Статья

Lessons from two decades of health reform in Central Asia

Bernd RechelEuropean Observatory on Health Systems and Policies, Brussels, BelgiumMohir AhmedovEuropean Observatory on Health Systems and Policies, London School of Hygiene & Tropical Medicine, London, UK, 2Department of Health Services, University of California, Los Angeles, USA, 3Health Policy Analysis Centre, Bishkek, Kyrgyzstan, 4Independent Health Policy Consultant, Toronto, Canada, 5State Surveillance Centre for Medical Activities, Ministry of Health, TajikistanBaktygul AkkazievaEuropean Observatory on Health Systems and Policies, London School of Hygiene & Tropical Medicine, London, UK, 2Department of Health Services, University of California, Los Angeles, USA, 3Health Policy Analysis Centre, Bishkek, Kyrgyzstan, 4Independent Health Policy Consultant, Toronto, Canada, 5State Surveillance Centre for Medical Activities, Ministry of Health, TajikistanAlexandr KatsagaEuropean Observatory on Health Systems and Policies, London School of Hygiene & Tropical Medicine, London, UK, 2Department of Health Services, University of California, Los Angeles, USA, 3Health Policy Analysis Centre, Bishkek, Kyrgyzstan, 4Independent Health Policy Consultant, Toronto, Canada, 5State Surveillance Centre for Medical Activities, Ministry of Health, TajikistanGhafur KhodjamurodovEuropean Observatory on Health Systems and Policies, London School of Hygiene & Tropical Medicine, London, UK, 2Department of Health Services, University of California, Los Angeles, USA, 3Health Policy Analysis Centre, Bishkek, Kyrgyzstan, 4Independent Health Policy Consultant, Toronto, Canada, 5State Surveillance Centre for Medical Activities, Ministry of Health, TajikistanMartin McKeeEuropean Observatory on Health Systems and Policies, London School of Hygiene & Tropical Medicine, London, UK, 2Department of Health Services, University of California, Los Angeles, USA, 3Health Policy Analysis Centre, Bishkek, Kyrgyzstan, 4Independent Health Policy Consultant, Toronto, Canada, 5State Surveillance Centre for Medical Activities, Ministry of Health, Tajikistan

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Аннотация

Since becoming independent at the break-up of the Soviet Union in 1991, the countries of Central Asia have made profound changes to their health systems, affecting organization and governance, financing and delivery of care. The changes took place in a context of adversity, with major political transition, economic recession, and, in the case of Tajikistan, civil war, and with varying degrees of success. In this paper we review these experiences in this rarely studied part of the world to identify what has worked. This includes effective governance, the co-ordination of donor activities, linkage of health care restructuring to new economic instruments, and the importance of pilot projects as precursors to national implementation, as well as gathering support among both health workers and the public.

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Идентификаторы

DOI: 10.1093/heapol/czr040

Цитирования и источники

Цитирований: 3Использованных источников: 0

Показатели — AkademScholar