A Survey of Health Reform in Central Asia, Volumes 23-344

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World Bank Publications, Jan 1, 1996 - Medical - 58 pages
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World Bank Technical Paper No. 352. Six years into the transition from planned to market economies in Central and Eastern Europe, high unemployment rates, including a growing proportion of the long-term unemployed, represent a serious challenge to social welfare systems and policymakers. This paper analyzes labor market development in nine transition countries of the region by focusing on the dynamics of labor force behavior, employment, and unemployment. The countries include Bulgaria, Croatia, the Czech Republic, the Former Yugoslav Republic of Macedonia, Hungary, Poland, Romania, the Slovak Republic, and Slovenia.

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Page 19 - The health sector appears to have been somewhat protected, at least in terms of its share in a declining economy in Azerbaijan, Tajikistan, and Uzbekistan. The elasticities of health spending relative to GDP (that is, the annual percentage change in health spending relative to the annual percentage change in GDP) for all six countries
Page 37 - the Central Asian countries is to improve the health status of their populations at a time of economic decline, while maintaining the strengths of the old system in terms of equity and access. Countries need to maximize the efficiency and effectiveness of their systems subject to the limited funding available. Since 1990, all
Page 17 - relied on by governments as an employment maintenance mechanism. These problems are fundamental and affect almost every aspect of the financing and delivery of health care at all levels in Central Asia and virtually all other FSU countries. Nonetheless, the system retains substantial elements of success.
Page 36 - that national governments not abrogate their public health, staff training, environmental health and quality assurance functions as the transition to insurance-based and decentralized systems pervades the reforms in most countries. The Central Asian countries
Page 30 - Benefits Deciding what benefits to cover has become increasingly problematic. People in Central Asia are accustomed to a system that, at least in theory, provided all the necessary care to treat
Page 15 - the public financing authority owned, budgeted, and managed facilities). Service Delivery System: The system was conceptually a well-integrated hierarchical structure of feldsher stations, health posts, polyclinics, and local, regional and
Page 28 - Financing Most of the focus in the current reform debates has been on financing~raising revenues available for health care. Given the large declines in national income and budget revenue, described
Page 19 - An elasticity of 0.87 means that a 10 percent change in GDP was accompanied by an 8.7 percent change in health spending.
Page 30 - individual's condition free of charge. Costs did not escalate out of control because of budget caps and supply constraints, constraints

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About the author (1996)

Klugman is Senior Economist in the Poverty Reduction and Economic Management group, the World Bank.