Health Sector Review Note, Vol. 1
Lead Author: Enis Baris
June 2005
Health outcomes in Azerbaijan are poor, in part due to a healthcare system that is persistently ineffective in delivering affordable, quality services with equal access for all segments of the population. This two-volume Sector Review Note outlines the burden of ill health, its distribution and trends, and addresses the adequacy of the existing healthcare system to meet healthcare needs and respond to epidemiologic and demographic challenges. Volume One provides policy recommendations, while Volume Two analyzes the current state of health care in Azerbaijan.
1. Structure and Content of the Review
This chapter briefly outlines the two-volume structure of the report and the intentions of each volume. It also discusses the report’s aims: to influence the Government of Azerbaijan’s policy reforms in health care, and to guide the World Bank’s ongoing lending program in the country.
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2. Key Findings, Issues, and Options for Reform
This chapter begins by discussing Azerbaijan’s demographic transition, with decreasing population growth due to a low fertility rate, an aging population, and a flattening dependency ratio. Almost 50 percent of the population of Azerbaijan is considered poor, which among other factors contributes to high adult mortality and reduced life expectancy. The rest of the chapter analyzes health care needs and the health care system, and provides recommendations on how the system can be improved to address these needs.
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3. An Agenda for Health Sector Reform
The need for health care reform is based on both deficiencies within the system as well as inaccurate data that policymakers continue to defend. The system’s failure is characterized by over-funding of excessive facilities and inefficient services and under-funding of primary health care services. This chapter’s recommendations for reform aim to create an entirely new model based on family-based primary health care that values disease prevention and health promotion. The recommendations are divided into system hierarchy, management, and funding.
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4. The Way Forward
The primary question confronting Azerbaijan’s health care system is what volume of funding, in addition to organizational and financial restructuring, is needed to make the system function again. Given the close relationship between health and the economy, a phased reform is proposed to foster a virtuous cycle of investment and improved health. Successful implementation of all phases of healthcare reform will require proper sequencing. Finally, a public information campaign, preferably conducted through the media, should be developed and properly financed.
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