WB GIFTS SECOND CHANCE FOR AZERBAIJANI HEALTH SYSTEM

The Board of Directors of the World Bank will approve in June three credits amounting to $90m. $20m of the loan approved in June will be allotted under the second phase pf the project on development and crediting the agrarian sector, $40-50m under the project on reforms in health system and $20m in reforming the court system.

So, the Azerbaijani healthcare will receive the biggest credit from the WB. It only a gift by this bank, as the WB approved in 2001 the first credit worth $5m for Azerbaijan for financing project on reforms in the countrys health system. Credit allotted on the terms of the International Association for Development (IAD) for 35-40 years under annual rates of 0.75% with 10-yea grace period, was of innovative character, which along with the target, envisaged conduct of complex researches in to necessary changes in the local health system and spheres of additional financing. Thus, in the end of the first project it was revealed that the sector is really in need of necessary decent finances and $5m will hardly cover the demand.

Then it was decided that the healthcare is in need of a project. Through the efforts of the sides a project on second crediting the health was designed at the expense of WB credit of $450,000.The project is estimated to $86mln, from which WB is issuing $50mln on preferential terms from funds of International Development Association (IDA). The project also involves USAID that is issuing a $8mln grant. Remaining funds ($20mln) are issued by Azeri Government and gained from other sources.

The project covers financing of new hospitals and clinics construction and modification of services provision. The pilot areas for medical services modification were selected Sheki, Gakh, Ismailli, Agdash and Absheron.

However there is probability that the cost of the project might rise, which will respectively impact on the amount of the WB credit, which will probably increase from $50m as proposed to $60m. The Health Ministry said that there is necessity in this respect, as since the estimation of he project the construction materials and equipment have risen in price. The final resolution will be taken as a result of official talks between the WB and the Azerbaijani government on the project scheduled for 17 May. The project is to be approved in a meeting of the WB Board of Directors due to continue till 30 June 2006.

No doubts, the approval of the project by the WB assumes paramount importance for Azerbaijan. The WB credit allocated for the implementation of the on reforms in the health sphere will give impetus to reforming the sector which suffered from cut in public expenses. Despite the Ministrys intensive work on revival of this sector, there are still too many problems in the healthcare system, which require urgent resolution. Many of them are settled independently, whereas there are still moments when new rules, procedures and instructions, as well as relevant international experience are required.

This project envisages measures starting from financing the construction of hospitals and medical centers to improvement of services. The certification of medical objects throughout the country will enable the Ministry to establish a database enabling to define the need of every village. A special software will be designed in this respect. The reforms will be conducted both in the central and district medical services. Shaki, Gakh, Ismayilly, Agdash and Absheron were selected as pilot regions for reorganization of medical services. Under project there will be built hospitals to prevent over flow of people from region to the capital. It is planned to set up stationary service, policlinics and first medical services in these medical facilities. The centers will be supplied with up-to-date equipment and render surgical and therapeutic services in these regions. The liquidation of old hospitals is regarded as expedient.

As official data, there are 732 hospitals, 1,594 ambulance stations, as well as 922 womens and children clinics in the country, which employ some 30,000 doctors and 60,000 medium-level medial personnel. So, 36.6 doctors and 72.6 medical personnel fell on every 10,000 citizens in the country. Along with large network of branches of hospital and clinics in the country, the quality of services differs there. The recent check-ups by the Health Ministry revealed that normal examination of a patient is almost impossible in many of them.

The strengthening of the potential of management in the sphere of health, improvement of opportunities of health services in the villages of districts elected for implementation of pilot projects, increase of professional level of medical employees are the major target of the project on Health reforms-2.

The project will be implemented in 4 years. Lets hope it to be efficient and to meet the deadline without any unpleasant delays, as it as in the first one. Oktai Shiraliyev, the Azerbaijani Health Minister, said in an interview with Trend that in the beginning of 2005 the first project was ceased in connection with danger of loss of approximately $1m, left from the project. In December 2005 as a result of joint efforts of the Ministry of Finances, the Ministry of Health, the Cabinet of Ministers and the World Bank the project continued and a process on transparent approval of funds to relevant spheres of heal was set up.

There was disagreement on two points of use of the credit. Renovation and services by the foreign consultations were accepted by Azerbaijan as wrong dissipation of the funds. It could put Azerbaijan, which is to repay the funds, in a uneasy and unprofitable state, when the country has more needs in consolidation of the logistics basis of the health, improvement of medical specialists and training of specialists. Finally, the use of the WB loan on the project Health Reforming in Azerbaijan by the performer of the project, the Health Ministry, was presented to public as inexpedient.

Today, as result of many-year cooperation with the international financial institutes in many projects the country achieved an experience on establishment of a team of managers, who can manage capital to make their use efficient. Moreover, the country now puts forward own requirements and terms.

The key tasks today set for the government are to make the health accessible for low-income families, improve the professionalism of medical personnel. WB credit can assist in it. The credits are of long-term efficiency and they should be spent for the sake of future generations.

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