The effects of the financial crisis on health systems in the Russian Federation

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1 MINISTRY OF HEALTH of the RUSSIAN FEDERATION The effects of the financial crisis on health systems in the Russian Federation Dr Svetlana Axelrod MD PhD 15 th EFHG W1 Financial crisis 1

2 THE EFFECT OF THE CRISIS ON THE RUSSIAN FEDERATION BUDGET POLICIES FOR The principles of budget formulation during a tough economical climate: 1) taking into account all of the government s social responsibilities during budget planning; 2) increasing the effectiveness of budget spending; 3) balancing regional budgets with extra-budgetary funds; 4) improving budget discipline: planned development of funds; 5) responsible budgetary politics. Features of the Russian Federation budget for (draft) 1) the Reserve Fund amount has increased by 2.5 times and has reached 2 trillion roubles (50 billion ) 2) the non-oil budget deficit remains high 9.7% of GDP in 2013 (the optimal level is - 4-5% of GDP) 3) new budget rules: accumulating reserves and limiting the current expenditure of excess profits from raw materials

3 EXPENDITURE COMMITMENTS IN HEALTHCARE FOR total amount of funding - 2,5 trillion roubles (62.5 billion ) - supply of drugs for persons entitled to - 40 billion roubles (1 billion ) Funding of public programs at the years ) Additional subsidy program for modernizing healthcare of federal subjects of the Russian Federation FFCMI 386,6 billion roubles (9.67 billion ) 2) The program Accessible Environment to improve the quality of life of 13 million people with disabilities - 46 billion roubles (1.15 billion ) 3) Prevention of noncommunicable diseases and the development of a healthy lifestyle 32,93 billion roubles (823,25 million ) 4) Biomedical development strategy provides for the active involvement of business in the industry

4 PRIORITIES FOR SOCIAL RESPONSIBILITY FOR GOVERNMENT POLICY IN THE HEALTHCARE SECTOR Key goals to develop the industry: (The RF Presidential Decree On the improvement of public health policy, 07/05/2012) TO THE GOVERNMENT OF THE RUSSIAN FEDERATION 1) ensure that by 2018: there is a decrease in mortality by 100 thousand people: - from circulatory system diseases to cases, - from tumors (including malignant ones) to cases; - from tuberculosis to 11.8 cases; - from road traffic accidents to 10.6 cases; there is a decrease in infant mortality to 7.5 per 1,000 live births; there is an increase in the amount of locally manufactured medications according to the nomenclature list of strategically important medications and the list of vital and essential medications up to 90%; 2) develop a range of measures to improve medical assistance, based on the State Programme The development of public healthcare ; 3) devise the Strategy for medical research development in the Russian Federation up to the year ) bring to the State Duma, by 01/11/2012, a Federal draft law On the protection of public health from the effects of tobacco use.

5 PRIORITIES FOR SOCIAL RESPONSIBILITY FOR GOVERNMENT POLICY IN THE HEALTHCARE SECTOR Key goals to develop the industry: (RF Presidential Decree On the improvement of public health policy, 07/05/2012) TO THE GOVERNMENT OF THE RUSSIAN FEDERATION and RF EXECUTIVE BODIES 1) ensure the ongoing implementation of measures to promote a healthy lifestyle; 2) develop the Strategy for medication provision for the population of the RF up to the year 2025 and plan its implementation; 3) approve the Action Plan for the implementation of principles of RF government policy in the field of population nutrition for the period up to 2020; 4) develop measures to ensure RF healthcare systems have sufficient medical personnel; within the RF regions, accept programs, which deliver professional development for medical personnel, which provide an assessment of their qualifications, step-by-step elimination of medical personnel shortages, and social support for healthcare workers; 5) complete by the 1 st of January 2016 the modernization of the Russian Federation Drug Control Service.

6 Government investment into activities for the prevention of NCD and the development of a healthy lifestyle for billion roubles ( million ) billion roubles ( million ) billion roubles (225.5 million ) billion roubles (262 million ) billion roubles

7 GOVERNMENT PROGRAMMES FOR MATERNAL AND CHILD HEALTH for The project Prenatal diagnosis of child developmental disorders : pregnant women were examined, out of whom (2.6%) had impaired foetal development. The programme for infant examination for the diagnosis of genetic diseases 2011: over 1.6 million newborns were examined, with genetic diseases discovered in 1087 cases. The infant mortality indicator in the whole of the Russian Federation decreased by 2.7% and was 7.3 per 1000 live births in 2011 as compared to 7.5 per 1000 live births in

8 GOVERNMENT PROGRAMMES FOR MATERNAL AND CHILD HEALTH, 2011 Audiology screening: an effective way of uncovering hearing loss (RF Ministry of Health, 2011) 1 st stage: 1.51 million children were examined 1 st stage: 54,700 children were found to suffer from hearing loss 2 nd stage: 5,400 children had their hearing loss confirmed 2 nd stage: 33,400 children were examined 3 rd stage: cochlear implant operations were carried out for the deaf children 8

9 GOVERNMENT PROGRAMMES FOR POPULATION HEALTH PROTECTION AND THE PREVENTION OF NON- COMMUNICABLE DISEASES, Health assessments of teenagers in the RF 2011: teenagers were seen 43% were healthy Health assessments of the RF working population 2011: million working people were seen 22.2% of the people were considered healthy Centers for adult and child health, : 692 adult health centers and 204 child health centers opened 3,882,000 adults and 962,000 children were seen

10 THE EFFECTIVENESS OF THE GOVERNMENT HEALTHCARE POLICY, RESULTS total population mortality decreased by more than 11%, from stroke, by 28%, from cardiovascular diseases, by 9%. mortality due to cancer in 2011 decreased by 1.6% (as compared to 2010) life expectancy in 2011 increased by 1.5 years and is now 70.3 years. life expectancy at birth increased: for the whole population by 3.9 years, for women by 2.9 years, for men by 3.9 years. Population decline in the Russian Federation, when taking into account population growth, has decreased by 21.2% (more than 5 times).

11 HEALTHCARE PROBLEMS IN THE RF, REQUIRING FURTHER ACTION Medical demographic indicators Circulatory system disease mortality per 100,000 people Tuberculosis mortality per 100,000 people Road traffic accident mortality per 100,000 people Infant mortality per 1,000 births 2011 Russia 7 th place EU countries Infectious and socially significant disease remain pertinent: tuberculosis, HIV/AIDS A key industry issue is the low level of training and a lack of medical personnel. Doctor and nursing staff levels in rural areas are 2.4 times lower than in the cities.

12 ENSURING ACCESS TO MEDICAL CARE Under the programme to retain young professionals in rural areas, each one was given 1 million roubles (25,000 ) and we managed to attract young professionals. In total, we plan to attract specialists to work in rural areas. On 01/09/2012, million roubles (99 million ) were spent in the form of one-off compensation payments from the Federal Fund for Compulsory Medical Insurance For the majority of Russian Federation regions, additional regional payments have been introduced, and specialists are provided with accommodation and transport.

13 INCREASING ACCESS TO MEDICAL CARE Developing a medical organization network through regional healthcare modernization programmes in Using mobile medical complexes for primary care: - mobile medical clinics - mobile Health Centers, and - mobile fluorographs. From 2013, there will again be yearly health assessments of children and certain groups of adults. To conduct the medical examinations, 200 mobile complexes will be acquired. Home delivery of medications and medical devices to patients is being developed in the Russian Federation regions.

14 The Russian Federation State Program Healthcare Development Dates and stages for program implementation First stage: Structural changes, Second stage: The development of the innovation potential in healthcare, Subprogram 8. Development of international relations in the healthcare sector Russia is acting as a donor for a series of programs and projects, conducted together with WHO, UNICEF, UNAIDS, and including the Commonwealth countries. The policy of international cooperation is based on the aim of achieving the Millennium Development Goals in the recipient countries.

15 THANK YOU FOR YOUR ATTENTION!

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