Publication:
Challenges on the Path to Universal Health Coverage: The Experience of Azerbaijan

Loading...
Thumbnail Image
Files in English
English PDF (1.44 MB)
3,329 downloads
English Text (119.69 KB)
57 downloads
Date
2018-01
ISSN
Published
2018-01
Editor(s)
Abstract
The objectives of this case study are to assess how the poor fared as a result of recent efforts toward universal health coverage in Azerbaijan, and to provide an overview of the government’s planned additional reforms, in the context of a difficult economic and fiscal situation.The case study will first focus on how the poor have fared as a result of Azerbaijan’s efforts in the last decade to improve health coverage and population financial protection in case of illness. These efforts occurred during a period of strong economic performance driven by natural-resource-based economic growth. Thanks to improvements in oil and gas revenues, public expenditure on health increased six-fold since 2000. Although the organization and functioning of the system did not significantly change during this period, the additional resources were used to provide pharmaceuticals and medical supplies at no cost to the population and to refurbish the health care infrastructure. During this time, the number of drugs and medical supplies provided at no cost in inpatient care increased, while the list of outpatient care drugs and medical supplies that were provided at no cost to eligible population groups either increased or became more widely available.The positive economic and fiscal outlook the country enjoyed from the mid-2000s has significantly changed in the last two years due to a sharp decrease in oil prices. This difficult context, as well as continuous challenges in ensuring financial protection and access to services, has highlighted the need for health financing reform, as well as reform of the functioning and organization of the health system. In this context, the country recently renewed previous efforts toward implementation of a Mandatory Social Health Insurance scheme, which was mandated in 2007. To contribute to the country’s policy debates, the second objective of this case study is to discuss how this reform plan could further contribute to universal health coverage, and what challenges the country would face in its implementation.
Link to Data Set
Citation
Bonilla-Chacin, Maria Eugenia; Afandiyeva, Gulara; Suaya, Agustina. 2018. Challenges on the Path to Universal Health Coverage: The Experience of Azerbaijan. Universal Health Coverage Studies Series;No. 28. © World Bank. http://hdl.handle.net/10986/29180 License: CC BY 3.0 IGO.
Associated URLs
Associated content
Report Series
Other publications in this report series
Journal
Journal Volume
Journal Issue

Related items

Showing items related by metadata.

  • Publication
    Learning from the Mexican Experience with Taxes on Sugar-Sweetened Beverages and Energy-Dense Foods of Low Nutritional Value
    (World Bank, Washington, DC, 2016-06) Bonilla-Chacin, Maria Eugenia; Iglesias, Roberto; Suaya, Agustina; Trezza, Claudia; Macías, Claudia
    Faced with a large and increasing obesity epidemic, the Mexican Government in the last years has increased efforts to prevent and control it. In October 2013, Mexico’s Congress passed legislation imposing taxes on sugar-sweetened beverages (SSBs) and calorie-dense foods of low nutritional value. These taxes were part of a comprehensive strategy to prevent and control obesity, overweight and diabetes. In addition to fiscal policy and regulation, this strategy included other health promotion and prevention interventions as well as measures to ensure better access to effective health care services. The decision to implement this fiscal policy was the result of a long advocacy process in which different actors participated, including civil society organizations and government agencies, which provided needed evidence on the status of the epidemic and options to fight against it. The taxes were designed to avoid, as much as possible, the substitution of consumption of the taxed goods for other unhealthy foods and beverages not subject to taxation. These taxes have been successful in increasing both the fiscal revenues and the price of the products taxed. There is also evidence that they have reduced consumption, particularly of SSBs. The taxes seem to have the highest impact among people in the poorest quintiles of the income distribution, who had experienced the highest increase in consumption of the goods under taxation in the last years. A debate remains on the actual impact of the taxes, particularly on health outcomes. Thus it is important to continue monitoring the impact of the taxes through the development of price and volume indicators, based on publicly available data, as well as health outcome indicators.
  • Publication
    Vietnam : Learning from Smart Reforms on the Road to Universal Health Coverage
    (World Bank Group, Washington, DC, 2014-08) Barroy, Helene; Jarawan, Eva; Bales, Sarah
    Universal Health Coverage is a powerful framework for a nation aiming to protect their population against health risks. However, countries face multiple challenges in implementing, achieving and sustaining UHC strategies. Sharing and learning from diverse country experiences may enable to foster global and country progress toward that goal. The study seeks to contribute to the global effort of sharing potentially useful lessons to address policy concerns on the design and implementation of UHC strategies in LMICs. Vietnam is one of the LMICs that have taken relatively quick and effective actions to expand health coverage and improve financial protection in the last two decades. The country study, first, takes stock of UHC progress in Vietnam, examining both the breadth and the depth of health coverage and assessing financial protection and equity outputs (chapter one). Chapter two includes an in-depth analysis of some of the major success strategies and policy actions that the country took to expand health coverage and financial protection for all, including for the poor. Chapter three focuses on some of the UHC-related challenges that the country faces in pursuing expansion and sustaining UHC. Vietnam s experience suggests that, moving toward greater UHC outputs, the system must be constantly adjusted, and that UHC strategies must be adaptive, those used in the past to cover the formal sector and the poor may turn out inadequate to reach the uninsured in the informal sector.
  • Publication
    Prevention of Health Risk Factors in Latin America and the Caribbean : Governance of Five Multisectoral Efforts
    (World Bank, Washington, DC, 2014) Bonilla-Chacin, Maria Eugenia; Bonilla-Chacin, Maria Eugenia
    Non-communicable diseases (NCDs) represent an important and growing burden to the health and economies of the Latin America and the Caribbean (LAC) region. However, some of this burden can be prevented or controlled through targeted clinical services and multi-sectoral activities aimed at improving diet, promoting physical activity, and reducing tobacco use and alcohol abuse. This study focuses on population-wide, multi-sectoral interventions to prevent risk factors for NCDs. This study seeks to answer the following questions: what is the health and economic burden of NCDs in the region?; what are countries doing to promote healthy living and prevent risk factors for NCDs?; what are the main governance challenges countries face in developing and implementing population-wide NCD prevention interventions and which are the success stories?; and what else can the region do to reduce health risk factors and prevent the onset of NCDs? This study documents governance challenges in the design and implementation of promising or successful population-wide interventions intended to prevent health risk factors in LAC. It focuses on the process whereby public officials develop and implement primary-prevention policies and programs. It is composed of five commissioned case studies on multi-sectoral interventions to promote healthy living in the region. These case studies examine which stakeholders participated directly or indirectly in the decision-making process; what positions they held; which incentives they faced; which strategies they pursued; how did existing institutional arrangements affect the decision-making process; what lessons can be drawn from these processes; and what were the successes and setbacks? This report provides a glimpse into the types of opposing interests and power games involved in proposing, passing, and implementing successful or promising population-based health interventions in LAC. The aim is to provide information on the struggles and challenges involved in the design and implementation of policies, presenting an array of possible instruments and models that can be useful and adaptable to specific scenarios.
  • Publication
    Universal Health Coverage and the Challenge of Informal Employment : Lessons from Developing Countries
    (World Bank, Washington, DC, 2014-01) Bitran, Ricardo
    The aim of the report is to review existing approaches and available policy options to improve access to health care services and financial protection against health shocks for informal-sector workers (ISWs). Along with their families, ISWs represent the majority of the population in many developing countries. The report reviews the definition and measurement of the informal sector and the literature on efforts toward its health insurance coverage. It also examines several country cases based on published and unpublished reports and on structured interviews of expert informants. Developing country efforts to expand health coverage are characterized by a common enrollment and financing pattern, starting with formal-sector workers and following with government-subsidized enrollment of the poor. Thus, ISWs are typically left behind and have been referred to as "the missing middle." They find themselves financially unprotected against health shocks and with limited access to quality and timely health care. ISWs are generally reluctant to enroll in insurance schemes, including social health insurance (SHI), community insurance, and other arrangements. Further, initiatives to enroll them in self-financed contributory schemes have generally resulted in adverse selection, as those with high anticipated health needs are more willing to pay and enroll than others. Successful initiatives to cover this population group are the ones where government has abandoned its expectations to derive relatively substantial revenue from it. Offering this group a benefits package that is relatively smaller than that of formal workers and charging them a premium that is only a fraction of that charged to formal workers is a strategy used by some countries to limit the need for public subsidies. While there is evidence that greater insurance coverage has improved access to health services for ISWs and their dependents, in several countries it has not yet improved financial protection for this target group. A broad set of reforms will be required to strengthen the supply side to ensure that additional public financing translates into improved coverage for ISWs.
  • Publication
    Integrating the Poor into Universal Health Coverage in Vietnam
    (World Bank, Washington DC, 2013-01) Dao, Huong Lan; Somanathan, Aparnaa; Tien, Tran Van
    This case study is aimed at providing a descriptive assessment of the key features of Vietnam's Social Health Insurance (SHI), focusing on the impediments to integrating the poor into universal coverage. The trajectory of SHI in Vietnam is similar to that of many other countries in the East Asia and Pacific region. The poor were covered under a separate Health Care Fund for the Poor to begin with. The 2009 Law on Health Insurance merged all of the different programs into one. Health insurance premiums for the poor were fully subsidized by the government and enrolment became mandatory, resulting in almost complete enrollment of the poor by 2011. Vietnam has combined elements of contributory social health insurance with substantial levels of tax financing to provide coverage for the poor and informal sector. The case study is structured as follows. Section 2 describes the institutional structure and system characteristics of Vietnam's SHI. Section 3 addresses the main topic of the case study - the impediments to integrating the poor. Section 4 concludes by addressing the pending agenda.

Users also downloaded

Showing related downloaded files

  • Publication
    Argentina Country Climate and Development Report
    (World Bank, Washington, DC, 2022-11) World Bank Group
    The Argentina Country Climate and Development Report (CCDR) explores opportunities and identifies trade-offs for aligning Argentina’s growth and poverty reduction policies with its commitments on, and its ability to withstand, climate change. It assesses how the country can: reduce its vulnerability to climate shocks through targeted public and private investments and adequation of social protection. The report also shows how Argentina can seize the benefits of a global decarbonization path to sustain a more robust economic growth through further development of Argentina’s potential for renewable energy, energy efficiency actions, the lithium value chain, as well as climate-smart agriculture (and land use) options. Given Argentina’s context, this CCDR focuses on win-win policies and investments, which have large co-benefits or can contribute to raising the country’s growth while helping to adapt the economy, also considering how human capital actions can accompany a just transition.
  • Publication
    The Journey Ahead
    (Washington, DC: World Bank, 2024-10-31) Bossavie, Laurent; Garrote Sánchez, Daniel; Makovec, Mattia
    The Journey Ahead: Supporting Successful Migration in Europe and Central Asia provides an in-depth analysis of international migration in Europe and Central Asia (ECA) and the implications for policy making. By identifying challenges and opportunities associated with migration in the region, it aims to inform a more nuanced, evidencebased debate on the costs and benefits of cross-border mobility. Using data-driven insights and new analysis, the report shows that migration has been an engine of prosperity and has helped address some of ECA’s demographic and socioeconomic disparities. Yet, migration’s full economic potential remains untapped. The report identifies multiple barriers keeping migration from achieving its full potential. Crucially, it argues that policies in both origin and destination countries can help maximize the development impacts of migration and effectively manage the economic, social, and political costs. Drawing from a wide range of literature, country experiences, and novel analysis, The Journey Ahead presents actionable policy options to enhance the benefits of migration for destination and origin countries and migrants themselves. Some measures can be taken unilaterally by countries, whereas others require close bilateral or regional coordination. The recommendations are tailored to different types of migration— forced displacement as well as high-skilled and low-skilled economic migration—and from the perspectives of both sending and receiving countries. This report serves as a comprehensive resource for governments, development partners, and other stakeholders throughout Europe and Central Asia, where the richness and diversity of migration experiences provide valuable insights for policy makers in other regions of the world.
  • Publication
    Classroom Assessment to Support Foundational Literacy
    (Washington, DC: World Bank, 2025-03-21) Luna-Bazaldua, Diego; Levin, Victoria; Liberman, Julia; Gala, Priyal Mukesh
    This document focuses primarily on how classroom assessment activities can measure students’ literacy skills as they progress along a learning trajectory towards reading fluently and with comprehension by the end of primary school grades. The document addresses considerations regarding the design and implementation of early grade reading classroom assessment, provides examples of assessment activities from a variety of countries and contexts, and discusses the importance of incorporating classroom assessment practices into teacher training and professional development opportunities for teachers. The structure of the document is as follows. The first section presents definitions and addresses basic questions on classroom assessment. Section 2 covers the intersection between assessment and early grade reading by discussing how learning assessment can measure early grade reading skills following the reading learning trajectory. Section 3 compares some of the most common early grade literacy assessment tools with respect to the early grade reading skills and developmental phases. Section 4 of the document addresses teacher training considerations in developing, scoring, and using early grade reading assessment. Additional issues in assessing reading skills in the classroom and using assessment results to improve teaching and learning are reviewed in section 5. Throughout the document, country cases are presented to demonstrate how assessment activities can be implemented in the classroom in different contexts.
  • Publication
    Lebanon Economic Monitor, Fall 2022
    (Washington, DC, 2022-11) World Bank
    The economy continues to contract, albeit at a somewhat slower pace. Public finances improved in 2021, but only because spending collapsed faster than revenue generation. Testament to the continued atrophy of Lebanon’s economy, the Lebanese Pound continues to depreciate sharply. The sharp deterioration in the currency continues to drive surging inflation, in triple digits since July 2020, impacting the poor and vulnerable the most. An unprecedented institutional vacuum will likely further delay any agreement on crisis resolution and much needed reforms; this includes prior actions as part of the April 2022 International Monetary Fund (IMF) staff-level agreement (SLA). Divergent views among key stakeholders on how to distribute the financial losses remains the main bottleneck for reaching an agreement on a comprehensive reform agenda. Lebanon needs to urgently adopt a domestic, equitable, and comprehensive solution that is predicated on: (i) addressing upfront the balance sheet impairments, (ii) restoring liquidity, and (iii) adhering to sound global practices of bail-in solutions based on a hierarchy of creditors (starting with banks’ shareholders) that protects small depositors.
  • Publication
    World Development Report 2006
    (Washington, DC, 2005) World Bank
    This year’s Word Development Report (WDR), the twenty-eighth, looks at the role of equity in the development process. It defines equity in terms of two basic principles. The first is equal opportunities: that a person’s chances in life should be determined by his or her talents and efforts, rather than by pre-determined circumstances such as race, gender, social or family background. The second principle is the avoidance of extreme deprivation in outcomes, particularly in health, education and consumption levels. This principle thus includes the objective of poverty reduction. The report’s main message is that, in the long run, the pursuit of equity and the pursuit of economic prosperity are complementary. In addition to detailed chapters exploring these and related issues, the Report contains selected data from the World Development Indicators 2005‹an appendix of economic and social data for over 200 countries. This Report offers practical insights for policymakers, executives, scholars, and all those with an interest in economic development.