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The Lancet. Health and health systems in the Commonwealth of Independent States
[Source: The Lancet, full text: (LINK). Abstract, edited.]
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The Lancet, Early Online Publication, 27 March 2013
doi:10.1016/S0140-6736(12)62084-4
Health and health systems in the Commonwealth of Independent States
Original Text
Dr Bernd Rechel PhD a b, Bayard Roberts PhD b, Erica Richardson PhD a b, Prof Sergey Shishkin PhD c, Prof Vladimir M Shkolnikov PhD d e, Prof David A Leon MD b, Prof Martin Bobak PhD f, Marina Karanikolos MSc a b, Prof Martin McKee MD a b
Summary
The countries of the Commonwealth of Independent States differ substantially in their post-Soviet economic development but face many of the same challenges to health and health systems. Life expectancies dropped steeply in the 1990s, and several countries have yet to recover the levels noted before the dissolution of the Soviet Union. Cardiovascular disease is a much bigger killer in the Commonwealth of Independent States than in western Europe because of hazardous alcohol consumption and high smoking rates in men, the breakdown of social safety nets, rising social inequality, and inadequate health services. These former Soviet countries have embarked on reforms to their health systems, often aiming to strengthen primary care, scale back hospital capacities, reform mechanisms for paying providers and pooling funds, and address the overall shortage of public funding for health. However, major challenges remain, such as frequent private out-of-pocket payments for health care and underdeveloped systems for improvement of quality of care.
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a European Observatory on Health Systems and Policies, London School of Hygiene & Tropical Medicine, London, UK; b European Centre on Health of Societies in Transition, London School of Hygiene & Tropical Medicine, London, UK; c Higher School of Economics, Moscow, Russia; d Laboratory of Demographic Data, Max Planck Institute for Demographic Research, Rostock, Germany; e Center for Demographic Research, New Economic School, Moscow, Russia; f University College London, London, UK
Correspondence to: Dr Bernd Rechel, London School of Hygiene & Tropical Medicine, 15?17 Tavistock Place, London WC1H 9SH, UK
-doi:10.1016/S0140-6736(12)62084-4
Health and health systems in the Commonwealth of Independent States
Original Text
Dr Bernd Rechel PhD a b, Bayard Roberts PhD b, Erica Richardson PhD a b, Prof Sergey Shishkin PhD c, Prof Vladimir M Shkolnikov PhD d e, Prof David A Leon MD b, Prof Martin Bobak PhD f, Marina Karanikolos MSc a b, Prof Martin McKee MD a b
Summary
The countries of the Commonwealth of Independent States differ substantially in their post-Soviet economic development but face many of the same challenges to health and health systems. Life expectancies dropped steeply in the 1990s, and several countries have yet to recover the levels noted before the dissolution of the Soviet Union. Cardiovascular disease is a much bigger killer in the Commonwealth of Independent States than in western Europe because of hazardous alcohol consumption and high smoking rates in men, the breakdown of social safety nets, rising social inequality, and inadequate health services. These former Soviet countries have embarked on reforms to their health systems, often aiming to strengthen primary care, scale back hospital capacities, reform mechanisms for paying providers and pooling funds, and address the overall shortage of public funding for health. However, major challenges remain, such as frequent private out-of-pocket payments for health care and underdeveloped systems for improvement of quality of care.
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a European Observatory on Health Systems and Policies, London School of Hygiene & Tropical Medicine, London, UK; b European Centre on Health of Societies in Transition, London School of Hygiene & Tropical Medicine, London, UK; c Higher School of Economics, Moscow, Russia; d Laboratory of Demographic Data, Max Planck Institute for Demographic Research, Rostock, Germany; e Center for Demographic Research, New Economic School, Moscow, Russia; f University College London, London, UK
Correspondence to: Dr Bernd Rechel, London School of Hygiene & Tropical Medicine, 15?17 Tavistock Place, London WC1H 9SH, UK
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