Publication: Kosovo : Report on Management Accountability in the Health Sector

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Gaumer, Gary
This report assesses the opportunities for improving the performance of the government health sector in Kosovo through better management and improved information for managers. Specifically, it concerns the kinds of information used by managers in the health system, and indications of demand for additional data and performance measures. Overall, we try to assess the need for new investments in information technology in the health system as a means for improving health system performance. The health system in Kosovo is a government system of six regional hospitals, several smaller facilities; all supported by a large tertiary university hospital and associated specialists in Prishtina, and a set of municipally-managed primary health centers (and their subordinate health houses and ambulances throughout the countryside). Written referrals are required for secondary and tertiary care. Essential drugs are free in the clinics, if available. The government operates and finances this system in a traditional line budget way by paying salaries directly from the Ministry of Economics and Finance (MOF), and setting strict budget limits for facility managers for goods and services and capital. Municipalities receive a capitation grant from the MOF to help to finance the clinics. Modest co payments are collected for ambulatory care. There is essentially no private insurance. Health behaviors are poor, particularly relating to reproductive health, where maternal and birth outcomes are very poor. Most telling about the service quality of the government health system, the use of the private sector and nearby out-of-country providers is growing, and may now exceed 50 percent of ambulatory care used by citizens. The report summarizes the data collection activities (section two), the framework for analysis (section three), the findings from the study (section four), recommendations (section five). Annexes contain data gathering forms and protocols referenced in the text.
Gaumer, Gary. 2007. Kosovo : Report on Management Accountability in the Health Sector. © World Bank, Washington, DC. License: CC BY 3.0 IGO.
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