“Health inequalities in Armenia - analysis of survey results”

Abstract

IntroductionPrevailing sociopolitical and economic obstacles have been implicated in the inadequate utilization and delivery of the Armenian health care system.MethodsA random survey of 1,000 local residents, from all administrative regions of Armenia, concerned with health care services cost and satisfaction was conducted. Participation in the survey was voluntary and the information was collected using anonymous telephone interviews.ResultsThe utilization of health care services was low, particularly in rural areas. This under-utilization of services correlated with low income of the population surveyed. The state funded health care services are inadequate to ensure availability of free-of-charge services even to economically disadvantaged groups. Continued reliance on direct out-of pocket and illicit payments, for medical services, are serious issues which plague healthcare, pharmaceutical and medical technology sectors of Armenia.ConclusionsRestructuring of the health care system to implement a cost-effective approach to the prevention and treatment of diseases, especially disproportionately affect the poor, should be undertaken. Public payments, increasing the amount of subsidies for poor and lower income groups through a compulsory health insurance system should be evaluated and included as appropriate in this health system redesign. Current medical services reimbursement practices undermine the principle of equity in financing and access. Measures designed to improve healthcare access and affordability for poor and disadvantaged households should be enacted.

Inequalities in utilization of maternal health care services in Nepal

“…Wagstaff and van Doorslaer, 1991;Kakwani et al, 1997;Gwatkin, 2000;Kawachi et al, 2002;Wagstaff, 2002a, b;Marmot, 2002;Wagstaff et al, 2003;Subramanian and Kawachi, 2004;Hosseinpoor et al, 2006;Subramanian et al, 2006;Subramanian and Ertel, 2009;Harper and Lynch, 2007;Van de Poel et al, 2008;Subramanian, 2008;Speybroeck et al, 2010;Konda et al, 2009;Po and Subramanian, 2010;Marmot, 2005Marmot, , 2010Subramanyam and Subramanian, 2011;Goland et al, 2012;van Bon-Martens et al, 2012;Jain et al, 2012;Tonoyan and Lusine, 2012;Suzuki et al, 2005;.…”

Individual and community level socioeconomic inequalities in contraceptive use in 10 Newly Independent States: a multilevel cross-sectional analysis

“…After the transition, Russia, Ukraine, Belarus, Azerbaijan, Tajikistan, Turkmenistan, and Uzbekistan retained most of the Soviet-era health system, whereas Moldova, Georgia, Armenia, Kyrgyzstan, and the Baltic states have undergone a greater degree of market reforms [5]. Growing out-of-pocket fees, both formal and informal, have occurred in many of the health systems, and are thought to have contributed to socioeconomic inequalities in access to health care [6]. However, despite the known weakness of family planning programs in this region, the extent of socioeconomic inequalities in modern contraceptive use in the context of social and economic transition has to our knowledge not been previously studied.…”

Factors Influencing Treatment Adherence Among Drug-Sensitive Tuberculosis (DS-TB) Patients in Armenia: A Qualitative Study

“…27 Previous surveys conducted in Armenia studying the utilization of healthcare services have demonstrated that the lack of trust towards physicians and their professional competencies might be one of the main barriers to seeking care. 28,29 Knowledge about TB and TB medications did not seem to facilitate adherence to treatment among our study participants, since many of them did not have even a basic understanding of TB. In contrast to our findings, researchers who studied adherence to DOT among TB patients in Ethiopia and China reported that TB knowledge was found to be a facilitator of adherence.…”

“…27 Previous surveys conducted in Armenia studying the utilization of healthcare services have demonstrated that the lack of trust towards physicians and their professional competencies might be one of the main barriers to seeking care. 28 , 29…”