Health and health systems in the Commonwealth of Independent States.

Bernd Rechel ORCID logo; Bayard Roberts ORCID logo; Erica Richardson; Sergey Shishkin; Vladimir M Shkolnikov; David A Leon ORCID logo; Martin Bobak; Marina Karanikolos; Martin McKee ORCID logo; (2013) Health and health systems in the Commonwealth of Independent States. Lancet, 381 (9872). pp. 1145-1155. ISSN 0140-6736 DOI: 10.1016/S0140-6736(12)62084-4
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The countries of the Commonwealth of Independent States differ substantially in their post-Soviet economic development but face many of the same challenges to health and health systems. Life expectancies dropped steeply in the 1990s, and several countries have yet to recover the levels noted before the dissolution of the Soviet Union. Cardiovascular disease is a much bigger killer in the Commonwealth of Independent States than in western Europe because of hazardous alcohol consumption and high smoking rates in men, the breakdown of social safety nets, rising social inequality, and inadequate health services. These former Soviet countries have embarked on reforms to their health systems, often aiming to strengthen primary care, scale back hospital capacities, reform mechanisms for paying providers and pooling funds, and address the overall shortage of public funding for health. However, major challenges remain, such as frequent private out-of-pocket payments for health care and underdeveloped systems for improvement of quality of care.

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