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Access to services

Health care in the Republic of Belarus is characterized by a high availability of medical personnel and hospital beds. In January 1995, there were 44,600 doctors (43.3 per 10,000 of the population) and 117,600 professional medical workers such as nurses and technologists/technicians (114.2 per 10,000 of the population). General practitioners account for 26 % of the total medical personnel, paediatricians for 11%, surgeons for 12%, dentists for 8 % and obstetrician/gynaecologists for 5 %. There are 128,500 hospital beds (125.4 per 10,000 of the population).

A well-developed network of treatment and preventive care institutions provides medical assistance (871 hospitals, inclu­ding 428 in rural areas, and 1579 out-patient and polyclinic institutions, including 789 in rural areas). There are 204 ambu­lance stations. In rural areas, 2960 doctor's assistants and midwifery centres offer assistance to the population living in a 7 to 8 km radius. Doctors of out-patient and district hospitals offer assistance within 10 to 12 km.

At the same time, the system lacks horizontal integration which leads to a fragmentation of individuals' health problems among several specialists.

For example, during the course of having a baby, a woman will see one specialist (obstetrician/gynaecologist) during and after pregnancy (or several if she has health problems) and will be attended by different specialist (s) at the time of delivery.

There is also a strong emphasis on curative and institution-based care, with little attention to Primary Health Care. Some 80 % of sick children begin and end their treatment in polyclinics.

Access to highly-qualified and specialized medical assistance for the population in rural areas was reduced in 1993-94, due to a considerable reduction in public transportation necessitated by the economic situation.

The state health care system includes health care institutions under the jurisdiction of the Ministry of Health (92 % of doctors work in these) as well as health care services belonging to the Ministries of Defence and Internal Affairs and to the Belarusian Railways.

2. What changes would you like to introduce in the National Health Care Services in Belarus? Discuss it with your partners.

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