to the risk of poverty and social exclusion, in the labour market, to improve the services and ... 2020» - equity. Source: Central Statistic Bureau of Latvia ... vegetables for children). â«Promoting physical activity â through social media campaigns.
«EVALUATION OF HEALTH POLICY IN LATVIA» Author:
Ieva Bikava, Andris Skride
Rīga, Latvia 2016
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Introduction Need of Health Care reforms – to improve inhabitants
access to Health Care and provide sustainability. Latvia – regional differencies, high degree of income
disparities, high level of people on poverty risk. Accessability in 2008-2015 has become worse, outpatient
visit and hospitalised patients – decreased, emergancy assistance – increased. Didn’t get health care because: in more than 50% «cannot
afford it».
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Aim
Reforms in Health Care must be coherent to society needs
and main guidlines of Health Care policy. Universal coverage, equity and towards society health improvements. Evaluate Health Care policy in Latvia accordingly to society
needs and Health policy guidliness, expressed by WHO in «Health 2020».
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Long term policy Sustainable Development Strategy of Latvia until 2030: Investments in human capital is a priority long-term task in
order to ensure the participation of all potential human resource, particularly the groups of inhabitants subjected to the risk of poverty and social exclusion, in the labour market, to improve the services and efficiency of health, social care and social security, as well as of lifelong educational systems; it is particularly important to perform timely investments
in health care, in knowledge and technologies related there to (in life sciences, biomedicine, pharmacy) and in promotion of healthy lifestyle in all generations. 4
Middle term policy Public Health Policy Guidlines 2014-2020: Based WHO Regional Strategy for Europe «Health 2020»; Identified problems - insufficiant financial support from
State; high level of direct payments. Objective of policy - to increase the number of healthy life
years of inhabitants of Latvia and to prevent premature death, preserving, improving and restoring health.
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Middle term policy (2) Sub – objectives of Public Health Policy Guidlines 2014-2020: 1. prevent inequality – ensure equal health promotion and
health care opportunities; 2. reduce premature death – reduce negative impact
factors; 3. reduce infant mortality; 4. Promote healthier environment, reduce injuries and
mortality from external causes of death; 5. reduce morbidity of communicable diseases; 6. Efficient managment and rational State budget resource
utilisation – to improve sustainability and equal access. 6
WHO «HEALTH 2020» Health 2020 focuses on improving health for all and
reducing health inequalities, through improved leadership and governance for health. Shifting mindset from combating illness to promote health
and well being. Based on values - universality, solidarity and equal access.
Including - fairness, sustainability, quality, transparency, accountability, gender equality, dignity and the right to participate in decision – making.
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WHO «HEALTH 2020» Social injustice is killing people on a grand scale,
demonstrating the ethical imperative of acting on these forms of inequity. Inequities in health reflect the fairnees and degree of social justice in a given society – government performance. People in the most disadvantaged groups and
communities, who are subjects to many different types of exclusionary processes, experience much worse health. Health inequities are also linked to health-related
behaviour, including tobacco and alcohol use, diet and physical activity, and mental health disorders
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WHO «HEALTH 2020» - equity
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WHO «HEALTH 2020» - equity
Source: Central Statistic Bureau of Latvia
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Health 2020 «Health in all policies» All sectors understand and act on their responsibility for health
while recognizing how health affects other sectors.
Source: Central Statistic Bureau of Latvia
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Health 2020 «Health in all policies»
Source: WHO
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Health 2020 «Health in all policies» Prime minister of Latvia – Māris Kučinskis and Minister of Finances Daina Rēzniece Ozola announces that priority of State budget in 2018 will be HEALTH CARE
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Health 2020 «Primary health care» Primary health care as a cornerstone on health systems in 21st century. Data from RAKUS (biggest hospital in Latvia): In Emergency department daily are brought on average 314
patients. About 200 patients are not hospitalized; In 60% of cases – because the primary care was not accessible. In
emergency department, they get blood test, cardiogram, computer tomography and other diagnostic - receive specialist consultation, results of all diagnostics, treatment recommendations and even medicine prescriptions.
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Health 2020 «Lifestyle and behaviour factors» Creating social and physical environment that fosters healthy behaviour: Tobacco control programmes – raising tax, encourage smoke free
environment, banning advertisment, etc. Alcohol policies – raising tax, restricting access, enforcing bans on
advertising, enforcing drink- driving laws; Prevent road crashes – one way streets, mandatory speed limits,
radar speed emforcement programmes.
In Latvia case – all proposed measures are taken and actions are restricted by legislature.
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Health 2020 «Lifestyle and behaviour factors»
Actions to promote healthy eating - reformulating processed food
to decrease salt, trans fatty acids and satured fat. Promoting healthier food (more fruits and vegetables for children). Promoting physical activity – through social media campaigns. Also
changes in transport system and urban design. In Latvia case – there are some initiatives, but the situiation is not satisfactory.
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Health 2020 «Health system governance» Targeting public expenditure better according to social need and so
protecting poor and vulnerable people. » In Latvia case public expenditure is not redirected to social needs, but to Health ministry announced priority programmes – cancer treatment, tariff changes etc.
Health technology assessment – to provide effectiveness and
efficiency. » Is not provided since the Health Economy Centre was reorganized Seeking efficiency gains by rationalizing service delivery structures.
» After the report of The World Bank there are discussions, but not the actions.
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CONCLUSIONS
Aims that are declared in long and middle term policy, are not performed in short term policy! 18
Thank You for Your attention!
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