This Functional Review was carried by aBank team upon request by the Government of Romania. As astarting point, it shows that: (i) health outcomes inRomania lag behind those of the EU; (ii) users are notsatisfied with its lack of responsiveness - long lines,informal payments, discourteous handling of patients, poorcleanliness, lack of maintenance, and breach of safetymeasures; (iii) the poor and other vulnerable groups (forexample Roma communities) suffer from a significant lack ofaccess to services; and (iv) the fiscal contraction of2008-2010 exposed the weakness of financial controls in thehealth sector. The Review examines four health functions indepth: service delivery, financing, stewardship andresources (including pharmaceuticals). Based on ourfindings, we present recommendations categorized by thethree set of challenges that the sector is facing: (i)improving governance and management; (ii) streamlining thehealth service network and re-launching quality controlsystems; and (iii) increasing preventive services andequity. For any expansion of the sector to be sustainable, anumber of pre-requisites will need to be in place, includinga private sector development strategy, stronger fiscalcontrols, a system of health technology assessment, andstronger management in key agencies.
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