Hakobyan, T;
Nazaretyan, M;
Makarova, T;
Aristakesyan, M;
Margaryants, H;
Nolte, E;
(2006)
Armenia: Health system review.
Technical Report.
World Health Organization on behalf of the European Observatory on Health Systems and Policies (Copenhagen).
https://researchonline.lshtm.ac.uk/id/eprint/2601163
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The Health Systems in Transition (HiT) profiles are country-based reports
that provide a detailed description of a health system and of policy initiatives
in progress or under development. HiTs examine different approaches to the
organization, financing and delivery of health services and the role of the main
actors in health systems; describe the institutional framework, process, content
and implementation of health and health care policies; and highlight challenges
and areas that require more in-depth analysis.
Since independence, the health system in Armenia has undergone numerous
changes that have effectively transformed a centrally run state system into a
fragmented one that is largely financed from out-of-pocket payments. The
population, especially those in need, meet with limited access to health services,
and those services which are available are often of questionable quality, as
health care standards and quality assessment systems are absent. Drugs on the
essential drugs list are generally not affordable to those in need. Many health
facilities, especially in rural areas, lack modern medical technology and what is
available is not distributed efficiently. The commitment to free health care thus
remains more declarative than factual, as informal payments are still expected
or required in many cases. Despite significant investments in primary care, a
disproportionate share of resources has been invested in secondary and tertiary
care. Nevertheless, Armenia is increasingly engaged in reforming the system
from one that emphasizes the treatment of disease and response to epidemics
towards a system that emphasizes prevention, family care and community
participation. The shift towards a primary care orientation is noticeable, with
gradually increased roles for health workers to influence the determinants of
health.