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Publication date
07-04-2007

Primary care reform in Central and Eastern Europe: can Belarus be taken as the control group in international comparison?

Boerma, W.G.W., Rousovich, V.S., Schellevis, F.G., Egorov, K. Primary care reform in Central and Eastern Europe: can Belarus be taken as the control group in international comparison? European Journal of Public Health: 2005, 15(suppl. 1), p. 38. Abstract. 13th Annual EUPHA Meeting "Promoting the public's health: reorienting health policies, linking health promotion and health care", Graz, 10-12 November 2005.
Background: Health care reform proceeds differently in Belarus. The country has not followed trends visible in most other countries. Financing and provision of health care is still in the hands of the state. Health insurance funds are unknown, private practices are rare and operating outside the system, and power of regional health authorities is limited. Besides, for political reasons the country does not benefit from important international aid programmes. Nevertheless, some change can be observed, particularly in Belarus primary care. A family doctor system is being implemented in rural areas, where the situation of health care is poor. Since 1998 two subsequent Dutch-sponsored bilateral projects have supported this development. This paper provides a state of affair of primary care policy development in Belarus and presents first results from a national survey among primary care doctors. Methods: Based on official documents and experiences from the authors, primary care development in Belarus has been analysed in the light of the role of regional health authorities, educational institutes, and the recently established association of family doctors. The national survey among a random sample of primary care doctors (including newly re-trained family doctors) in three regions of the country has been implemented in Spring 2005. The survey instrument has been used internationally. Results: The do’s and dont’s of health care policy in Belarus will be presented.First, results of the national survey among doctors in primary care will be presented, in particular, on the provision of their clinical tasks and aspects of their workload. Family doctor will be compared to doctors who have not been re-trained; Belarus will be compared with other countries. Conclusions: Health care develops very slowly in Belarus, but the country cannot be considered as the open air museum of the Semasko system. (aut.ref.)

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Background: Health care reform proceeds differently in Belarus. The country has not followed trends visible in most other countries. Financing and provision of health care is still in the hands of the state. Health insurance funds are unknown, private practices are rare and operating outside the system, and power of regional health authorities is limited. Besides, for political reasons the country does not benefit from important international aid programmes. Nevertheless, some change can be observed, particularly in Belarus primary care. A family doctor system is being implemented in rural areas, where the situation of health care is poor. Since 1998 two subsequent Dutch-sponsored bilateral projects have supported this development. This paper provides a state of affair of primary care policy development in Belarus and presents first results from a national survey among primary care doctors. Methods: Based on official documents and experiences from the authors, primary care development in Belarus has been analysed in the light of the role of regional health authorities, educational institutes, and the recently established association of family doctors. The national survey among a random sample of primary care doctors (including newly re-trained family doctors) in three regions of the country has been implemented in Spring 2005. The survey instrument has been used internationally. Results: The do’s and dont’s of health care policy in Belarus will be presented.First, results of the national survey among doctors in primary care will be presented, in particular, on the provision of their clinical tasks and aspects of their workload. Family doctor will be compared to doctors who have not been re-trained; Belarus will be compared with other countries. Conclusions: Health care develops very slowly in Belarus, but the country cannot be considered as the open air museum of the Semasko system. (aut.ref.)