Challenges on the Path to Universal Health Coverage : The Experience of Azerbaijan

Bonilla-Chacin, Maria Eugenia ; Afandiyeva, Gulara ; Suaya, Agustina

World Bank, Washington, DC

关键词: UNIVERSAL HEALTH COVERAGE;    HEALTH FINANCE;    HEALTH SYSTEM REFORM;    PUBLIC HEALTH;    PRIMARY HEALTHCARE;   

RP-ID  :  122830

学科分类：社会科学、人文和艺术（综合）

来源: World Bank Open Knowledge Repository

【 摘 要 】

The objectives of this case study are toassess how the poor fared as a result of recent effortstoward universal health coverage in Azerbaijan, and toprovide an overview of the government’s planned additionalreforms, in the context of a difficult economic and fiscalsituation.The case study will first focus on how the poorhave fared as a result of Azerbaijan’s efforts in the lastdecade to improve health coverage and population financialprotection in case of illness. These efforts occurred duringa period of strong economic performance driven bynatural-resource-based economic growth. Thanks toimprovements in oil and gas revenues, public expenditure onhealth increased six-fold since 2000. Although theorganization and functioning of the system did notsignificantly change during this period, the additionalresources were used to provide pharmaceuticals and medicalsupplies at no cost to the population and to refurbish thehealth care infrastructure. During this time, the number ofdrugs and medical supplies provided at no cost in inpatientcare increased, while the list of outpatient care drugs andmedical supplies that were provided at no cost to eligiblepopulation groups either increased or became more widelyavailable.The positive economic and fiscal outlook thecountry enjoyed from the mid-2000s has significantly changedin the last two years due to a sharp decrease in oil prices.This difficult context, as well as continuous challenges inensuring financial protection and access to services, hashighlighted the need for health financing reform, as well asreform of the functioning and organization of the healthsystem. In this context, the country recently renewedprevious efforts toward implementation of a Mandatory SocialHealth Insurance scheme, which was mandated in 2007. Tocontribute to the country’s policy debates, the secondobjective of this case study is to discuss how this reformplan could further contribute to universal health coverage,and what challenges the country would face in its implementation.