This report assesses the opportunitiesfor improving the performance of the government healthsector in Kosovo through better management and improvedinformation for managers. Specifically, it concerns thekinds of information used by managers in the health system,and indications of demand for additional data andperformance measures. Overall, we try to assess the need fornew investments in information technology in the healthsystem as a means for improving health system performance.The health system in Kosovo is a government system of sixregional hospitals, several smaller facilities; allsupported by a large tertiary university hospital andassociated specialists in Prishtina, and a set ofmunicipally-managed primary health centers (and theirsubordinate health houses and ambulances throughout thecountryside). Written referrals are required for secondaryand tertiary care. Essential drugs are free in the clinics,if available. The government operates and finances thissystem in a traditional line budget way by paying salariesdirectly from the Ministry of Economics and Finance (MOF),and setting strict budget limits for facility managers forgoods and services and capital. Municipalities receive acapitation grant from the MOF to help to finance theclinics. Modest co payments are collected for ambulatorycare. There is essentially no private insurance. Healthbehaviors are poor, particularly relating to reproductivehealth, where maternal and birth outcomes are very poor.Most telling about the service quality of the governmenthealth system, the use of the private sector and nearbyout-of-country providers is growing, and may now exceed 50percent of ambulatory care used by citizens. The reportsummarizes the data collection activities (section two), theframework for analysis (section three), the findings fromthe study (section four), recommendations (section five).Annexes contain data gathering forms and protocolsreferenced in the text.
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