Policy-makers in countries in transition,2
as in all countries, are faced with the
challenge of improving the performance of their health systems. However, these
countries share a common historical experience – the period and collapse of
communist rule – and all embarked on an unprecedented social, political and
economic transition that began at the end of the 1980s. Despite this common
history, differences emerged or became more apparent in the early years of
transition. Most obviously, there are large economic differences between the
countries, with the richest among them – Slovenia – having a per capita gross
domestic product (GDP) in 2004 that was more than 17 times (adjusted for
purchasing power parity) that of the poorest, Tajikistan (World Bank 2006).
Parallel to this, most of the countries had similar types of health financing
system and expenditure pattern at the end of the 1980s but there are now
important differences between these systems, as countries responded in various
ways to the challenges and opportunities created by the transition experience.