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Azerbaijan Healthcare

Azerbaijan's healthcare system was one of the least effective in the Soviet republics, and it deteriorated further after independence. On the eve of the breakup of the Soviet Union in 1991, the number of physicians per 1,000 people in Azerbaijan was about four, the number of hospital beds about ten, and the number of pharmacists about seven – all figures below average for the Soviet Union as a whole. According to reports, in the late 1980s some 736 hospitals and clinics were operating in Azerbaijan, but according to Soviet data some of those were rudimentary facilities with little equipment. Medical facilities also include several dozen sanitoriums and special children's health facilities. The leading medical schools in Azerbaijan are the Azerbaijan Medical Institute in Baku, which trains doctors and pharmacists, and the Institute for Advanced Training for Physicians. Several research institutes also conduct medical studies.

After the breakup of the Soviet Union, Azerbaijan's declining economy made it impossible for the Azerbaijani government to provide full support of the health infrastructure. Shortages of medicines and equipment have occurred, and some rural clinics have closed. In 1993 a Western report evaluated Azerbaijan's sanitation, pharmacies, medical system, medical industry, and medical research and development as below average, relative to similar services in the other former Soviet republics.

As of 1999, there were an estimated 3.6 doctors and 9.7 hospital beds per 1,000 people. In 1999, the total expenditure on health was estimated at 1.8% of GDP. Staff salaries are inadequate and informal payments are often required, particularly in rural areas. Implementation of mandatory health insurance has been delayed.

The healthcare system remains highly centralised and organised on the basis of centrally-determined norms without reference to local conditions or the changing epidemiological situation. Proliferation of small specialised facilities dilutes expertise and resources. Funding for health is controlled by the Ministry of Finance (MoF) independently of performance and service quality. The Ministry of Health (MoH) has weak stewardship capacity and lacks a clear health policy. Health promotion is not addressed.

Primary care services are not well developed and facilities are often in very poor condition, some lacking in water and electricity, and staff are poorly trained. Secondary care follows the former centralised Soviet model with large numbers of hospitals and beds; many people attend hospitals for basic needs. Privatisation of some facilities has been introduced but does not address the need for overall rationalisation of services.




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