The international community and the reconstruction of health care in South Eastern Europe

Abstract

Today, with the aid of the international community [European Union (EU), World Bank (WB), World Health Organisation (WHO), United Nations Children's Fund (UNICEF), nongovernmental organisations (NGOs), Global Fund (GF), Stability Pact, etc.] the ministries of health in transitional countries in the South Eastern Europe (SEE) region are in the process of expanding the capacities and skills of the health workforce in order to achieve successful health care reform and accomplish necessary steps for EU integration. The aim of this paper is to review international community support to reconstruction of the health care in SEE countries, with main focus on the EU and WB donors and projects. Review was done on the basis of existing donor reports, Internet search (search of official Web sites and electronic databases, check of references from selected documents, and use of a generic Internet search engine) and authors' experience from different health projects. The governments of SEE countries, in order to create an effective and efficient health system, overcame a period of transition and soon or later became ready for the process of EU integration, and began working on the following issues: rehabilitation, reconstruction and equipping of health facilities; developing a health strategy and policy documents; legislation and financing framework; building institutional, human resource and management capacity; health care sector reform; support to public health development and restructuring of the pharmaceutical sector. In many SEE countries, the capacity of the Ministry of Health and Health Insurance Fund was strengthened, and policy and strategy documents were drafted to guide reorganisation and reorientation of health care services. The public health system was strengthened. A family medicine model was introduced and developed in most countries. Development of enabling legislation mostly followed proposed changes in the health system. Although progress on several important fronts in achieving transition and progress in the rehabilitation health sector in SEE countries is significant, a lot remains to be done. Experience in some countries can be used to stimulate, motivate and encourage professionals throughout the civil service to grasp with both hands the opportunities for positive change.

Training hospital managers for strategic planning and management: a prospective study

“…The need for stronger management in Serbian health care is well recognized and the European Union, in particular, is supporting management capacity building programs [ 25 - 28 ]. Continuing education in health care management is being offered in Serbia at an increasing scale, in response to the health care system’s well-known deficits.…”

“…This was recognized by different international organizations and supporting management capacity building programs [ 26 , 27 ]. Formal training of health managers was not common in Serbia before the democratic transition that took place in the year 2000 [ 28 ]. In the mid - 2000, the Serbian government adopted laws which supported formal education and the necessity to improve the specific skills and knowledge of health professionals in the field of health care management (continuing education, postgraduate academic programs) [ 29 - 31 ].…”

The challenge of public health transition in South Eastern Europe

“…To cope successfully with these challenges two preconditions must be fulfilled: (1) training facilities for public health and health sciences (see Karadzinska-Bislimovska and Tozija 2006; see Bjegovic et al 2006;see Vodenicharov et al 2006; see Roshi et al 2006) for examples of schools of public health in Skopje, Belgrade, Tirana and Sofia) as well as viable associations of public health professionals (Zeegers Paget et al 2004), and (2) effective mechanisms to channel donor support for health development (see Matovic-Miljanovic et al 2006). …”

“…Another precondition for successful transition is the effective channelling of indispensable financial donor support (see Matovic-Miljanovic et al 2006). Several aspects of this issue are very problematic.…”

Regulating Iranian Medical Institutes: Towards Criminal Policy for a Clear Regulatory Model

“…Historically, there has not been a multi-departmental approach to health planning. This resulted in the awkward situation where a hospital general manager had to manage a complex hospital institution through considerable change with limited knowledge and skills [14] other health institutions had no strategic character [15,16,17]. Manager reacts to the challenges which they face by modifying and improving hospital management structures and upgrading managerial skills [18].…”