| |
|
Global Cardiovascular Strategies
Berislav Skupnjak, MD, Croatia
Liaison Officer, WHO Liaison Office Croatia
WORLD HEALTH ORGANISATION: HEALTH SYSTEM REFORMS - LJUBLJANA CHARTER
SUMMARY
The author starts his presentation with a statement and an information: there is practically no country in Europe, and wider, that is not in the state of so called constructive restlessness, i.e. no country that does not in the reforming process its health system.
World Health Organisation (WHO) has been very active in this connection since this issue is very pressing in its member-states, while on the other side, WHO with its expertise became aware that existing health systems are submitted to the universality of changes of their surroundings. Population, economic, social, health and technological transitions are underway. The most radical political changes have occurred and it would be impossible for health system to remain intact and not to adapt to the totality of changes taking place in its environment. For that reason WHO constantly keeps an eye on all these happenings in countries, and undertakes numerous activities aimed at exchanging of experiences, providing expertise, giving recommendations, etc.
In the field of health system reform that are, as above mentioned, underway practically in all European countries, the most important event had been the Ministerial Conference of all Ministers of Health of all the European countries, who met in June 1996 in Ljubljana. The Conference was dedicated to the health care reforms and was attended not only by the WHO member states’ delegations, but also by representatives of a number of other international organisations (primarily the World Bank, European Union, OECD, UNICEF, etc.), which are also very interested in the state and development of health in Europe.
The meeting was concluded with endorsement of so called The Ljubljana Charter on Reforming Health Care.
The main idea of the Charter is expressed in its basic principles that rely on the current foundations of each health policy, and these are in the first place social justice and equity, which provide universality of approach of every citizen to health system according to his health needs. Furthermore, the principal aim of every reform is to achieve so called health gains, whose basis is sound health financing, strengthening of health system with special accent on primary health care, respecting of the basic values such as social justice and equity, quality of health care delivery and patients' rights.
In that context, the author considers the existing health systems, respectively the ones that used to be dominant in European countries and compares these systems with Croatian health system. In doing so he comes across one phenomenon that deserves our full attention. Namely, in spite of extremely unfavourable circumstances (incrased health needs, difficult economic situation accompanied by the fall of the GDP, the great number of unemployed, poor and irregular financing of health system, relatively modest number of health professionals and health infrastructure in comparison to other countries) the health status of the population is better than one could expect.
The author believes that the reason for this positive trend lies in great devotedness of health professionals as well as in some determinants of health system that had been promulgated by Andrija Štampar as late as some 70 ago in Croatia, namely the network of health centres and relatively unpolluted environment, etc. However, the author, while considering this area very interesting for further study, hesitates to propose final conclusions on the matter.
Key words: health care reform, health insurance systems, transition in Croatian health, WHO role
CARDIOnet® - registered trade mark name.
Copyright © 1996-2004 by CARDIOnet®. All rights reserved.
