Getting Better: Improving Health System Outcomes in Europe and Central Asia

Improving health system outcomes is a major development challenge for Europe and Central Asia (ECA). Fifty years ago, average lifespans in the region were slightly behind those in Western Europe, but far better than in East Asia, Latin America, or the Middle East. Since then, the gap between ECA and its western neighbors has widened, while the other middle-income regions have now all moved ahead. Some countries in ECA have performed very well, and the overall regional trend has recently improved, but long-term progress has certainly lagged behind the rest of the world.

In the future, health sector issues are likely to loom ever larger in policy agendas across the region. Living a long, healthy life will increasingly matter to people as much as achieving ever-higher incomes. Opinion polls indicate that health is the top priority for government spending among populations across ECA, and expectations for a strong government role in the sector are high. Yet these aspirations must be reconciled with the reality of aging populations and significant fiscal constraints.

Getting Better: Improving Health System Outcomes in Europe and Central Asia draws on a wealth of new evidence to explore the challenges facing health sectors in ECA. It highlights three key agendas to help countries seeking to catch up with the world's best-performing health systems. The first is the health agenda, where the main priority is to strengthen public health and primary care to help achieve the 'cardiovascular revolution' that has taken place elsewhere in recent decades. The second is the financing agenda, in which the growing demand for medical care must be satisfied without imposing an undue burden on households or government budgets. The third agenda relates to broader institutional arrangements, where the task is to adopt some of the key ingredients common to most advanced health systems that are still missing in many ECA countries. A common theme for all three agendas is the emphasis on improving outcomes, or 'Getting Better'.


Note: My nickname - interes