How is it Working?

World Bank

How is it Working?

Autores

World Bank

Editor

Washington, DC: World Bank

Descripción

This study is the result of the World Bank research to support Ukraine’s on-going health reform policy debate. It was produced by a team of experts led by Paolo Belli, World Bank Lead Economist and Sector Leader for Human Development. Key authors: Paolo Belli; Yuriy Dzhygyr; Kateryna Maynzyuk. Surveys to collect data for this study were conducted by Kyiv International Institute of Sociology, whose team was led by Artem Miroshnichenko, Alona Goroshko, and Tetiana Stepurko. This report presents a new diagnostic tool for measuring the current status of public sector management policies and practices (or governance) as applied to the Ukrainian health sector. Using the tool, the study identifies strengths to build upon as well as weaknesses in the current system, and proposes concrete interventions to improve existing policies and practices. The issues which the report brings to light, related to the sector’s inability to harness, motivate and hold staff accountable for results, the poor information management, the rigid budgetary system but at the same time the pervasiveness of informal payments and corruption, surely play a key role in explaining why existing health services largely fail to prevent, detect, and treat diseases effectively. The problem is not one of physical accessibility. Ukraine has already an oversized number of hospitals and hospital beds, approximately 40 percent more than the EU average. The problem lies in inefficient allocation and use of resources, decades of neglected investments, and corruption in the sector. In summary, the main problem is one of governance, and that is why this study could play a critical role in guiding decision-makers not only on the main reform strategies, but also on the nitty-gritty initiatives which should contribute to improve governance, and thus service delivery and over the medium-term health outcomes.