Implementing Health Sector Reform in Central Asia

Implementing Health Sector Reform in Central Asia PDF

Author: Zuzana Feachem

Publisher: World Bank Publications

Published: 1999

Total Pages: 172

ISBN-13: 9780821343371

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It is easy for reformers and their overseas advisers to develop conceptually strong plans for health sector reform that appeal to governments, donors, and academics. Transforming these plans into successful action has proved to be extremely difficult. Toward the goal of improving assistance to this sector, the Economic Development Institute (EDI) of the World Bank held a seminar in Ashgabat, Turkmenistan in June 1996. This publication provides a summary of the proceedings and papers presented at that seminar. It was attended by delegations from five countries in Central Asia and from Azerbaijan and Mongolia. The content of this volume emphasizes topics central to the restructuring of health sector financing and health care delivery systems at a time of transition to market economies and to democracy. Maintaining and improving the health status of the population while preventing rapid escalation of health care expenditure were the recurrent themes throughout the seminar.

A Survey of Health Reform in Central Asia

A Survey of Health Reform in Central Asia PDF

Author: Jeni Klugman

Publisher: World Bank Publications

Published: 1996-01-01

Total Pages: 72

ISBN-13: 9780821338049

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World Bank Technical Paper No. 352. Six years into the transition from planned to market economies in Central and Eastern Europe, high unemployment rates, including a growing proportion of the long-term unemployed, represent a serious challenge to social welfare systems and policymakers. This paper analyzes labor market development in nine transition countries of the region by focusing on the dynamics of labor force behavior, employment, and unemployment. The countries include Bulgaria, Croatia, the Czech Republic, the Former Yugoslav Republic of Macedonia, Hungary, Poland, Romania, the Slovak Republic, and Slovenia.

Implementing Health Financing Reform

Implementing Health Financing Reform PDF

Author: Joseph Kutzin

Publisher: Observatory Studies

Published: 2010

Total Pages: 438

ISBN-13:

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Analyses the experience with the financing reforms implemented by the countries of Central Europe, Eastern Europe, the Cauxasus and Central Asia.

Economic Transition and Health Care Reform

Economic Transition and Health Care Reform PDF

Author: Adam Leive

Publisher: International Monetary Fund

Published: 2010-03-01

Total Pages: 43

ISBN-13: 1451982186

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This paper exploits the staggered adoption of major concurrent health reforms in countries in Europe and Central Asia after 1990 to estimate their impact on public health expenditure, utilization, and avoidable deaths. While the health systems all derived from the same paradigm under central planning, they have since introduced changes to policies regarding cost-sharing, provider payment, financing, and the rationalization of hospital infrastructure. Social health insurance is predicted to increase this share, although the leads of both social health insurance and primary care fee-for-service suggest endogeneity may be an issue with the outpatient share regressions. Provider payment reforms produce the largest impact on spending, with fee-for-service increasing spending and patient-based payment reducing it. The impact on avoidable deaths is generally negligible, but there is some evidence of improvements due to fee-for-service. Considering the corresponding relative reduction in inpatient admissions and the incentives fee-for-service provides to deliver additional services, perhaps there is an overprovision of services in the primary care setting and an underutilization of more specialized hospital services.

Health Care In Central Asia

Health Care In Central Asia PDF

Author: Mckee

Publisher: Open University Press

Published: 2002

Total Pages: 248

ISBN-13:

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Central Asia remains one of the least known parts of the former Soviet Union. The five central Asian republics gained their unexpected independence in 1991. They have faced enormous challenges over the last decade in reforming their health care systems, including adverse macro-economic conditions and political instability. To varying extents, each country is diverging from a hierarchical and unsustainable Soviet model health care system. Common strategies have involved devolving the ownership of health services, seeking sources of revenue additional to shrinking state taxes, 'down-sizing' their excessive hospital systems, introducing general practitioners into primary care services, and enhancing the training of health professionals. This book draws on a decade of experience of what has worked and what has not. It is an invaluable source for those working in the region and for others interested in the experiences of countries in political and economic transition.

Getting Better

Getting Better PDF

Author: Owen Smith

Publisher: World Bank Publications

Published: 2013-06-10

Total Pages: 214

ISBN-13: 0821398849

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Fifty years ago, health outcomes in the countries of Eastern Europe and Central Asia were not far behind those in Western Europe and well ahead of most other regions of the world. But progress since then has been slow. While life expectancy in the ECA region today is close to the global average, the gap with its western neighbors has doubled, and other middle-income regions have all surpassed ECA. Some countries in the region are doing better, but full convergence with the world’s most advanced health systems is still a long way off. At the same time, survey evidence suggests that the health sector is the top priority for additional investment among populations across the region. The experience of high-income countries also suggests that popular demand for strong and accessible health systems will only grow over time. Yet these aspirations must be reconciled with current fiscal realities. In brief, health sector issues are a challenge here to stay for policy-makers across the ECA region. This report draws on new evidence to explore the development challenge facing health sectors in ECA, and highlights three key agendas to help policy-makers seeking to achieve more rapid convergence with the world’s best performing health systems. The first is the health agenda, where the task is to strengthen public health and primary care interventions to help launch the “cardiovascular revolution” that has taken place in the West in recent decades. The second is the financing agenda, in which growing demand for medical care must be satisfied without imposing undue burden on households or government budgets. The third agenda relates to broader institutional arrangements. Here there are some key reform ingredients common to most advanced health systems that are still missing in many ECA countries. A common theme in each of these three agendas is the emphasis on improving outcomes, or “Getting Better”.

Transforming Post-Communist Political Economies

Transforming Post-Communist Political Economies PDF

Author: National Research Council

Publisher: National Academies Press

Published: 1998-03-02

Total Pages: 534

ISBN-13: 9780309059299

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This ground-breaking new volume focuses on the interaction between political, social, and economic change in Central and Eastern Europe and the New Independent States. It includes a wide selection of analytic papers, thought-provoking essays by leading scholars in diverse fields, and an agenda for future research. It integrates work on the micro and macro levels of the economy and provides a broad overview of the transition process. This volume broadens the current intellectual and policy debate concerning the historic transition now taking place from a narrow concern with purely economic factors to the dynamics of political and social change. It questions the assumption that the post-communist economies are all following the same path and that they will inevitably develop into replicas of economies in the advanced industrial West. It challenges accepted thinking and promotes the utilization of new methods and perspectives.

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