Tajikistan : Review of Public Expenditures on Health

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collection.link.9
https://openknowledge.worldbank.org/handle/10986/2109
collection.name.9
Public Expenditure Review
dc.contributor.author
World Bank
dc.date.accessioned
2014-12-17T21:36:13Z
dc.date.available
2014-12-17T21:36:13Z
dc.date.issued
2013-08
dc.description.abstract
This policy note is part of the World Bank's Programmatic Public Expenditure Review (PER) work program for FY2012-2014. The PER consists of a series of fiscal policy notes, which aim at providing the Government of Tajikistan with recommendations to strengthen budgetary processes and analysis. This policy note, the second in the series, examines public expenditures on health in Tajikistan. After an introductory section, the note describes the institutional and administrative structure of the health sector. Section 3 presents health outcomes and health care utilization indicators. Section 4 describes health financing in Tajikistan and presents the main options to expand fiscal space for health. Section 5 reviews the health financing and organizational reforms implemented in Tajikistan. Section 6 provides the main conclusions: 1) despite progress, health sector outcomes are mixed in Tajikistan and utilization pattern of health services is characterized by significant inequalities; 2) public spending on health is relatively low and skewed towards hospitals rather than outpatient care; 3) the hospital sector is characterized by oversupply of beds, avoidable inpatient admissions, low occupancy rates, and excessive average length of stay; 4) an increase in public health expenditures since 2000 was largely driven by the expanding wage bill, while other expenditures had been compressed; 5) public health expenditures show a regressive incidence, with the distribution of inpatient care more pro-rich than outpatient care; 6) the large reliance on out-of-pocket produces a high incidence of catastrophic spending; 7) a number of health financing and organizational reforms have been initiated since 2000, but the scope and coverage is still limited; and 8) the overall prospect for increasing fiscal space for health in Tajikistan are positive, with rationalization of both the overall budget and the public health delivery system.
en
dc.identifier
http://documents.worldbank.org/curated/en/2013/08/19760470/review-public-expenditures-health
dc.identifier.uri
http://hdl.handle.net/10986/20771
dc.language
English
dc.language.iso
en_US
dc.publisher
Washington, DC
dc.relation.ispartofseries
Takijistan policy notes on public expenditures;policy note no. 2
dc.rights
CC BY 3.0 IGO
dc.rights.uri
http://creativecommons.org/licenses/by/3.0/igo/
dc.subject
FISCAL SPACE
dc.subject
HEALTHCARE USE
dc.subject
HEALTH FINANCING
dc.subject
HEALTH OUTCOMES
dc.subject
HEALTH SECTOR
dc.subject
HEALTH SERVICE INEQUALITY
dc.subject
ORGANIZATIONAL REFORMS
dc.subject
PUBLIC HEALTH EXPENDITURES
dc.title
Tajikistan : Review of Public Expenditures on Health
en
okr.date.disclosure
2014-10-20
okr.doctype
Economic & Sector Work :: Public Expenditure Review
okr.docurl
http://documents.worldbank.org/curated/en/2013/08/19760470/review-public-expenditures-health
okr.globalpractice
Health, Nutrition, and Population
okr.globalpractice
Governance
okr.globalpractice
Macroeconomics and Fiscal Management
okr.googlescholar.linkpresent
yes
okr.identifier.externaldocumentum
000469775_20140703132655
okr.identifier.internaldocumentum
19760470
okr.identifier.report
89181
okr.language.supported
en
okr.pdfurl
http://www-wds.worldbank.org/external/default/WDSContentServer/WDSP/IB/2014/07/03/000469775_20140703132655/Rendered/PDF/891810NWP0P14700TJK0NOTE20final0web.pdf
en
okr.region.administrative
Europe and Central Asia
okr.region.country
Tajikistan
okr.sector
Public Administration, Law, and Justice :: General public administration sector
okr.sector
Energy and mining :: General energy sector
okr.sector
Transportation
okr.sector
Water, sanitation and flood protection
okr.sector
Industry and trade
okr.theme
Economic management :: Debt management and fiscal sustainability
okr.theme
Economic management :: Macroeconomic management
okr.theme
Public sector governance :: Public expenditure, financial management and procurement
okr.theme
Public sector governance :: Other accountability/anti-corruption
okr.theme
Public sector governance :: Managing for development results
okr.topic
Health Monitoring and Evaluation
okr.topic
Public Sector Expenditure Policy
okr.topic
Health Economics and Finance
okr.topic
Health Systems Development and Reform
okr.topic
Health, Nutrition and Population :: Population Policies
okr.topic
Public Sector Development
okr.unit
Poverty Reduction and Economic Management Sector Unit, Europe and Central Asia Region

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