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Health Targets in the Former Soviet Countries: Responding to the NCD Challenge?
Public Health Reviews volume 35, Article number: 6 (2013)
Abstract
This article examines health target-setting in 12 former Soviet countries: Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, Tajikistan, Turkmenistan, Ukraine, and Uzbekistan. We explored which health targets were set out in national health strategies and within the context of the United Nations initiative on the Millennium Development Goals (MDGs). We found that few former Soviet countries embraced health targets in national health strategies that were quantitative and time-bound. In contrast, measurable and time-bound targets were adopted by almost all countries in the region within the MDG initiative. As the MDG initiative failed to reflect the considerable burden of non-communicable disease in the region, and focussed entirely on communicable disease and mother and child health, this meant that health targets were missing for one of the most severe health challenges in the former Soviet countries. The quality of health data that could guide national health policies is another major challenge for the control of both communicable and non-communicable disease, as well as improvements in mother and child health.
References
van Herten LM, Gunning-Schepers LJ. Targets as a tool in health policy: Part I: lessons learned. Health Policy. 2000;53:1–11.
Ritsatakis A. Experience in setting targets for health in Europe. Eur J Public Health. 2000;4:7–10.
World Health Organization. Targets for Health for All. Copenhagen: WHO, Regional Office for Europe; 1985.
Wismar M, McKee M, Ernst K, Srivastava D, Busse R. Introduction. In: Wismar M, McKee M, Ernst K, Srivastava D, Busse R, (editors). Health Targets in Europe–Learning from Experience. World Health Organization on behalf of the European Observatory on Health Systems and Policies; 2008. p.1–6.
Wismar M, Busse R. Outcome-related health targets—political strategies for better health outcomes: a conceptual and comparative study (part 2). Health Policy. 59:223–41.
Ernst K, Wismar M, Busse R, McKee M. Improving the Effectiveness of Health Targets. Health Targets in Europe–Learning from experience. Copenhagen: European Observatory on Health Systems and Policies; 2008. p.42–9.
Smith PC, Busse R. Learning from the European experience of using targets to improve population health. Prev Chronic Dis. 15 August 2010. 7;5:A102. Epub.
Rechel B, Roberts B, Richardson E, Shishkin S, Shkolnikov V, et al. Health and health systems in the Commonwealth of Independent States. Lancet. 2013;381:1145–55.
Gotsadze G, Chikovani I, Goguadze K, Balabanova D, McKee M. Reforming sanitary-epidemiological service in Central and Eastern Europe and the former Soviet Union: an exploratory study. BMC Public Health. 2010;10:440.
Rechel B, McKee M. Health reform in Central and Eastern Europe and the former Soviet Union. Lancet. 2009;374:1186–95.
Danishevski K. The Russian Federation: Difficult History of Target Setting. In: Wismar M, McKee M, Ernst K, Srivastava D, Busse R, (editors). Health Targets in Europe–Learning from experience. World Health Organization on behalf of the European Observatory on Health Systems and Policies; 2008.
McKee M, Zwi A, Koupilova I, Sethi D, Leon D. Health policy-making in Central and Eastern Europe: lessons from the inaction on injuries? Health Policy Plan. 2000;15:263–9.
United Nations. Millenium Development Goals Indicators- The official United Nations site for the MDG indicators 2013. Available from URL: www.mdgs.un.org (Accessed 8 April 2013).
Muller JE, Abdellah FG, Billings FT, Hess AE, Petit D, Egeberg RO. The Soviet health system—aspects of relevance for medicine in the United States. N Engl J Med. 1972;286:693–702.
Field MG. Doctor and Patient in Soviet Russia. Cambridge (MA): Harvard University Press; 1957. p.14–9.
Glass RI. The SANEPID Service in the USSR. Public Health Rep. 1976;91:154–8.
Ryan M, Stephen J. General practitioners and family doctors in the Russian Federation. Br J Gen Pract. 1996;46:487–9.
Sigerist H. Socialized Medicine in the Soviet Union. New York (NY): Norton; 1937.
Healy J, McKee M. Implementing hospital reform in Central and Eastern Europe. Health Policy. 2002;61:1–19.
Field MG. The position of the Soviet physician: the bureaucratic professional. Milbank Q. 1988;66 (2 Suppl):182–201.
Ryan M. The organization of Soviet Medical Care. Oxford: Basil Blackwell; 1978.
Tulchinsky T, Varavikova E. Addressing the epidemiologic transition in the former Soviet Union: strategies for health system and public health reform in Russia. Am J Public Health. 1996;86:313–20.
Barr DA, Field MG. The current state of health care in the former Soviet Union: implications for health care policy and reform. Am J Public Health. 1996;86:307–12.
Hill SR Jr. Medicine in the Union of Soviet Socialist Republics. Trans Am Clin Climatol Assoc. 1984;95:163–9.
McKee M. Cochrane on Communism: the influence of ideology on the search for evidence. Int J Ep idemiol. 2007;36:269–73.
Andreev EM, Nolte E, Shkolnikov VM, Varavikova E, McKee M. The evolving pattern of avoidable mortality in Russia. Int J Epidemiol. 2003;32:437–46.
Davis C. Rising Infant Mortality in the USSR in the 1970s. Washington (DC): United States Department of Commerce; 1980.
Schultz DS, Rafferty MP. Soviet health care and perestroika. Am J Public Health. 1990;80:193–7.
Anderson BA, Silver BD. Trends in mortality of the Soviet population. Sov Econ. 1990;6:191–251.
Omran AR. The epidemiologic transition: a theory of the epidemiology of population change. 1971. Milbank Q. 2005;83:731–57.
Rowland D, Telyukov AV. Soviet health care from two perspectives. Health Aff (Millwood) 1991;10:71–86.
Maier C, Martin-Moreno J. Quo vadis SANEPID? A cross-country analysis of public health reforms in 10 post-Soviet states. Health Policy. 2011;102:18–25.
Khodjamurodov G, Rechel B. Tajikistan: health system review. Health Syst Transit. 2010;12:v–xix, 1-154.
Katsaga A, Kulzhanov M, Karanikolos M, Rechel B. Kazakhkstan health system review. Health Syst Transit. 2012;14:1–154.
United Nations. United Nations Millennium Declaration 2000. Available from URL: http://www.un.org/millennium/declaration/ares552e.htm (Accessed 8 April 2013).
United Nations. Millenium Development Goals Indicators–The official United Nations site. The MDG Indicators 2013. Available from URL: http://mdgs.un.org/unsd/mdg/ (Accessed 8 April 2013).
Government of Armenia, Armenia UNCTi. Armenia: MDG National Progress Report. 2010.
Singer H. Millenium Development Goals in Kazakhstan. Astana: United Nations; 2010.
Skuratowicz J. The Kyrgyz Republic–Millennium Development Goals Progress Report. Bishkek: United Nations; 2003.
Secretariat of State Programme on Poverty Reduction and Economic Development, Azerbaijan U. Azerbaijan: Where East Meets the West–MDG Progress Report to the 2005 World Summit. 2005.
Government of Georgia, Georgia UNCTU. Millennium Development Goals in Georgia: Progress Report for 2004–2005. Tbilisi: 2005.
Government of Moldova, Moldova UNA. The Second Millennium Development Goals Report–Republic of Moldova. 2010.
Government of Turkmenistan. Millennium Development Goals Report: Turkmenistan. Ashghabat: 2003.
Government of Ukraine, Ukraine UNAi. Millennium Development Goals–Ukraine 2010 National Report. Kiev: 2010.
United Nations Country Team. Millennium Development Goals Report. Taschkent: 2006.
United Nations Development Programme. Millennium Development Goals in Russia: Looking into the Future. Moscow: UNDP; 2010.
Popovich L, Potapchik E, Shishkin S, Richardson E, Vacroux A, Mathivet B. Russian Federation: Health system review. Health Syst Transit. 2011;13:1–190.
Ahmedov M, Azimov R, Alimova V, Rechel B. Uzbekistan - Health system review. World Health Organization on behalf of the European Observatory on Health Systems and Policies; 2007.
Katsaga A, Kehler J. WHO mission to evaluate the quality of data for the purpose of assessing health system performance. Baku: World Health Organization Regional Office for Europe; 2008.
Vlassov V. Is there epidemiology in Russia? J Epidemiol Community Health. 2000;54:740–4.
Hakobyan T, Nazaretyan M, Makarova T, Aristakesyan M, Margaryants H, Nolte E. Armenia Health System Review. Yerevan: European Observatory on Health Systems and Policies; 2006.
Turcanu G, Domente S, Buga M, Richardson E. Republic of Moldova Health System Review. 2012.
Bernitz BL, Rechel B. HIV data in Central and Eastern Europe: fact or fiction? In: Matic S, Lazarus JV, Donoghoe MC, (editors). HIV/AIDS in Europe Moving from Death Sentence to Chronic Disease Management. Copenhagen: World Health Organization Regional Office for Europe; 2006. p.232–42.
Ibrahimov F, Ibrahimova A, Kehler J, Richardson E. Azerbaijan: health system review. Health Syst Transit. 2010;12:1–115.
Rechel B, Shapo L, McKee M, Health NaPG, Europe and Central Asia Region, World Bank. Are the health Millennium Development Goals appropriate for Eastern Europe and Central Asia? Health Policy. 2005;73:339–51.
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Glonti, K., Rechel, B. Health Targets in the Former Soviet Countries: Responding to the NCD Challenge?. Public Health Rev 35, 6 (2013). https://doi.org/10.1007/BF03391691
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DOI: https://doi.org/10.1007/BF03391691
Key Words
- Health targets
- health indicators
- Millennium Development Goals
- Commonwealth of Independent States
- Eastern Europe