Armenians struggle for health care and medicines

Private financing constitutes about half of total health expenditures in Armenia and most of that comes directly out of the consumer’s pocket. In the current economic downturn, fewer and fewer people can afford it. Monika Mkhitaryan and Onnik Krikorian report.

The Armenian government is trying to redress the problem, notably by introducing primary health care reforms with an emphasis on preventive care and the management of chronic diseases. But as Dr Ara Babloyan, Armenia’s minister of health between 1991 and 1997, puts it, “Despite efforts in the area of primary health care, the health system requires new improvements”, he said, adding that the scope and definition of primary health care should be revised and enlarged.

One of the most pressing concerns is the cost of treatment and medicine for working Armenians who don’t benefit from the minimal social programmes that are in place.

To address this, the ministry of health has implemented several programmes since independence in 1991 including a Basic Benefits Package (BBP) established in 1999. The package provides specific health-care services, including medicines, at no charge to vulnerable segments of the population, including children, the elderly and disabled, impoverished people and injured military personnel. Since 2006, primary health care services have been free of charge under the BBP.

But, of course, being eligible is not the same as being covered. And concern about the BBP being stretched a little thin is expressed in the highest places: “Each year the number of people included on the ‘vulnerable’ list is increased by the Armenian authorities and as a consequence, the money attributed to each individual decreases,” explains Babloyan. In concrete terms this means that people like Naira Thovmasian, a 34-year-old woman living in Yerevan, who since 1999 has needed dialysis to compensate for her failing kidneys, cannot always get the medicines they need. “By law, the hospital has to provide the medicines for me, but what happens if they don’t have them?” Thovmasian asks.

The full article is available in the World Health Organization Bulletin.