Europe and Central Asia Knowledge Brief

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This is a regular series of notes highlighting recent analyses, good practices, and lessons learned from the development work program of the World Bank’s Europe and Central Asia Region.

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Mitigating the Impact of the Global Economic Crisis on Household Health Spending

2009-08, Docteur, Elizabeth

The ongoing financial and economic crisis has hit hard the lives of citizens in Eastern Europe and Central Asian (ECA) countries. Economic growth has started to dip, unemployment is rising and government revenues are expected to fall. The crisis is having a direct impact on the ability of households to pay for health care, a situation that will likely be exacerbated as real government spending on health care declines in many countries due to reduced revenues from the general government budget and payroll-funded health insurance. Patients may have to pay higher prices for health care, make do with reduced access to necessary health services and medicines, and face other health-related financial hardships as well. This brief draws on the experience of countries (outside ECA) in coping with public financing shortfalls, to provide suggestions for mitigating the impact on ECA households of reduced public health spending. First, however, it is important to examine private health spending patterns in the ECA region.

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World Bank Health Sector Assists Crisis-Hit Eastern Europe Countries

2009-08, Docteur, Elizabeth

In an environment characterized by growing financing constraints, the health sectors of Eastern European countries are under increased pressure to perform efficiently. Policy-makers are challenged to ensure access to health care and financial protection for vulnerable populations. To mitigate the impact of the economic crisis on government budgets, sector spending and household income, the World Bank is providing fiscal support to a number of Eastern European countries. In the health sector, these loan programs include technical assistance and policy dialogue for reforms. This knowledge brief describes how the World Bank is collaborating in health sector reform with four countries Hungary, Latvia, Poland, and Romania. It focuses on issues related to the economic crisis that threaten the financial sustainability of the health sectors in these countries and suggests reforms to mitigate the impact of the crisis.