Claudia B Maier1, José M Martin-Moreno. 1. European Observatory on Health Systems and Policies, Rue de l'Autonomie 4 B-1070 Brussels, Belgium. cma@obs.euro.who.int
Abstract
BACKGROUND: The public health systems of the post-Soviet states have evolved from the san-epid system, which dominated public health practice throughout the former Soviet Union. Since independence, reforms have taken different directions. This article provides a cross-country comparison of public health reform processes and contents in 10 post-Soviet states. METHODS: The study is descriptive and comparative, based on a literature review of the major health databases, the Health Systems in Transition (HiT) volumes and grey literature. Search terms included terms on public health, the san-epid services and organizational reforms in one or several post-Soviet states. RESULTS: Public health reforms have varied greatly: some countries have preserved the san-epid structure, some have built structures in addition to the san-epid system, and others have set up a new public health infrastructure. Traditional "functions" of the former san-epid system, such as vaccination, are still more advanced, while health promotion and intersectoral collaboration are less developed. CONCLUSION: Critical self-evaluation, implementation of performance measurement and rigorous external research will prove essential in identifying strengths and weaknesses of past reforms and learning for the future.
BACKGROUND: The public health systems of the post-Soviet states have evolved from the san-epid system, which dominated public health practice throughout the former Soviet Union. Since independence, reforms have taken different directions. This article provides a cross-country comparison of public health reform processes and contents in 10 post-Soviet states. METHODS: The study is descriptive and comparative, based on a literature review of the major health databases, the Health Systems in Transition (HiT) volumes and grey literature. Search terms included terms on public health, the san-epid services and organizational reforms in one or several post-Soviet states. RESULTS: Public health reforms have varied greatly: some countries have preserved the san-epid structure, some have built structures in addition to the san-epid system, and others have set up a new public health infrastructure. Traditional "functions" of the former san-epid system, such as vaccination, are still more advanced, while health promotion and intersectoral collaboration are less developed. CONCLUSION: Critical self-evaluation, implementation of performance measurement and rigorous external research will prove essential in identifying strengths and weaknesses of past reforms and learning for the future.
Authors: Stojgniew J Sitko; Iwona Kowalska-Bobko; Anna Mokrzycka; Michał Zabdyr-Jamróz; Alicja Domagała; Nicola Magnavita; Andrea Poscia; Maciej Rogala; Anna Szetela; Stanisława Golinowska Journal: BMC Health Serv Res Date: 2016-09-05 Impact factor: 2.655