Tajikistan : Review of Public Expenditures on Health
This policy note is part of the World Bank's Programmatic Public Expenditure Review (PER) work program for FY2012-2014. The PER consists of a series of fiscal policy notes, which aim at providing the Government of Tajikistan with recommendatio...
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| Format: | Public Expenditure Review |
| Language: | English en_US |
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Washington, DC
2014
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| Online Access: | http://documents.worldbank.org/curated/en/2013/08/19760470/review-public-expenditures-health http://hdl.handle.net/10986/20771 |
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okr-10986-207712021-04-23T14:03:56Z Tajikistan : Review of Public Expenditures on Health World Bank FISCAL SPACE HEALTHCARE USE HEALTH FINANCING HEALTH OUTCOMES HEALTH SECTOR HEALTH SERVICE INEQUALITY ORGANIZATIONAL REFORMS PUBLIC HEALTH EXPENDITURES This policy note is part of the World Bank's Programmatic Public Expenditure Review (PER) work program for FY2012-2014. The PER consists of a series of fiscal policy notes, which aim at providing the Government of Tajikistan with recommendations to strengthen budgetary processes and analysis. This policy note, the second in the series, examines public expenditures on health in Tajikistan. After an introductory section, the note describes the institutional and administrative structure of the health sector. Section 3 presents health outcomes and health care utilization indicators. Section 4 describes health financing in Tajikistan and presents the main options to expand fiscal space for health. Section 5 reviews the health financing and organizational reforms implemented in Tajikistan. Section 6 provides the main conclusions: 1) despite progress, health sector outcomes are mixed in Tajikistan and utilization pattern of health services is characterized by significant inequalities; 2) public spending on health is relatively low and skewed towards hospitals rather than outpatient care; 3) the hospital sector is characterized by oversupply of beds, avoidable inpatient admissions, low occupancy rates, and excessive average length of stay; 4) an increase in public health expenditures since 2000 was largely driven by the expanding wage bill, while other expenditures had been compressed; 5) public health expenditures show a regressive incidence, with the distribution of inpatient care more pro-rich than outpatient care; 6) the large reliance on out-of-pocket produces a high incidence of catastrophic spending; 7) a number of health financing and organizational reforms have been initiated since 2000, but the scope and coverage is still limited; and 8) the overall prospect for increasing fiscal space for health in Tajikistan are positive, with rationalization of both the overall budget and the public health delivery system. 2014-12-17T21:36:13Z 2014-12-17T21:36:13Z 2013-08 http://documents.worldbank.org/curated/en/2013/08/19760470/review-public-expenditures-health http://hdl.handle.net/10986/20771 English en_US Takijistan policy notes on public expenditures;policy note no. 2 CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ Washington, DC Economic & Sector Work :: Public Expenditure Review Europe and Central Asia Tajikistan |
| repository_type |
Digital Repository |
| institution_category |
Foreign Institution |
| institution |
Digital Repositories |
| building |
World Bank Open Knowledge Repository |
| collection |
World Bank |
| language |
English en_US |
| topic |
FISCAL SPACE HEALTHCARE USE HEALTH FINANCING HEALTH OUTCOMES HEALTH SECTOR HEALTH SERVICE INEQUALITY ORGANIZATIONAL REFORMS PUBLIC HEALTH EXPENDITURES |
| spellingShingle |
FISCAL SPACE HEALTHCARE USE HEALTH FINANCING HEALTH OUTCOMES HEALTH SECTOR HEALTH SERVICE INEQUALITY ORGANIZATIONAL REFORMS PUBLIC HEALTH EXPENDITURES World Bank Tajikistan : Review of Public Expenditures on Health |
| geographic_facet |
Europe and Central Asia Tajikistan |
| relation |
Takijistan policy notes on public
expenditures;policy note no. 2 |
| description |
This policy note is part of the World
Bank's Programmatic Public Expenditure Review (PER)
work program for FY2012-2014. The PER consists of a series
of fiscal policy notes, which aim at providing the
Government of Tajikistan with recommendations to strengthen
budgetary processes and analysis. This policy note, the
second in the series, examines public expenditures on health
in Tajikistan. After an introductory section, the note
describes the institutional and administrative structure of
the health sector. Section 3 presents health outcomes and
health care utilization indicators. Section 4 describes
health financing in Tajikistan and presents the main options
to expand fiscal space for health. Section 5 reviews the
health financing and organizational reforms implemented in
Tajikistan. Section 6 provides the main conclusions: 1)
despite progress, health sector outcomes are mixed in
Tajikistan and utilization pattern of health services is
characterized by significant inequalities; 2) public
spending on health is relatively low and skewed towards
hospitals rather than outpatient care; 3) the hospital
sector is characterized by oversupply of beds, avoidable
inpatient admissions, low occupancy rates, and excessive
average length of stay; 4) an increase in public health
expenditures since 2000 was largely driven by the expanding
wage bill, while other expenditures had been compressed; 5)
public health expenditures show a regressive incidence, with
the distribution of inpatient care more pro-rich than
outpatient care; 6) the large reliance on out-of-pocket
produces a high incidence of catastrophic spending; 7) a
number of health financing and organizational reforms have
been initiated since 2000, but the scope and coverage is
still limited; and 8) the overall prospect for increasing
fiscal space for health in Tajikistan are positive, with
rationalization of both the overall budget and the public
health delivery system. |
| format |
Economic & Sector Work :: Public Expenditure Review |
| author |
World Bank |
| author_facet |
World Bank |
| author_sort |
World Bank |
| title |
Tajikistan : Review of Public Expenditures on Health |
| title_short |
Tajikistan : Review of Public Expenditures on Health |
| title_full |
Tajikistan : Review of Public Expenditures on Health |
| title_fullStr |
Tajikistan : Review of Public Expenditures on Health |
| title_full_unstemmed |
Tajikistan : Review of Public Expenditures on Health |
| title_sort |
tajikistan : review of public expenditures on health |
| publisher |
Washington, DC |
| publishDate |
2014 |
| url |
http://documents.worldbank.org/curated/en/2013/08/19760470/review-public-expenditures-health http://hdl.handle.net/10986/20771 |
| _version_ |
1764445964766019584 |