Health system performance assessement : Armenia: Report / National Institute of Health; edt. Diana Andreasyan, Samvel Manukyan, P. Zelveian.

This report summarizes the main findings of an assessment of the performance of the Armenian health system, which was carried out by the Ministry of Health of Armenia, with the technical and financial support from the WHO Regional Office for Europe and from the World Bank. This assessment was carried out in 2008 and 2009 and contributes to the efforts pursued by the government of Armenia to strengthen the capacities of the Ministry of Health for effective stewardship of the health system.

This report presents an assessment of the performance of the health system against a number of key performance dimensions: health system stewardship, health management information system, development of health human resources, equity in financing and financial protection, health system efficiency, access to health care services, quality and safety of health care services, risk factors, health promotion and disease prevention, health system responsiveness, and improvement in health status. Policy recommendations are presented at the end of each section of this report. An executive summary is enclosed. This health system performance assessment is the first in a series of similar reports released this year by the World Health Organization Regional Office for Europe. Other reports to be released in 2009 include Georgia, Estonia and Portugal.

The reports show that as a result of a sustained public investment increase in the health sector preceding the 2009 economic crisis, a number of health indicators have improved in recent years. Child, infant and neonatal mortality have decreased substantially, and life expectancy at birth has increased. Furthermore, the country is in the midst of carrying out significant institutional and structural health care reforms. The implementation of primary health care reforms and optimization of the hospital network in regions are instrumental to achieving the country’s Millennium Development Goals by 2015.

The “Health system performance assessment” report indicates that the key challenge remaining is the high burden of out-of-pocket payments for a significant number of people. This creates barriers to access to health care when people need it, and explains why 25 percent of the poorest people cannot yet access the services they need, despite the improved access to health care in general and to primary care services in particular. The report advises that increase in public health and health promotion expenditures, still considerably lower than in other European countries, coupled with well-targeted investments in the health sector, will greatly help improve health and equity in the country.