incompatible with life or in the case of a serious and incurable disease. If you are 16 or 17, you don't need parental consent to terminate a pregnancy.

As said above, coverage of fertility treatments differs by region of Spain, so it's good to check with your family doctor about what specific types are available in your area.

Alternative/complementary therapies

Spanish healthcare does not pay for alternative therapies, such as holistic medicines, homeopathy, acupuncture, reflexology, and chiropractic treatment. Some private insurance companies do offer coverage, but you'll have to select this as an add-on and will likely pay a higher rate.

How to apply for public health insurance

You can access public healthcare with a European Health Insurance Card or a TSI. Both cards come free with medical insurance.

Before getting a TSI, you must register for a Spanish social security number. Your employer will likely have taken care of this for you. However, if you haven't received one, you can sort this out through your local Social Security Office ( Oficina del Instituto Nacional de Seguridad Social).

How to get public health insurance as an expat

You must first download a certificate that states you are entitled to medical care. You can do that by:

Visiting the Social Security e-Office

On the top left of the page, select the option Citizen > Healthcare > Healthcare. Application for recognition of entitlement (as an insured person)

Select your preferred identification method (this will open a new portal "Tu Seguridad Social")

Underneath the section 'Healthcare', you will find the option to download your certificate

After that, you can apply for a Spanish health card at your local primary healthcare center ( centre d'atenció primària - CAP). You will need to provide:

Your TSI will be sent to your home within two or three weeks of filing. This card proves that you have medical insurance in Spain. Be sure to keep it on you at all times, so you are able to present it whenever you use a public health service or purchase a prescription from a pharmacy.

It allows you to register with an individual doctor or health center within your local healthcare district. To see any other specialists, however, you must be referred by your family doctor.

Private health insurance in Spain

Should I get private health insurance?

Private health insurance is widely popular among expats and temporary residents who don't want - or can't - sign up for public healthcare. Around 25% of the Spanish population has some form of private medical coverage.

The advantages of private health insurance in Spain

One of the advantages of private medical insurance is that you have easier and faster access to healthcare. You can skip waiting lines and don't need a referral from a family doctor. In addition, some insurance companies cover additional procedures that are not covered by public healthcare. For example, the SNS does not cover home births.

Best of all, you can easily choose a doctor with a strong grasp of English if you're not fluent in Spanish. You can find a list of doctors at your local embassy or consulate or through the non-profit English Speaking Healthcare Association Spain.

How to choose the best health insurance provider

When deciding on an insurance company, you should choose one that offers the coverage you need and is accredited. As usual, it's important to thoroughly research your medical insurance options and seek as much advice as possible before committing to a specific plan. International expats should check if their package provides the same protection in Spain as it does back home.

When choosing a medical insurance provider, you should make sure they are accredited by the Official Colleges of Physicians ( Consejo General de Colegios Oficiales de Médicos - CGCOM) in Spain. This is the official body that regulates the Spanish medical profession.

When choosing between medical professionals, it might be worth comparing your options on a portal such as SaludOnNet.

How much is private health insurance in Spain?

Generally, private insurance costs on average between €50-200 a month, depending on the coverage plan. If you need additional specialized care or regular treatment, your premium can go up. Some insurance providers do not work with monthly fees, but allow you to only pay for the treatment you need.

You can compare private health insurance companies and get free medical insurance quotes here.

Some of the best medical insurance providers in Spain include:

Health insurance contributions and reimbursements

The healthcare system in Spain is funded by social security payments ( reportedly around 11% of the Spanish GDP). These contributions are automatically deducted from your wages. Employers also provide the system with an extra percentage for each of their workers.

How much you pay on average is based on minimum and maximum contribution rates set by the government each year. In general:

The 2022 payment rates were fixed at 4.7% of the annual salary. Your employer will contribute the equivalent of 23.6% of your earnings, for a total of 28.3%.

Freelancers and self-employed workers pay 18.75-26.5% per year, depending on their income.

Retirees have already contributed to the system during their working life, and are exempt from making payments.

Medical insurance for unemployed or low-earners

If you are unemployed or have a low income, you can benefit from the pay-in scheme Convenio Especial (special agreement). It is essentially a low-cost insurance scheme that provides coverage in exchange for a low monthly fee. You can choose to pay a minimum, average, or maximum contribution base.

The convenio especial is suspended during periods of normal employment where your contributions will be met through your salary.

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Whether you're using public or private medical care, learn how you can cover your bases with this article on health insurance in Spain.

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The IP address used for your Internet connection is part of a subnet that has been blocked from access to PubMed Central. Addresses across the entire subnet were used to download content in bulk, in violation of the terms of the PMC Copyright Notice.

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https://www.riksjatravel.nl/zuid-afrika/informatie/gezondheid/

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Zuid-Afrika en Mozambique zijn deels (sub)tropische landen en daarom loop je meer risico om ziek te worden dan thuis. Dit komt doordat er meer bacteriën zijn in een tropisch klimaat. Een tropisch klimaat vormt met zijn vochtige warmte een goede voedingsbodem voor ziekteverwekkers. Hoewel het risico op ziekten niet moet worden overdreven en zeker niet je reisplezier in de weg zou moeten staan, raden we aan om je goed voor te bereiden en ook ter plekke bewust om te gaan met gezondheidsrisico's.

Gezondheidsmaatregelen voor vertrek

Zorg dat je voor vertrek contact opneemt met een medische instantie die verstand van zaken heeft, zoals een ziekenhuis of in grote steden de GGD. Zelf hebben we goede ervaringen met Thuisvaccinatie.nl. Deskundige artsen komen thuis of op kantoor langs wanneer het jou uitkomt, dus ook 's avonds en in het weekend, om advies te geven en direct in te enten. De rekening wordt rechtstreeks naar je zorgverzekering gestuurd, wel zo handig. Vaak worden het consult en/of de vaccinaties zelf ook nog eens vergoed.

Een lastminutereis naar Zuid-Afrika en Mozambique hoeft voor een gezond persoon geen probleem te zijn; je zou desnoods op Schiphol nog naar Travel Clinic van KLM Health Services of Airport Medical Services kunnen gaan. Neem sowieso altijd je vaccinatieboekje mee. Natuurlijk heeft het de voorkeur je vaccinaties ruim van tevoren te regelen. Wat daarbij van belang is, is dat de instelling waartoe je je wendt (bijvoorbeeld GGD, huisarts of ziekenhuis), aangesloten is bij het Landelijk Coördinatiecentrum Reizigersadvisering (LCR). Deze organisatie zorgt dat de aangesloten instellingen up-to-date zijn op het gebied van vaccinaties en ziektepreventie voor de tropen.

Drie andere instanties die dicht bij het vuur zitten (zij bepalen het beleid van het LCR): Het LUMC in Leiden, tel. 071-5263636, (informatie en afspraken voor de vaccinatiepoli 's morgens van 09.30-11.30 uur), Travel Clinic te Rotterdam, (bandje met info: 0900-5034090, eerst 1 kiezen), in Amsterdam het AMC (bandje met info allerlei landen tel. 0900-9584). Verder kun je bij Inside Travel News (030-6912752) een gratis informatiepakket aanvragen. De prijzen voor vaccinaties kunnen uiteenlopen; het kan de moeite waard zijn een beetje te shoppen.

Hieronder volgt wat informatie over voor de hand liggende ziektes gericht op de reiziger die gezond is, niet zwanger is en niet langer dan een maand in Zuid-Afrika zal blijven. Zorg ervoor zelf up-to-date informatie te krijgen voor je eigen situatie.

Malaria

In de warme zomermaanden (onze winter) komt in en rondom het Krugerpark, Swaziland en St. Lucia malaria voor. In Mozambique komt het hele jaar malaria voor. Voor een officieel advies over het gebruik van profylaxen (malariapillen) raden we je aan contact op te nemen met je huisarts, de Travel Clinic of bijvoorbeeld de GGD. Zij kunnen je precies vertellen welke maatregelen je moet nemen. Ook voor bepaalde gebieden in Namibië en Botswana geldt dat er malaria voorkomt. Informeer je dus goed voordat je het vliegtuig instapt. Naast eventuele malariapillen, adviseren we je ook de volgende risicobeperkende maatregelen te treffen: 's avonds de armen, benen en voeten bedekken, een muggenmiddel opsmeren waar DEET in zit en een klamboe gebruiken. De klamboe kun je eventueel impregneren met een muskietendodend middel. Zorg dat je ook iets bij je hebt waarmee je de klamboe kunt ophangen. Mocht je ondanks de nodige voorzorgsmaatregelen toch ineens koorts krijgen die langer dan twee dagen aanhoudt, dan moet een arts worden geraadpleegd om malaria uit te sluiten. Dit geldt tot twee maanden na terugkeer in Nederland.

Vaccinaties

In de landen van Zuidelijk Afrika worden vaccinaties tegen dtp(difterie, tetanus en polio) en hepatitis A aangeraden. Een dtp-inenting hebben de meeste mensen in hun jeugd al gehad. Na een herhaalprik kun je er dan weer een poosje tegen. De reguliere hepatitis-A-injectie heeft een beperkte werkingsduur, dus het is zaak deze kort voor vertrek te plannen. Als je frequent of voor langere tijd naar landen gaat waar hepatitis-A voorkomt, dan is het te overwegen om injecties voor langere termijn te nemen, zoals Havrix. Houd er wel rekening mee dat dit dure vaccins zijn en dat je na zes maanden een herhaalprik nodig hebt. Onlangs is de gelekoortsrichtlijn aangescherpt. Alle reizigers die per vliegtuig naar Zuid-Afrika reizen en een tussenstop maken in een land waar gele koorts voorkomt, moeten een vaccinatiebewijs tegen gele koorts tonen bij aankomst in Zuid-Afrika. Ook als men tijdens de tussenstop (transit) het vliegveld of vliegtuig niet verlaat, is een gelekoortsvaccinatiebewijs verplicht. Zonder dit gelekoortsvaccinatiebewijs kan de toegang tot het land geweigerd worden. Een gelekoortsvaccinatie moet tien dagen voor vertrek worden toegediend. In Mozambique en Zimbabwe wordt soms om een choleraverklaring gevraagd. Informeer hiernaar bij je medisch adviseur.

Verdere voorbereiding

Handig om bij je te hebben is een EHBO-setje voor de tropen. Je kunt dit zelf samenstellen of er een kopen bij onder andere vaccinerende instanties en winkels als de Joho Company. Als je medicijnen gebruikt, raden we je aan de bijsluiter en een medisch certificaat van je huisarts mee te nemen. Dit is een brief waarin de arts het medicijn benoemt en de reden van gebruik uitlegt in het Engels. Het kan voorkomen dat de douane om dit certificaat vraagt, zo kun je aantonen dat het om een noodzakelijk medicijn gaat. Neem ook altijd een extra voorraadje mee, zodat je geen risico loopt dat je ter plekke zonder komt te zitten. Heb je een bril of draag je lenzen, neem dan de opticienbeschrijving mee of een extra bril of extra paar lenzen. Voor snorkelaars/duikers worden duikbrillen op sterkte verkocht (en verhuurd) bij duikwinkels/duikscholen.

Gezondheid ter plekke

Naast het in acht nemen van de op jouw situatie afgestemde vaccinaties en ervoor te zorgen dat je gezond op reis gaat, is het natuurlijk belangrijk om te voorkomen dat je in Zuid-Afrika ziek wordt. Wees ter plaatse zeer alert: als je twijfelt over wat je hebt, raadpleeg een arts.

Jetlag

Jetlag is een ontregeling van je biologisch klok die veroorzaakt wordt door het vliegen over meer dan drie tijdszones. De eerste dagen na de vlucht moet je lichaam wennen aan het nieuwe bioritme waardoor je moe en suf kunt zijn. Om je jetlag te beperken is het aan te raden om in het vliegtuig weinig koffie en alcohol te drinken en na aankomst de eerste een à twee dagen niet te veel van jezelf te vergen. Er is niet of nauwelijks tijdsverschil tussen Nederland en Zuidelijk Afrika (alleen in de wintertijdperiode is er een uur verschil), maar je hebt een lange vlucht achter de rug, waarvan je altijd een terugslag krijgt. Daarnaast kost het meestal wat tijd om te wennen aan het klimaat en klaar te zijn voor alle nieuwe indrukken.

Bilharzia

Een Bilharziainfectie wordt overgebracht door larven die de huid binnendringen. Deze voorkom je door niet te zwemmen, pootje te baden of zelfs handen te wassen in stilstaand (of zwakstromend) water.

Nog wat meer (semi-)medische tips:

Huidverzorging

Neem wondjes in de tropen serieus: houd ze in de gaten, desinfecteer het en gebruik eventueel een pleister. Gebruik altijd een hoge factor zonnebrandcrème op de blote huid, ook in het regenseizoen. Snorkelen met T-shirt en (korte)broek is aan te raden. Draag geen felgekleurde of zwarte kleding en geen sterke geurtjes om stekende insecten op afstand te houden. Als je gevoelig bent voor huidirritatie, kun je het beste katoenen of linnen kleding dragen. Was vaak je handen of gebruik een desinfecterend middel.

Zonnesteek

Voorkom een zonnesteek door een hoofddeksel en eventueel een zonnebril te dragen. Zorg ervoor altijd een fles water bij je te hebben, zeker als je de natuur ingaat en niet snel aan drinkwater kunt komen. Vermoed je een zonnesteek (word je licht in het hoofd of krijg je hoofdpijn): drink wat, ga lekker in de schaduw zitten en blijf daar als het mogelijk is.

Gezondheid na thuiskomst

Als je na terugkomst (en dat kan eventueel maanden later zijn) koorts, darmklachten of andere onverklaarbare kwalen krijgt die je niet zo goed kunt thuisbrengen: neem contact op met je huisarts en vermeld hoe lang en waar je in Zuid-Afrika bent geweest en wat je er gedaan hebt. Als je veel contact hebt gehad met de plaatselijke bevolking is het verstandig een Mantoux te laten zetten (test op tbc).

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Gezondheid Zuid-Afrika " Alle informatie | Riksja Travel

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Zijn er voor een rondreis door Zuid-Afrika inentingen verplicht of aanbevolen? Wij geven je hierbij informatie op basis van onze eerdere ervaring.

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Over the last 20 years, Thailand's universal healthcare system has greatly improved the health outcomes of its residents. Most medical services and medications are available for free or very affordable rates, and the quality of care is high.

However, only certain expats qualify for healthcare coverage in Thailand (ประเทศไทย) without taking out private health insurance.

Keep reading to find out more about Thai healthcare for internationals, including:

Overview of healthcare in Thailand

The healthcare system in Thailand

Since 2002, Thailand has had a universal public healthcare system (ระบบการดูแลสุขภาพ) that offers mostly free medical treatment to 98% of the population.

Healthcare in Thailand is very high quality, currently ranking 31 st on the 2023 Legatum Prosperity Index and an impressive 5 th on the 2021 Global Health Security Index. However, there are still major disparities in the access available between larger cities and rural areas.

The Ministry of Public Health (MOPH - กระทรวงสาธารณสุข) is responsible for healthcare in Thailand, while the National Health Security Office (NHSO - สำนักงานหลักประกันสุขภาพแห่งชาติ) issues funding across 13 health regions. Although most of the population uses the universal coverage scheme (UCS), there is also a sizable private health sector. Public services are delivered through a network of hospitals (โรงพยาบาล, rong phyābā n), healthcare centers, and clinics operating across the country.

Life expectancy in Thailand has dramatically increased in the last few decades and currently stands at 74.4 years (PDF) for men and 81 years for women.

Who can access healthcare in Thailand?

Thai healthcare is accessible to both citizens and working legal residents through the following schemes:

Social security

Universal Coverage Scheme (UCS)

2%

Civil servant medical benefit

Thai civil service workers and their dependents

7.7%

Social health insurance

Private sector workers with health insurance

19%

Universal Coverage Scheme (UCS)

The general tax-paying population

71.3%

However, some private employers providing social health insurance coverage don't include dependent family members of employees, so they may need to get separate private insurance coverage. Check the situation with your employer to be sure.

On the other hand, short-term visitors and tourists will usually need to take out private health insurance (การประกันสุขภาพภาคเอกชน) to access medical services in Thailand. You can compare the health insurance packagages to see which suits your needs and budget best, and you can start with these providers:

How much is Thai healthcare?

Thai healthcare costs are generally very affordable but can vary depending on whether you have universal health coverage and if you're a citizen or a foreigner.

Under the public healthcare system, doctors and specialists charge ฿30 to 500 for a basic checkup. If you decide to go to a private healthcare provider without insurance, you can expect to pay from around ฿700 for a basic health check to ฿500,000 or more for extensive surgery.

Before Thailand moved to its current universal public-funded system, the Thai government and the people made nearly equal contributions to healthcare costs. In 2020, however, government spending (70.4%) was far greater than out-of-pocket costs (10.5%), with the remainder mainly funded through insurance payments.

Thailand currently spends 4.36% of its gross domestic product (GDP) on healthcare (2020), which is less than half the average of 9.6% (2021).

Do you need health insurance in Thailand?

Healthcare in Thailand is partly insurance-based. Most private sector employees, whether national citizens or expats, make social security payments that include health insurance contributions.

This entitles them to public healthcare treatments. The remainder of the citizen population can access mostly free public healthcare through the UCS, funded through general taxation.

Short-stay visitors to Thailand and those moving to the country without the intention to work will need to purchase private health insurance. This is usually a stipulation of Thai visa applications.

Even if you have public health insurance in Thailand, you may still want to supplement this with private coverage, giving you access to a wider variety of medical services.

How do you register for Thai healthcare as an international?

Employers register their expat employees for public healthcare in Thailand, giving them access to the same services as Thai citizens.

Your employer should enroll you in social security (ประกันสังคม) - either the social health insurance or the civil servant medical welfare scheme - once you start working in Thailand.

After registration, you will receive a social security card to take to any healthcare appointments to prove you are entitled to treatment. Everyone who uses public healthcare in Thailand is registered with health centers and hospitals within their district, though they can use any facility in the country.

Private healthcare in Thailand

Although public healthcare in Thailand is excellent, private services typically have shorter waiting times, provide a greater selection of treatments, and are more likely to have English-speaking staff.

However, costs are typically more expensive. You can usually cover treatments with a private health insurance policy. Some private employment-based health insurance policies may also cover some treatments in private facilities.

It's good to check your insurance policy with the facility before agreeing to any medical treatment. If you don't have insurance, you'll need to pay the total costs yourself.

Private facilities in Thailand include hospitals and medical clinics (คลินิกการแพทย์). Some of the best private healthcare options in the country include:

Most private providers offer different packages and have details of costs and plans on their websites. You can shop around for good private health insurance plans that will help you mitigate these costs.

How do you find a doctor in Thailand?

Doctors are part of primary healthcare in Thailand.

The first time you use public healthcare, staff will register you to a primary care unit (clinic, health center, or community hospital) where you can see a family doctor or general practitioner. Most general doctors in Thailand offer appointments and walk-in services, though waiting times may vary.

In 2021, Thailand had 0.5 doctors per 1,000 people, below global averages. The majority of doctors in the country are specialists rather than general doctors. Specialists typically work in hospital settings, though some are in clinics.

Unless you go private, you usually need a referral to access a Thai specialist. There are many medical specialists in Thailand, including:

Oncologists (ผู้เชี่ยวชาญด้านเนื้องอกวิทยา)

Gynecologists (นรีแพทย์)

Cardiologists (แพทย์โรคหัวใจ)

Psychologists (นักจิตวิทยา)

Radiologists (นักรังสีวิทยา)

Women's healthcare in Thailand

Public facilities in Thailand provide many free women's healthcare services, including reproductive healthcare, maternity, and cancer screenings.

Women in Thailand can access gynecologists at clinics, health centers, and hospitals. The MOPH began a National Family Planning Program in 1976 to try and reduce the country's birth rate. This increased access to birth control methods free of charge.

Abortion (การทำแท้ง) in Thailand was only legal under special circumstances until 2020, when the law changed to allow terminations until the 12 th week of pregnancy. This was increased to 20 weeks in certain circumstances in 2022.

The NHSO provides funding of up to ฿3,000 towards abortion costs, although there is currently a lack of public facilities equipped to carry out abortions. Because of this, many are forced to go private. Reproductive technologies are available in Thailand but only through private healthcare.

There are many private providers of women's healthcare in Thailand, including the Women's Health Center based at Bangkok Hospital.

Children's healthcare in Thailand

Children of Thai citizens automatically receive free healthcare through the UCS, including access to pediatricians (กุมารแพทย์), dental treatment, and specialist healthcare treatment.

Schools in Thailand deliver health promotion programs around issues such as dental care, healthy eating and nutrition, and physical activity. Child health in Thailand is generally good, and the country has an infant mortality rate of 9 deaths per 1,000 live births, below Southeast Asia's regional average of 30 (WHO, 2022).

Expats working in Thailand can often access free public healthcare for their children through their workplace health insurance plans. If you move to Thailand and your insurance policy doesn't cover family members, you can look to take out private family health insurance or a separate child health insurance policy.

Most general public and private hospitals in Thailand include pediatric departments or children's facilities staffed by specialists. There are also a number of high-quality children's hospitals, for example, the privately-run Samitivej Children's Hospital.

Thailand has a vaccination program for children which includes immunization against diphtheria, hepatitis B, and MMR.

Dentists in Thailand

You can access dentists in Thailand through the public and private sectors in health centers, clinics, and hospitals.

Around half of dentists and hygienists work in the private sector. Public health insurance covers basic checkups and treatments up to a set amount per year. You will need private insurance to avoid paying the full fees for anything above this threshold or specific specialist treatments.

Thailand has 2.7 dentists per 10,000 people, above the Southeast Asia average of 1.5 (WHO, 2022). However, the country has had low levels of dental usage among the population, measured at only 9% in 2011. The Dental Council of Thailand regulates the dental industry to ensure minimum standards.

Thai hospitals

There are almost 1,300 hospitals in Thailand, 80% of which are public and run by the MOPH.

In Thailand, hospitals generally provide inpatient and outpatient care, plus emergency treatment and maternity services. Community hospitals are smaller, usually with a maximum of 120 beds, and provide primary care services.

General and regional hospitals provide secondary and specialist care, often via community hospital referral. Specialist hospitals in Thailand include children's, psychiatric, and cardiac hospitals.

Public health insurance covers most standard treatment in MOPH hospitals, and some private hospitals also provide services under public insurance.

Thai health centers and clinics

Health centers are generally the first level of localized primary healthcare in Thailand and where you will typically find medical professionals, including:

The MOPH runs almost 10,000 health centers at the sub-district level that cover around 5,000 residents each. In addition to this are a number of clinics and community medical centers operated by local government authorities. When you register for public healthcare in Thailand, you will be allocated to your nearest health center or clinic, which will act as your first port of call when it comes to medical needs.

In addition to public sector facilities, there are over 17,000 private clinics where you will find private general doctors and other specialist medical professionals.

Pharmacies in Thailand

Thai pharmacies (ร้านขายยา, raan kai yaa) provide a range of medications, with some also offering advice and information on health issues.

There are essentially two types of Thai pharmacies. These are:

Type I pharmacies - accredited pharmacies licensed to sell prescription drugs as well as over-the-counter products, usually found in primary healthcare units (e.g., health centers or hospitals) as well as in other areas. They are typically staffed with at least one medical expert

Type II pharmacies - can only sell over-the-counter medication and may not be able to provide expert advice, found on the main street as well as within supermarket stores

Some expats may be surprised to find that many Thai pharmacies sell medications like antibiotic drugs over the counter. Type II pharmacies often also sell unregulated alternative and herbal remedies. In Thailand, the Government Pharmaceutical Organization (GPO - องค์การเภสัชกรรม) oversees drug regulation, and all official drugs need a license from the Thai Food and Drug Administration (TFDA - สำนักงานคณะกรรมการอาหารและยา).

Public health insurance in Thailand covers most prescription medications. You can also take out private insurance to cover out-of-pocket costs if you take expensive medicines regularly. However, medication prices are low in Thailand, even without insurance. It is the least expensive of 50 countries on the 2019 Medicine Price Index.

There are over 17,000 pharmacies in Thailand, easily identified with a green cross logo. Many have late-night opening hours, with 24-hour pharmacies in urban areas.

Thai mental healthcare

As with so many countries, Thailand's mental healthcare (การดูแลสุขภาพจิต) provision falls some way below that of physical healthcare. Focus has improved recently, and the Department of Mental Health (กรมสุขภาพจิต) advises the MOPH on what is needed.

Unfortunately, Thailand severely lacks preventative mental healthcare and has a shortage of professionals available to help those with serious problems.

If you experience mental health issues in Thailand, you should contact your doctor, who will refer you to specialist services if needed. There are numerous hospitals and health centers in Thailand that deal specifically with mental health. Through private insurance, you also gain access to therapy and wellness services.

COVID-19 in Thailand

As of 2023, Thailand has no COVID-related travel restrictions or social distancing measures in place, but the government still recommends booster vaccines for all residents over 18.

When COVID-19 was first reported, the Thai government acted swiftly to restrict the spread of the virus, including screening, immigration controls, contact tracing measures, and partial lockdowns. Although restrictions are lifted, at-home COVID-19 tests are still widely available at pharmacies across Thailand, and hospitals offer PCR tests.

The Thai government continues to urge residents to get COVID-19 booster vaccines, even as cases drop to all-time lows in 2023.

Thai support for long COVID

People who contract COVID-19 can often experience lingering after-effects, including fatigue, concentration problems, body aches, and long-term loss of taste/smell. This condition is known as long COVID and has gained growing attention over the past couple of years, but there is so far still limited research.

According to the Department of Medical Services (กรมบริการทางการแพทย์) in Thailand, 10 to 20% of COVID-19 patients develop long COVID. Private medical facilities have led the way in the response to the condition, including:

Public facilities are catching up, and the MOPH has issued guidelines to regional health authorities on setting up long COVID Clinics. The Bangkok Metropolitan Administration has now established nine clinics in the area.

There is a lack of long COVID support networks in Thailand. However, those wanting advice or support can reach out to the Survivor Corps, which is a worldwide online support group.

Physical therapy in Thailand

Most physical therapy available through public facilities in Thailand is focused on rehabilitation from illness or injury.

You can find therapists such as physiotherapists, occupational therapists, sports therapists, or cardiorespiratory therapists at some community hospitals, health centers, and general hospitals.

Typically, you will need a referral for treatment.

Private facilities tend to offer a wider range of treatment options. Prices are higher - starting at around ฿2,000 per hour - but you can cover costs using many private insurance packages.

Most registered physiotherapists are members of the Physical Therapy Association of Thailand (สมาคมกายภาพบำบัดแห่งประเทศไทย), which has a list of physical therapy facilities in the country.

Alternative medicine in Thailand

Thai traditional medicine (TTM - การแพทย์แผนไทย) is widely available in Thailand. This includes practices such as Thai massage, sauna, and herbal compression. Around 90% of public hospitals and 55% of health centers offer some form of TTM treatment.

TTM is more widely accepted and available than other forms of alternative medicine in Thailand and is the only form of complementary therapy that is fully regulated in the country. You can also find practitioners of traditional Chinese medicine (TCM) treatments, including acupuncture, homeopathy, osteopathy, and chiropractic therapy. However, these are less widely available through public healthcare and usually need private insurance coverage if you want to avoid paying full costs.

Thai community-based health and wellbeing

Thailand has a strong culture of community health volunteers that assist with health promotion and disease prevention in the country. These volunteers are largely based in rural parts of Thailand and number approximately one million - around 15 per 1,000 inhabitants.

Volunteers work to assist public health professionals and perform duties such as:

Disseminating health information and advice

Promoting health activities and initiatives

Running small community wellness projects

Assisting with data collection and record keeping, like helping with health surveys

Community health volunteers were also praised as heroes in Thailand for their support during the COVID-19 pandemic.

What do you do in an emergency in Thailand?

The number for a medical emergency in Thailand is 1669. You can also call 1155 to reach an emergency (ฉุกเฉิน, chuk cheun) advice line for foreigners.

Alternatively, travel to the nearest general or regional hospital, as these usually have emergency rooms.

Thailand has a somewhat unique emergency response setup that consists of three levels. The first is staffed with volunteers trained to respond to non-life-threatening situations. Level two is basic life support, and level three is advanced life support. The level you require will be determined when you make the initial emergency call.

All hospitals in Thailand offer emergency care regardless of financial or insurance situation. However, you may receive a bill for payment if you don't have insurance coverage. This is more likely if you receive treatment in a private facility.

How do you make a complaint about Thai healthcare?

If you have a complaint about a healthcare provider in Thailand, you should contact the provider directly in the first instance. They may be able to resolve the issue so that you don't have to take it further.

If this is unsuccessful, you can contact:

For public healthcare providers: Ministry of Public Health (MOPH) Tivanond Road, Nonthaburi 11000, Thailand (if you are complaining about a public healthcare service)

For private healthcare providers: Foundation for Consumers: 4/2 Soi Watthanayothin, Thanon Phaya Thai, Ratchathewi, Bangkok 10400, Thailand (if you are complaining about a private provider)

Alternatively, you can take legal action through the Thai courts. However, this can be a long, expensive process, so it's a good idea to seek advice from an attorney first.

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From general doctors and specialist treatments to who can access medical services, learn all about healthcare in Thailand.

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An Overview of Turkey's Healthcare System

Straddling Europe and Asia and known for its hospitality, Turkey is a popular destination for expats. In addition to the must-see attractions, the country also offers excellent healthcare to all residents. In 2018, The Lancet ranked healthcare in Turkey at 60th out of 195 countries. The public scheme offers comprehensive coverage and is available to all citizens or people who have resided in the country for at least one year.

Keep in mind, though, that medical insurance is a requirement for anyone under 65 applying for a visa and foreigners must wait one year to enroll in the public system. Furthermore, European Health Insurance Cards are not valid in Turkey. To ensure extensive coverage during this waiting period, most expats rely on international health insurance plans. This guarantees coverage both in and out of Turkey and gives access to high-quality private hospitals with shorter waiting times. Another benefit of private hospitals is that there's a better chance that your healthcare providers will speak English.

The History of Turkey's Healthcare System

Turkey started to improve its healthcare system at the turn of the century. Before this, the healthcare system in Turkey had high levels of patient dissatisfaction. Less than two-thirds of the population had health insurance and the system to receive care was inefficient. To combat this, the government launched the Health Transformation Program (HTP) with the support of the World Bank in 2003. The goal was to overhaul the system and provide universal healthcare, ensuring all citizens would have equal access to quality care.

In 2010, the Ministry of Health developed the public-private partnership program (PPP) to expand its resources. With the backing of the World Bank, more private firms began to enter the health insurance market in Turkey. The result of this was more financial support for public hospitals, an increase in private hospitals, and more focus on specialized services.

Healthcare in Turkey is now often cited as a success story. The HTP managed to achieve all health-related Millennium Development Goals ahead of the 2015 deadline. There are now hospitals and clinics offering high-quality care available throughout the country, although there is still some disparity between services and amenities in more rural areas.

Healthcare in Turkey Pros & Cons

Pros of Turkey's Healthcare System

Turkey has offered universal healthcare through its Social Security Institution (SGK) since 2003. The system offers comprehensive and equal access to care for all citizens, regardless of income level. Patients are able to make appointments online through the Ministry of Health's website or mobile app. While the majority of emergency and primary care services are fully covered, some are only subsidized. Luckily, out-of-pocket fees for services tend to be minimal.

Due to the affordable costs of healthcare in Turkey, medical tourism is booming in the country. Cosmetic surgery, fertility treatments and laser refractive surgery are some of the most common treatments visitors seek. The rise in medical tourism has infused more money into their healthcare system and further helped to improve the country's medical services.

Turkey is also working to integrate alternative care treatments with modern practices. In 2014, the Ministry of Health created the Complementary and Alternative Medicine Practices Department. Acupuncture, homeopathy and cupping therapy are some of the treatments being studied and offered at certain medical centers. However, these alternative treatments are not covered by insurance.

Cons of Turkey's Healthcare System

Although healthcare in Turkey has made great strides in the past decades, care can still be limited in rural areas. You may find poorly maintained or out-of-date equipment in rural hospitals, especially public ones. While doctors are well-trained throughout the country, there are fewer medical workers willing to work in rural areas, so you'll find that doctor-to-patient ratios are far lower outside of urban areas. This means overcrowding is a consistent issue in rural areas and long wait times for specialized services are common. Foreigners living in rural areas may be hard-pressed to find an English-speaking doctor.

Challenges of Turkey's Healthcare System

There are big limitations with mental health treatment in Turkey. The country's Mental Health Law has been pending in legislation since 2019. Funding is lacking and there are not enough trained mental health professionals to serve the country. Due to the limited workforce, the vast majority of mental health services are only found within the cities of Istanbul, Ankara and İzmir. Some regions have no mental health specialists on staff at all.

Does Turkey Have Universal Healthcare?

Yes, Turkey has provided universal healthcare through the SGK for the past decade. The system is funded by the state, employers, and workers. For all economically active people, the contribution rate is 12.5% of earnings. This is split between the employees, who pay 5%, and employers, who pay the remaining 7.5%. For unemployed people, the contribution rates vary. Pensioners have a default right to universal healthcare after one year of residency, with their fees being covered by either the SGK or the State depending on whether they contributed to the healthcare scheme before. While people do pay different contribution rates, everyone receives equal coverage regardless of income level.

What's Covered Under Turkey's Universal Healthcare

Primary, preventative, and emergency care are all fully covered.

Tests and different diagnostic methods.

Dental and optical examinations and treatments. However, not all SGK hospitals offer these services - patients often rely on the private system and cover the costs themselves. Additionally, anything done for aesthetic purposes as opposed to medical needs will require out-of-pocket payments.

Pregnancy and maternity services are covered. This includes assisted reproductive technology such as IVF, though the treatment is normally limited to three attempts.

Rehabilitation services.

Healthcare services due to a work accident or occupational disease.

Prescription drugs are only partially covered by Turkey's universal healthcare and require co-payments. Generally, patients pay about 20% of the costs of medications out-of-pocket, with retirees paying a reduced 10% of the medication costs.

Travel expenses in the case of treatment needed outside your city of residence, including expenses for a companion in some cases.

In certain cases, treatment received abroad may also be covered.

Complementary Insurance in Turkey

While the healthcare system in Turkey has made great improvements and offers comprehensive coverage for residents, most people still opt to purchase supplemental health insurance plans. These plans can be bought from licensed brokers, banks, or directly from insurance companies.

Holding additional private insurance allows patients to access the private hospital system. Private hospitals often have shorter waiting times, state-of-the-art medical equipment, and better amenities. For those who do not speak Turkish, it's much easier to find English-speaking doctors within the private system.

While the SGK often makes contracts with private hospitals to receive discounted care for residents, the patients will still be expected to pay some out-of-pocket expenses. Complementary insurance plans are used to cover these bills and minimize unexpected expenses.

How to Access & Receive Healthcare in Turkey

Turkey's universal healthcare system is a compulsory system that covers nearly all citizens of the country. Public services are provided by the Ministry of Health. Every town in Turkey has a healthcare clinic and pharmacies are found on nearly every street.

To receive care, you can go to your local center and wait in line or call the Central Physician Appointment System (MHRs) at 182 to schedule an appointment. MHRS also has an app available in Turkish that you can make appointments on. Additionally, some hospitals and clinics allow patients to make appointments on their websites. Due to the difference of amenities between rural and urban centers, it's a good idea to seek treatment in larger cities.

The healthcare system in Turkey has three different types of hospitals: government-funded hospitals, university hospitals, and private hospitals. Generally, state hospitals suffer from overcrowding and limited funding. University hospitals offer the highest standard of care with more highly-specialized personnel. Private hospitals provide high-quality care and treatment and have the added benefit of more English-speaking doctors. If you are just traveling to Turkey you can also look into Travel Insurance in Turkey. This will give you some more options and access to the private hospitals.

Emergency care is free at all state hospitals, even for those who are not insured. Dial 112 to reach emergency health services. Both public and private hospitals have emergency departments open 24 hours a day, though private hospitals may charge a fee for treatment.

Who is Eligible for Healthcare in Turkey?

After one year of residency, foreigners are eligible to apply for public healthcare. First, you must register with the Turkish Healthcare System at your local SGK office. To do this you will need copies of your passport, your residency application form, proof of your address from the Goc Idaresi, and a health assessment from an approved doctor. You should ask your SGK office for a list of their approved doctors in advance. You will also need to show proof that you aren't already insured or entitled to benefits from your home country.

Learn More: Insurance in Turkey for Foreigners

Once you are registered in the public system, you must select your primary care physician. You must contribute to the SGK for at least 30 days before requesting care. After that, you are able to use Turkey's healthcare system the same as any citizen. However, when it comes time to renew your residency permit, you will again need to visit your nearest SGK office to update your coverage period.

Due to the long waiting period and visa requirements, many expats opt to purchase international health insurance plans. These plans can be used in private hospitals throughout the world and offer better access to English-speaking doctors.

Healthcare for Expats in Turkey

Expat Insurance for Turkey

Most people in Turkey tend to carry private insurance even if they are enrolled in the public system. This guarantees shorter wait times, better hospital amenities, and English-speaking doctors. To learn about the best health insurance plans in Turkey for both short and long-term visits, check out our Insurance in Turkey for Foreigners page.

The Best Health Insurance in Turkey for US Citizens

The Best Health Insurance in Turkey for European Citizens

The Best Health Insurance in Turkey for Non-US Expats
Related Articles:
Author: Elizabeth Baugh is a content editor at International Citizens Insurance. She is writer specializing in education, travel, health, and wellness topics. With over a decade of international living and travel experience, Elizabeth is an expert in the realms of international travel, moving abroad, insurance, and immigration.

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Learn the advantages and disadvantages of Turkey's healthcare system and how to get treatment as a foreigner.

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https://www.helsenorge.no/en/healthcare/

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Do you need healthcare?

Where to get help

Are you going to a hospital or to see a specialist?

Paying for healthcare

Work and illness

In Norway, we have a number of support schemes which will provide you with an income if you are unable to work due to illness or injury.

You can also receive support if you need care, have additional medical expenses or need assistive devices and adaptations.

What you are entitled to depends on your situation. You will find more information about which financial support you may be entitled to based on your situation, on NAV's website: Helse og sykdom (nav.no).

Pregnancy, contraception and abortion

Are you pregnant?

Contraception and abortion

Children and adolescents

Mental health

Are you next of kin?

When a family member has a serious or long-term illness, it can make all the difference to you what kind of help they receive. However, it is also important how you feel as next of kin. It is important that you seek advice and support before the problems become too big.

How the health service works in Norway

Log in to Helsenorge

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Below, you will find basic information about how the health service works in Norway and who you can contact and when. The information was written and quality-assured by the public health authorities in Norway.

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Egypt Country Overview | World Health Organization

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Egypt Country Overview | World Health Organization

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Zuid-Afrika en Mozambique zijn deels (sub)tropische landen en daarom loop je meer risico om ziek te worden dan thuis. Dit komt doordat er meer bacteriën zijn in een tropisch klimaat. Een tropisch klimaat vormt met zijn vochtige warmte een goede voedingsbodem voor ziekteverwekkers. Hoewel het risico op ziekten niet moet worden overdreven en zeker niet je reisplezier in de weg zou moeten staan, raden we aan om je goed voor te bereiden en ook ter plekke bewust om te gaan met gezondheidsrisico's.

Gezondheidsmaatregelen voor vertrek

Zorg dat je voor vertrek contact opneemt met een medische instantie die verstand van zaken heeft, zoals een ziekenhuis of in grote steden de GGD. Zelf hebben we goede ervaringen met Thuisvaccinatie.nl. Deskundige artsen komen thuis of op kantoor langs wanneer het jou uitkomt, dus ook 's avonds en in het weekend, om advies te geven en direct in te enten. De rekening wordt rechtstreeks naar je zorgverzekering gestuurd, wel zo handig. Vaak worden het consult en/of de vaccinaties zelf ook nog eens vergoed.

Een lastminutereis naar Zuid-Afrika en Mozambique hoeft voor een gezond persoon geen probleem te zijn; je zou desnoods op Schiphol nog naar Travel Clinic van KLM Health Services of Airport Medical Services kunnen gaan. Neem sowieso altijd je vaccinatieboekje mee. Natuurlijk heeft het de voorkeur je vaccinaties ruim van tevoren te regelen. Wat daarbij van belang is, is dat de instelling waartoe je je wendt (bijvoorbeeld GGD, huisarts of ziekenhuis), aangesloten is bij het Landelijk Coördinatiecentrum Reizigersadvisering (LCR). Deze organisatie zorgt dat de aangesloten instellingen up-to-date zijn op het gebied van vaccinaties en ziektepreventie voor de tropen.

Drie andere instanties die dicht bij het vuur zitten (zij bepalen het beleid van het LCR): Het LUMC in Leiden, tel. 071-5263636, (informatie en afspraken voor de vaccinatiepoli 's morgens van 09.30-11.30 uur), Travel Clinic te Rotterdam, (bandje met info: 0900-5034090, eerst 1 kiezen), in Amsterdam het AMC (bandje met info allerlei landen tel. 0900-9584). Verder kun je bij Inside Travel News (030-6912752) een gratis informatiepakket aanvragen. De prijzen voor vaccinaties kunnen uiteenlopen; het kan de moeite waard zijn een beetje te shoppen.

Hieronder volgt wat informatie over voor de hand liggende ziektes gericht op de reiziger die gezond is, niet zwanger is en niet langer dan een maand in Zuid-Afrika zal blijven. Zorg ervoor zelf up-to-date informatie te krijgen voor je eigen situatie.

Malaria

In de warme zomermaanden (onze winter) komt in en rondom het Krugerpark, Swaziland en St. Lucia malaria voor. In Mozambique komt het hele jaar malaria voor. Voor een officieel advies over het gebruik van profylaxen (malariapillen) raden we je aan contact op te nemen met je huisarts, de Travel Clinic of bijvoorbeeld de GGD. Zij kunnen je precies vertellen welke maatregelen je moet nemen. Ook voor bepaalde gebieden in Namibië en Botswana geldt dat er malaria voorkomt. Informeer je dus goed voordat je het vliegtuig instapt. Naast eventuele malariapillen, adviseren we je ook de volgende risicobeperkende maatregelen te treffen: 's avonds de armen, benen en voeten bedekken, een muggenmiddel opsmeren waar DEET in zit en een klamboe gebruiken. De klamboe kun je eventueel impregneren met een muskietendodend middel. Zorg dat je ook iets bij je hebt waarmee je de klamboe kunt ophangen. Mocht je ondanks de nodige voorzorgsmaatregelen toch ineens koorts krijgen die langer dan twee dagen aanhoudt, dan moet een arts worden geraadpleegd om malaria uit te sluiten. Dit geldt tot twee maanden na terugkeer in Nederland.

Vaccinaties

In de landen van Zuidelijk Afrika worden vaccinaties tegen dtp(difterie, tetanus en polio) en hepatitis A aangeraden. Een dtp-inenting hebben de meeste mensen in hun jeugd al gehad. Na een herhaalprik kun je er dan weer een poosje tegen. De reguliere hepatitis-A-injectie heeft een beperkte werkingsduur, dus het is zaak deze kort voor vertrek te plannen. Als je frequent of voor langere tijd naar landen gaat waar hepatitis-A voorkomt, dan is het te overwegen om injecties voor langere termijn te nemen, zoals Havrix. Houd er wel rekening mee dat dit dure vaccins zijn en dat je na zes maanden een herhaalprik nodig hebt. Onlangs is de gelekoortsrichtlijn aangescherpt. Alle reizigers die per vliegtuig naar Zuid-Afrika reizen en een tussenstop maken in een land waar gele koorts voorkomt, moeten een vaccinatiebewijs tegen gele koorts tonen bij aankomst in Zuid-Afrika. Ook als men tijdens de tussenstop (transit) het vliegveld of vliegtuig niet verlaat, is een gelekoortsvaccinatiebewijs verplicht. Zonder dit gelekoortsvaccinatiebewijs kan de toegang tot het land geweigerd worden. Een gelekoortsvaccinatie moet tien dagen voor vertrek worden toegediend. In Mozambique en Zimbabwe wordt soms om een choleraverklaring gevraagd. Informeer hiernaar bij je medisch adviseur.

Verdere voorbereiding

Handig om bij je te hebben is een EHBO-setje voor de tropen. Je kunt dit zelf samenstellen of er een kopen bij onder andere vaccinerende instanties en winkels als de Joho Company. Als je medicijnen gebruikt, raden we je aan de bijsluiter en een medisch certificaat van je huisarts mee te nemen. Dit is een brief waarin de arts het medicijn benoemt en de reden van gebruik uitlegt in het Engels. Het kan voorkomen dat de douane om dit certificaat vraagt, zo kun je aantonen dat het om een noodzakelijk medicijn gaat. Neem ook altijd een extra voorraadje mee, zodat je geen risico loopt dat je ter plekke zonder komt te zitten. Heb je een bril of draag je lenzen, neem dan de opticienbeschrijving mee of een extra bril of extra paar lenzen. Voor snorkelaars/duikers worden duikbrillen op sterkte verkocht (en verhuurd) bij duikwinkels/duikscholen.

Gezondheid ter plekke

Naast het in acht nemen van de op jouw situatie afgestemde vaccinaties en ervoor te zorgen dat je gezond op reis gaat, is het natuurlijk belangrijk om te voorkomen dat je in Zuid-Afrika ziek wordt. Wees ter plaatse zeer alert: als je twijfelt over wat je hebt, raadpleeg een arts.

Jetlag

Jetlag is een ontregeling van je biologisch klok die veroorzaakt wordt door het vliegen over meer dan drie tijdszones. De eerste dagen na de vlucht moet je lichaam wennen aan het nieuwe bioritme waardoor je moe en suf kunt zijn. Om je jetlag te beperken is het aan te raden om in het vliegtuig weinig koffie en alcohol te drinken en na aankomst de eerste een à twee dagen niet te veel van jezelf te vergen. Er is niet of nauwelijks tijdsverschil tussen Nederland en Zuidelijk Afrika (alleen in de wintertijdperiode is er een uur verschil), maar je hebt een lange vlucht achter de rug, waarvan je altijd een terugslag krijgt. Daarnaast kost het meestal wat tijd om te wennen aan het klimaat en klaar te zijn voor alle nieuwe indrukken.

Bilharzia

Een Bilharziainfectie wordt overgebracht door larven die de huid binnendringen. Deze voorkom je door niet te zwemmen, pootje te baden of zelfs handen te wassen in stilstaand (of zwakstromend) water.

Nog wat meer (semi-)medische tips:

Huidverzorging

Neem wondjes in de tropen serieus: houd ze in de gaten, desinfecteer het en gebruik eventueel een pleister. Gebruik altijd een hoge factor zonnebrandcrème op de blote huid, ook in het regenseizoen. Snorkelen met T-shirt en (korte)broek is aan te raden. Draag geen felgekleurde of zwarte kleding en geen sterke geurtjes om stekende insecten op afstand te houden. Als je gevoelig bent voor huidirritatie, kun je het beste katoenen of linnen kleding dragen. Was vaak je handen of gebruik een desinfecterend middel.

Zonnesteek

Voorkom een zonnesteek door een hoofddeksel en eventueel een zonnebril te dragen. Zorg ervoor altijd een fles water bij je te hebben, zeker als je de natuur ingaat en niet snel aan drinkwater kunt komen. Vermoed je een zonnesteek (word je licht in het hoofd of krijg je hoofdpijn): drink wat, ga lekker in de schaduw zitten en blijf daar als het mogelijk is.

Gezondheid na thuiskomst

Als je na terugkomst (en dat kan eventueel maanden later zijn) koorts, darmklachten of andere onverklaarbare kwalen krijgt die je niet zo goed kunt thuisbrengen: neem contact op met je huisarts en vermeld hoe lang en waar je in Zuid-Afrika bent geweest en wat je er gedaan hebt. Als je veel contact hebt gehad met de plaatselijke bevolking is het verstandig een Mantoux te laten zetten (test op tbc).

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Gezondheid Zuid-Afrika " Alle informatie | Riksja Travel

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Zijn er voor een rondreis door Zuid-Afrika inentingen verplicht of aanbevolen? Wij geven je hierbij informatie op basis van onze eerdere ervaring.

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Generally, expat residents and their families have access to free or low-cost public healthcare if they contribute to the Social Insurance Institute (IKA). IKA is a public insurance company that oversees Greece's social security. As soon as expats start working, they will need to apply for national health insurance, which is administered by IKA, and they will be given a social security card known as AMKA. Medical care by IKA-approved practitioners is generally free, although patients are required to pay a fee for prescribed medicines. Other benefits include free laboratory services, maternity care, medical-related appliances or devices and emergency transportation. Other European Union nationals can also avail of free healthcare benefits provided they have their European Health Card, which entitles the bearer to public health cover for a limited period of time. Retirees from EU countries who are receiving their pension from their home country, and who intend to settle in Greece, are also entitled to state health benefits.

Primary healthcare is provided through ESY. This includes rural health centres and surgeries, as well as public hospital outpatient departments. Other public primary healthcare is provided through health centres operated by social insurance funds, local authorities and municipalities. According to the type of services they offer, Greek hospitals are categorised as either general or specialised. General hospitals include multi-specialty departments across most disciplines of medicine. Specialised hospitals are referral centres usually for a single specialty.

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Guide to Healthcare in Greece | Allianz Care

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Generally, expat residents and their families have access to free or low-cost public healthcare if they contribute to the Social Insurance Institute (IKA). IKA is a public insurance company that oversees Greece's social security. As soon as expats start working, they will need to apply for national health insurance, which is administered by IKA, and they will be given a social security card known as AMKA.

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The Swiss healthcare system reflects the country's federal structure. It ensures high-quality healthcare with a dense network of doctors' surgeries and hospitals. Health insurance is compulsory for all residents of Switzerland.

Switzerland has a high-quality healthcare system - although it is also one of the most expensive in the world © FDFA, Presence Switzerland

In Switzerland the cantons have primary responsibility for overseeing healthcare provision, including hospital care, advanced medicine, the licensing of healthcare professionals and prevention. The federal government is responsible for the compulsory health insurance scheme, control of communicable diseases, as well as medically assisted reproduction and transplant medicine.

Basic compulsory health insurance

Compulsory health insurance protects insured individuals in the event of illness, accident and maternity. The approximately 50 health insurance companies approved by the federal government must treat all insured individuals under basic insurance equally without exception (e.g. admission to the insurance scheme, free choice of insurance type, reimbursement of benefits).

Everyone residing in Switzerland is therefore obliged to take out basic insurance with a health insurer of their choice. The monthly premium depends on the place of residence, age and the selected level of the annual deductible, which can range from CHF 300 to a maximum of CHF 2,500 for adults. In addition to basic insurance, individuals can also opt to take out supplementary insurance.

Healthcare costs

Switzerland's total healthcare expenditure amounted to CHF 86.3 billion in 2021. This represented 11.8% of GDP, up from 9.3% of GDP in 2007. Switzerland ranks seventh among OECD countries in terms of per capita healthcare expenditure, well behind the United States and neighbouring countries such as Germany, France and Austria.

The rise in healthcare costs can be attributed to an ageing population, medical advances and rising public demand for medical services. A series of measures have been introduced to curb health costs in Switzerland, including the promotion of managed-care models, a new hospital financing system based on a set price for each service provided, and an 'eHealth' strategy.

Infrastructure

In Switzerland, there were 4.4 hospital beds per 1,000 inhabitants in 2021, with 60% of these beds located in general care hospitals. By comparison, South Korea and Japan had more than 12 hospital beds, Germany 7.8 beds, France 5.7 beds and Italy 3.1 beds per 1,000 residents (source: OECD). Over the last few years a number of cantons have restructured their hospital network, grouping certain specialist areas in one location or closing under-utilised facilities.

Switzerland boasts a comprehensive network of doctors and outpatient centres, enabling patients to receive treatment relatively quickly. On average, Swiss residents live just one kilometre from the nearest medical service provider.

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health system and healthcare in switzerland

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The Swiss healthcare system integrates both the public and private sectors, ensuring the provision of high-quality medical services.

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ICHS clinic pharmacies are administering the updated 2023-2024 COVID-19 vaccines to adolescents and adults (ages 12 and older) on a walk-in basis at ICHS' International District, Holly Park, and Shoreline locations.

ICHS patients 6 months to 11 years old may receive their COVID-19 vaccines by making an appointment.

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International Community Health Services provides medical & dental care to Seattle & King County Asian & Pacific Islander communities as a nonprofit (ICHS).

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Sienna Studio มิลาโน่ทาวน์ Surasak, Amphoe Sri Racha, Changwat Chonburi, Thailand

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"The nursing care my dad received in Braefield was second to none. The home is spotless and dad was always clean and well looked after. We were always kept informed of changes in dads health and any concerns.

We visited the care home on a daily basis, and saw first hand that residents are treated like members of the family This gave us great comfort.

The dignity and compassion shown towards dad and the family in his latter days was comforting, and we couldn't have asked for anything more. I would highly recommend Braefield they are a fantastic team."

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"The nursing care my dad received in Braefield was second to none. The home is spotless and dad was always clean and well looked after. We were always kept informed of changes in dads health and any concerns.