Europe and Central Asia Knowledge Brief

2010-10, Marquez, Patricio V., Lebedeva, Nadezhda

The delivery of health services in Russia is a federal, regional and municipal responsibility. Reform of the regional health systems, which suffer from over-reliance on curative and inpatient care, deteriorating infrastructure and equipment, and poor quality of services, is a major challenge for the country. From 2003-2008, the World Bank helped strengthen the stewardship capacity of Russia's Federal Ministry of Health and Social Development (MOHSD) and restructure health systems in two pilot regions: the Chuvash Republic and Voronezh oblast. In both regions, hospital bed numbers were reduced while simultaneously increasing service delivery capacity at the primary care, specialized ambulatory, and long-term care facility levels through the introduction of new technologies, clinical protocols, and resource allocation mechanisms that link payments to performance.

2010-09, Marquez, Patricio V., Jakubowiak, Wieslaw, Pashkevich, Dmitry D., Grechukha, Vladimir A.

Across Russia, the deep socio-economic crisis of the 1990s and early 2000s provided fertile ground for the spread of Tuberculosis (TB). Indeed, as noted, 'people who were already living very precariously saw their real incomes drop by 25 percent to 30 percent at a time when government spending was also falling.' As a result, social and health conditions deteriorated, and TB spread rapidly. Russia also had one of the highest rates of imprisonment in the world that, coupled with adverse conditions in prisons, increased the risk of TB, HIV and other infectious diseases among prisoners. The Project was designed in accordance with the federal targeted social disease prevention and control program (2002-2006). About 80 percent of project funds were allocated for TB control with the goal of contributing to a leveling-off or reduction in morbidity, mortality and transmission of TB. The project covered 79 of the 83 regions across the vast Russian territory - from the Baltic Sea to the Pacific Ocean, strengthening both the civilian and prison health systems.