Public health framework and population health in two converging Koreas : A critical literature review

Abstract

Objectives: Population healths in the Democratic People’s Republic of Korea (DPRK) and the Republic of Korea (ROK) appeared to differ largely. The objective of this thesis was to study the public health framework and population healths of two Koreas, with a particular emphasis on DPRK. Methods: A literature review on Pubmed produced twenty peer-reviewed publications. Further literature review on the ROK National Knowledge Information System (NKIS) resulted in six findings. Employing document analysis methods, numerous reports and survey findings published by the International Non-Governmental Organizations (INGOs) along with the DPRK government announcements were closely examined. As a reference, a separate literature review was conducted on the German unification and the Eastern German population health. Background: Since the 1950s, DPRK has been legally committed to providing universal health coverage (UHC), stressing preventive medicine and sector doctor system. However, due to strained foreign relations, economic hardships, and natural disasters, the state has mostly failed to provide UHC. While the current leader, Kim Jong-un, has urged for improvements in public health, the population health relies heavily on medical resources from the private market. Results: In contrast to ROK, striding to advance UHC, DPRK has encountered a shortage of essential medicine, equipment, and medical personal. Yet, existing and remaining infrastructure in DPRK such as hospitals can speed up the potential recovering efforts in the future. Despite appearing differences, two Koreas share similar risks and causes for premature deaths. The overall mortality rate of the DPRK children has improved but many still suffer from an inadequate level of nutrition and sanitation. DPRK is encouraged to further cooperate with INGOs and ROK. The German experience can offer specifics to avoid or learn for two Koreas. Conclusion: With a potential increase in contacts, two Koreas are at an opportune moment to partner over the peninsula’s population health. INGOs’ continued participation in the trusted and committed relationship of two Koreas is highly encouraged as well.