The project will help to determine which changes to scale up and how to do so on the basis of Federal-level guidelines that will be tested at the local level. Strengthening of Federal-level functions will be combined with reforms at the local level, starting with two participating subjects of the Federation - the Republic of Chuvash and the Region of Voronezh.
The Russian health system became highly decentralized in the course of the early 1990s. While Russia's regions have taken a more active role in the sector, many aspects of the relationship between regional and federal levels remain unclear. Also, as a result of limited resources and sometimes outdated practices, the quality of the health care system in Russia needs significant improvement. The old Soviet system emphasized specialists and hospital care, while basic services, such as primary care and preventive measures, were less developed. Now, in a constrained financial environment, it is essential to get the best value for money from the health care system and to make it more responsive to the needs of the population. The Government is providing leadership for this process, in support of which the Health Reform Implementation Project will emphasize high-impact polices and interventions in order to maximize the effects of domestic spending, with a focus on the effectiveness, efficiency and equity of the health system.
- establish a system of federal regulations required for effective governance and management of the health system;
- develop and implement strategic approaches to health sector reform in selected regions;
- strengthen the institutional capacity of the Ministry of Health as a federal executive agency;
- draw lessons from the implementation of regional programs and disseminate them to other regions;
develop and implement an efficient scheme of restructuring of the health system, with an emphasis on increased access, quality and efficiency of health services that will benefit from direct investment under the project.