Reforming sanitary-epidemiological service in Central and Eastern Europe and the former Soviet Union: an exploratory study

Gotsadze, George; Chikovani, Ivdity; Goguadze, Ketevan; Balabanova, Dina; McKee, Martin
January 2010
BMC Public Health;2010, Vol. 10, p440
Academic Journal
Background: Public health services in the Soviet Union and its satellite states in Central and Eastern Europe were delivered through centrally planned and managed networks of sanitary-epidemiological (san-epid) facilities. Many countries sought to reform this service following the political transition in the 1990s. In this paper we describe the major themes within these reforms. Methods: A review of literature was conducted. A conceptual framework was developed to guide the review, which focused on the two traditional core public health functions of the san-epid system: communicable disease surveillance, prevention and control and environmental health. The review included twenty-two former communist countries in the former Soviet Union (fSU) and in Central and Eastern Europe (CEE). Results: The countries studied fall into two broad groups. Reforms were more extensive in the CEE countries than in the fSU. The CEE countries have moved away from the former centrally managed san-epid system, adopting a variety of models of decentralization. The reformed systems remain mainly funded centrally level, but in some countries there are contributions by local government. In almost all countries, epidemiological surveillance and environmental monitoring remained together under a single organizational umbrella but in a few responsibilities for environmental health have been divided among different ministries. Conclusions: Progress in reform of public health services has varied considerably. There is considerable scope to learn from the differing experiences but also a need for rigorous evaluation of how public health functions are provided.


Related Articles

  • Effectiveness of an intervention in groups of family caregivers of dependent patients for their application in primary health centers. Study protocol. Rodríguez-Sánchez, Emiliano; Mora-Simón, Sara; Porras-Santos, Nieves; Patino-Alonso, Maria C.; Recio-Rodríguez, José I.; Becerro-Muñoz, Concepción; Pérez-Arechaederra, Diana; Gomez-Marcos, Manuel A.; Garcia-Ortiz, Luis // BMC Public Health;2010, Vol. 10, p559 

    Background: Although Primary Health Care (PHC) Teams are used to deal with prevention and treatment of sanitary problems in adults with chronic diseases, they usually have a lack of experience in development of psychotherapeutic interventions. However, these interventions are the ones that...

  • Response to 'The European health strategy—so what next?'.  // European Journal of Public Health;Dec2008, Vol. 18 Issue 6, p557 

    The article presents a viewpoint on the European Union's (EU's) Health Strategy for 2008-2013, which is said to mark the coming of age of public health within the European Commission (EC). Accordingly, there was no concept of any kind of all-embracing strategy for public health in those days but...

  • An Assessment of Health Hazard/ Health Risk Appraisal. Wagner, Edward H.; Beery, William L.; Schoenbach, Victor J.; Graham, Robin M. // American Journal of Public Health;Apr1982, Vol. 72 Issue 4, p347 

    Abstract: A state-of-the-art review of a widely- used health promotion technique, the health hazard/ health risk appraisal (HHA/HRA), was conducted. The review included preparing a 212-item annotated bibliography, compiling an inventory of 217 programs that have used HHA/HRA, holding discussions...

  • A systematic review of evidence for the added benefits to health of exposure to natural environments. Bowler, Diana E.; Buyung-Ali, Lisette M.; Knight, Teri M.; Pullin, Andrew S. // BMC Public Health;2010, Vol. 10, p456 

    Background: There is increasing interest in the potential role of the natural environment in human health and well-being. However, the evidence-base for specific and direct health or well-being benefits of activity within natural compared to more synthetic environments has not been...

  • preventive medicine. Peters, Michael // BMA A-Z Family Medical Encyclopedia;2004, p628 

    An encyclopedia entry for "preventive medicine" is presented. Preventive medicine refers to the branch of medicine dealing with the prevention of disease, which is attained by implementing public health measures including the provision of pure water supplies and sanitation, health education and...

  • The European data protection legislation and its consequences for public health monitoring: a plea for action. Verschuuren, Marieke; Badeyan, Gerard; Carnicero, Javier; Gissler, Mika; Asciak, Renzo Pace; Sakkeus, Luule; Magnus Stenbeck7; Walter Devillé1 // European Journal of Public Health;Dec2008, Vol. 18 Issue 6, p550 

    The article focuses on the data protection legislation in Europe and its impact on the public health monitoring. Accordingly, the Network of Competent Authorities (NCA) is one of the implementing structures of the Health Information and Knowledge Strand of the European Public Health Programme...

  • Heading off a web of deceit.  // Nature Medicine;Jan2001, Vol. 7 Issue 1, p1 

    Editorial. Focuses on the issues related to providing health information on the Internet. Advantages of availability of health information online; Proposal of World Health Organization for the establishment and regulation of restricted Internet domain.

  • Adapting online learning for Canada's Northern public health workforce. Bell, Marnie; MacDougall, Karen // Circumpolar Health Supplements;2013 Supplement 1, Vol. 72, p895 

    Background. Canada's North is a diverse, sparsely populated land, where inequalities and public health issues are evident, particularly for Aboriginal people. The Northern public health workforce is a unique mix of professional and paraprofessional workers. Few have formal public health...

  • 'SGoFicance Trace': Assessing Significance in High Dimensional Testing Problems. de Uña-Alvarez, Jacobo; Carvajal-Rodriguez, Antonio // PLoS ONE;2010, Vol. 5 Issue 12, p1 

    Recently, an exact binomial test called SGoF (Sequential Goodness-of-Fit) has been introduced as a new method for handling high dimensional testing problems. SGoF looks for statistical significance when comparing the amount of null hypotheses individually rejected at level γ = 0.05 with the...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics