Russia and Commonwealth of Independent States
Informal payments for health care in the Former Soviet Union: some evidence from Kazakhstan
Informal payments may hamper health reforms in Kazakhstan
Authors:
T. Ensor; L. Savelyeva
Publisher:
Health Policy and Planning, 1998
This paper, published in Health Policy and Planning, examines informal or under-the-table payments in Kazakhstan. Anecdotal evidence suggests that the health system has been kept operating during Kazakhstan’s difficult transition through informal contributions from patients to medical institutions and staff. However, there is little research-based evidence and few reliable statistics exist. The research that does exist suggests that informal payments for medicines may add 30 per cent to national health expenditure, and payments to staff are likely to add substantially to this figure.
Listing the policy implications of informal payments, the paper notes that they may: limit access to health care, increase the demand for inappropriate treatment, lead to less efficient purchasing, thwart attempts to introduce new formal payment systems, and allow the government to put off difficult decisions about prioritisation and reform. However, information on the real importance of these possible impacts is lacking and more research is needed. The paper concludes by setting out a research agenda that would help countries in transition to account for informal payments when forming health policy.
Please note: This document is not available freely online. Photocopies can be obtained from the British Library of Development Studies (BLDS). There is a charge for this service.
