Azerbaijan - Health Sector Review Note, Vol. 2

Health Sector Review Note, Vol. 2

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. Health Status. Healthcare Needs and Determinants in Azerbaijan

Despite the economic growth of recent years, poverty in Azerbaijan has had a substantially negative impact on the health of the population. This chapter will review the current health status of the population and examine risks to and determinants of poor health outcomes in Azerbaijan. Based on this analysis, the chapter will outline issues that need to be addressed through a variety of public health policies and programs in order to improve public health.

2. Demand for and Utilization of Healthcare Services

This chapter will use a theoretical framework to explore the demand for and utilization of healthcare services in Azerbaijan. The chapter seeks to identify the relative importance of predisposing and enabling factors in service use; utilization levels of different types of services and their main determinants; as well as satisfaction levels with different types of facilities.

3. Health System Stewardship

This chapter describes stewardship of the health system in Azerbaijan in order to understand the current stewardship environment and the sociopolitical and economic feasibility of proposed health sector reforms. Stewardship is “the careful and responsible management of the well-being of the population,” and it refers to good principles of health and healthcare governance. Stewardship is considered a core function of healthcare, together with financing, human resource generation and service delivery.

4. Financing Health Care in Azerbaijan

This chapter analyzes healthcare financing in Azerbaijan, where most patients pay for all types of health services and medication. The framework used for this analysis uses four sub-functions to describe the system of health sector financing: fund collection, fund pooling; service purchasing; and service provision.

5. Human Resources in Azerbaijan

This chapter assesses the current status of the health workforce in Azerbaijan and makes recommendations to assist the Ministry of Health and the districts to improve their institutional capacity for human resource policy and planning.

6. Health Services Organization and Delivery in Azerbaijan

This chapter describes the current state of the organization and delivery of healthcare services in Azerbaijan. It examines the reasons behind the mismatch between the demand for and supply of services, which results in skewed allocation of resources, low utilization and quality of care, as well as a large burden of preventable morbidity and mortality in the country.

7. Toward Greater Access to Pharmaceuticals in Azerbaijan

Public expenditure on pharmaceuticals in Azerbaijan is one of the lowest in the region. As a share of total healthcare expenditures, however, it is one of the highest. This inconsistency is due to the fact that a very large proportion of pharmaceutical purchases are made out-of-pocket. Although the availability of drug supplies has improved, the drug quality-control system must be modernized and efforts to monitor the drug supply strengthened.