Armenia: health system review
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World Health Organization. Regional Office for Europe
Abstract
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99 p.
This analysis of the Armenian health system reviews the developmentsin organization and governance, health financing, health care provision,health reforms and health system performance since 2006.Armenia inherited a Semashko-style health system on independence fromthe Soviet Union in 1991. Initial severe economic and sociopolitical difficultiesduring the 1990s affected the population health, though strong economic growthfrom 2000 benefited the population’s health. Nevertheless, the Armenian healthsystem remains unduly tilted towards inpatient care concentrated in the capitalcity despite overall reductions in hospital beds and concerted efforts to reformprimary care provision. Changes in health system financing since independencehave been more profound, as out-of-pocket payments now account forover half of total health expenditure. This reduces access to essential servicesfor the poorest households – particularly for inpatient care and pharmaceuticals– and many households face catastrophic health expenditure. Improving healthsystem performance and financial equity are therefore the key challenges forhealth system reform. The scaling up of some successful recent programmes formaternal and child health may offer solutions, but require sustained financialresources that will be challenging in the context of financial austerity and thelow base of public financing.
This analysis of the Armenian health system reviews the developmentsin organization and governance, health financing, health care provision,health reforms and health system performance since 2006.Armenia inherited a Semashko-style health system on independence fromthe Soviet Union in 1991. Initial severe economic and sociopolitical difficultiesduring the 1990s affected the population health, though strong economic growthfrom 2000 benefited the population’s health. Nevertheless, the Armenian healthsystem remains unduly tilted towards inpatient care concentrated in the capitalcity despite overall reductions in hospital beds and concerted efforts to reformprimary care provision. Changes in health system financing since independencehave been more profound, as out-of-pocket payments now account forover half of total health expenditure. This reduces access to essential servicesfor the poorest households – particularly for inpatient care and pharmaceuticals– and many households face catastrophic health expenditure. Improving healthsystem performance and financial equity are therefore the key challenges forhealth system reform. The scaling up of some successful recent programmes formaternal and child health may offer solutions, but require sustained financialresources that will be challenging in the context of financial austerity and thelow base of public financing.