Realization of the social type policy in the country provides opportunity to develop healthcare and to solve problems related with protection of the population’s healthcare. The Law of the Republic of Azerbaijan on ‘protection of the population’s healthcare’ has been adopted in 1997. The Law reflected most important and necessary matters such as free of charge medical care for pensioners and poor persons, rendering of acute care to population etc.
Free of charge services are being provided by enterprises of the Ministry of Health financed from state budget since 1 February 2008.
According to adopted State Programs persons suffering from insular diabetes, renal insufficiency, blood diseases and infectious diseases are being treated and provided with free of charge treatment and medicine.
The amount of funds allocated from state budget for health is being increased annually. During first 10 years of the independence 267.9 million mantas were allocated for this branch, then this amount being increased by 1.6 times made 429.4 million mantas in 2010.
There were 516 hospitals, 1688 outpatient clinics, 72 ambulances, 472 antenatal clinics, children’s outpatient clinics and ambulatories, 75 sanatoriumrest homes with 33 thousand physicians, and 60 thousand paramedical personnel at the beginning of 2011. New hospitals, diagnosis centers, outpatient clinics equipped with modern types of medical equipments were built and submitted into use in different regions of the country during last 20 years.
Different infectious diseases were decreased and some of them were fully eliminated in the result of carrying out measures. So, elimination of measles and rubella was reached in the result of joining of the Ministry of Healthcare of the Republic of Azerbaijan in 2006 to the WHO Program on ‘Elimination of measles before 2010’ and vaccination of population aged 7-23 years old against measles and rubella.
There were not registered morbidity cases with measles in 2010 while this figure in 2003 has made 1950 and number of morbidity cases with rubella decreased relatively from 1058 persons to 1 person, epidemic parotitis – from 794 to 125 persons, malaria – from 482 to 52 persons.
The Decree of Heydar Aliyev dated December 29, 1998 approved current Regulations for the Ministry of Health of the Azerbaijan Republic.
Main duties of the Ministry of Health The Ministry of Health has the following duties:
1. Provide medical assistance to the population;
2. Develop and implement state programs in the sphere of healthcare;
3. Take actions necessary for the development of all types of healthcare, regardless of the type of property;
4. Ensure the control over the state sanitary and epidemiological healthcare in the territory of the Azerbaijan Republic;
5. Ensure the development and implementation of the actions on the protection of maternity and child, and family planning;
6. Provide the population of the Azerbaijan Republic and medioprophilactic institution with medicines, bacteriological, virus drugs and other medical-purpose products;
7. With the purpose of implementing state programs, to ensure the development of subordinated departments and enterprises, network of drugstores, and ensure that performance and financial-economic discipline are strictly followed;
8. Ensure the development of scientific researches in the spheres of medicine and pharmacy, improve their efficiency, and make progress in science, technique and best practices;
9. Ensure the formation and development of the spheres of medical and clinical equipment;
10. Manage the preparation of medical and pharmaceutical staff at medical education institutions, improve knowledge and practical skills of such personnel on their profession; provide subordinated departments and enterprises with skilled staff;
11. Improve management using economic methods, apply new economic mechanisms, ministerial machinery in the medicine, advanced forms of management in the works of local healthcare bodies and organization;
12. Efficiently use capital investments in the construction of healthcare objects and improve their efficiency;
13. Ensure sound and safe labour conditions for employees working at the subordinate departments and enterprises;
14. Define the directions of development of the healthcare system, improve the forms of organization of medical aid, establish medical statistics and information-analytical bank in order to study the demographic condition, health and death condition of the population, and organize its activity;
15. Prevent infectious diseases from entering into and dissemination in the territory of the Republic of Azerbaijan;
16. Timely examine letters, applications and complaints and take appropriate actions.
Basic rights of the Ministry of Health
The Ministry of Health shall have the following rights arising from its function;
1. Study the health condition of the population of the Azerbaijan Republic and define, in this connection, main directions of development of the healthcare in the republic, to prevent diseases from occurring, take actions to reduce the cases of illness, disability and death, and ensure longevity;
2. Develop measures on the protection of mothers and children, and family planning, organize treatment and prophylactic aid to maternity and children, carry out activities with relevant ministries, central departments and organizations on protection of women and teenage labour, health of children, and physical and hygienic education, carry out control over the health condition of the children at pre-school establishments, impose requirements on production, sale and consumption of child nutrition products;
3. Study resort resources of the Azerbaijan Republic, participate in the preparation of the activities on the improvement of resorts and health improvement zones, develop more efficient methods associated with comprehensive use of the resort factors;
4. Manage forensic-medical, forensic-psychology and forensic-narcology examination and organize their activity;
5. Organize and carry out activities in the spheres of ensuring the sanitary and epidemiological well-being of the population, organize agitation and education activity in the sphere of healthcare;
6. Ensure the sanitary protection of the territory of Azerbaijan Republic from entering in and dissemination of quarantine infections, and import of food products and consumer products being dangerous for the population;
7. Carry out works on hygienic certification on prevention of factors that would cause potential threat to human health as a result of production and use of products in daily life and national economy;
8. Ensure the application of state-of-art practice, achievements of the medical science and technology in the medical practice of the Republic of Azerbaijan, direct the scientific researches carried out in the medical and pharmaceutical spheres together with the State Committee of the Azerbaijan Republic for Science and Technology and the Academy of Science;
9. Carry out record of the needs for specialists with higher and secondary medical- pharmaceutical education, organize employment of such specialists at medical institutions, as well as in training of scientific-pedagogical and scientific staff. Provide healthcare institutions with qualified medical staff according to their needs, and take actions in order to improve professionalism of physicians, chemists and other healthcare employees;
10. Find out the needs of healthcare institutions and of the population of the Republic of Azerbaijan for information of medical nature, sanitary cars and medical equipment and ensure provision thereof;
11. Organize control over the condition of routine works carried out in the ministerial system; develop perspective development plans of departments and institutions for the cities and districts of the Azerbaijan Republic and, on the Republican healthcare system as a whole, as well as the plan for training, specialized training and additional training for higher and secondary education medical and pharmaceutical staff;
12. Develop current construction plans for healthcare objects of the Azerbaijan Republic and give recommendations for their agreement and approval;
13. Organize supervision and revision works, preliminary registration and reporting in the system of ministry, discuss and approve balance sheets of subordinated departments and institutions, carry out control over the correct keeping of recording and making calculations in the accounting work, as well as ensure observation of the regime of saving and protection of state property and timely compensation of damage caused;
14. Organize collection of state-report data, generalization, adjustment thereof, and timely delivery to statistical bodies;
15. Manage the works on the development of inventiveness and rationalization in the system of healthcare in the Azerbaijan Republic, and apply recommendations on inventions, discoveries and improvement suggestions;
16. Cooperate with the World Health Organization (WHO), UNICEF and other international government and non-government organizations in important directions of the healthcare;
17. Reward advanced medical and pharmaceutical workers, as well as persons actively participating in the organization of healthcare with honorary awards and other encouraging means in the established order;
18. Organize Republican Medical Conference and Congresses related to healthcare institutions in an accepted manner;
19. Organize publication of circular press materials related to the medical science;
20. Adopt normative legal acts within their authorities and based on the current legislation;
21. Cancel orders and resolutions of the subordinate departments and institutions; to petition before relevant bodies to stop execution and cancellation of decisions having harmful influence on the health condition of the population, as well as those not complying with the Regulations of the Ministry of Health.
Resolution No.760 of the President of the Republic of Azerbaijan dated March 13, 1998 established a Government Commission established aimed at the organization and conducting reforms in the healthcare system. The Commission included ministers of economy, finance and justice, chairmen of the Central Bank, Social Protection Fund, Trade Unions Confederation, Social Insurance Control, heads of other ministries and central departments, officials of the Cabinet of Ministers of the Azerbaijan Republic etc.
Decree No.49 of the President of the Azerbaijan Republic dated December 29, 1998 approved “The Regulations on the State Committee for reforms in the sphere of healthcare in the Republic of Azerbaijan”.
The Ministry of Health of the Azerbaijan Republic has developed and approved a number of normative and methodical documents aimed at implementation of legislative acts and State programs.
Reforms in the sphere of changing this area, provision the population with medical aid and organization of such aid should go in the following directions.
- Creation of legislative and legal basis of the new system for protection of the population’s health;
- Defining centralized and non-centralized forms of management of the healthcare system;
- Advantage of the initial medical and sanitary aid;
- Improvement of the medical institutions network and their bed fund;
- Conducting reforms in the sanitary and epidemiological system;
- Transition to the principles of medical insurance;
- Development of paid medical services;
- Reforms in the pharmacy system;
- Privatization in the public healthcare system;
- Accreditation, certification and licensing of medical institutions, medical staff, medicines and food products;
- Reforms in the medical education;
- Reforms in the analytical information service.
New stage in the international relations of the public healthcare system
As far back as in nineties, as all other spheres of the State of Azerbaijan, which had just started its way of democracy, our national public healthcare and medical science could not develop remaining within the borders of our country. There was a need for presenting the Azerbaijani public healthcare to the world, as well as the world public healthcare to Azerbaijan.
For this reason, a special department for international relations was established in 1994 at the Ministry of Health. Priorities of the department included innovations in the public health system of foreign countries, reforms in the Azerbaijani public health system, preparation of projects together with donor organizations acting in Azerbaijan related to public healthcare, in general, cooperation with World Health Organization (WHO), World Bank, UN Children Fund, and USAID, Doctors without Border, Red Cross Federation and influential non-government institutions. In addition, the department had other duties such as joint works with embassies of foreign countries acting in our country and international relations departments of other ministries in Azerbaijan.
In the implementation of the State Program of “Reduction of poverty and economic development” in Azerbaijan, in addition to economic and social issues, reforms in the public health system is of great importance. Implementation of reforms related to the public health and regulation of the projects complying with world standards are included in the Regulations of the international relations department.
The International Relations Department has been playing an essential role in the coordination of the targets included in the priority tasks of the public health and conducting activities conforming to them.
The International Relations Department has actively participated in the composition of the document titled as Medium Text Programme (MTP), which reflected the joint activity of the Azerbaijani Government and WHO European Office and its approval on all government and international levels and progress of the document. Activity of every project within this program, as well as activities associated with the participation of national professionals in international conferences and this department coordinates seminars.
Projects such as struggle with tuberculosis, AIDS, malaria, infectious diseases, family medicine, rescue of children, safe motherhood, family planning and reproductive well-being, strengthening initial public health services, demographic enquiry, and protection of children’s health in districts, mass immunization and prophylaxis have been carried out with direct participation of the International Relations Department and National Coordinators of the Ministry of Health.
We would like to note that due to the works done and great efforts the World Health Organization (WHO) a country free from poliomyelitis has already proclaimed Azerbaijan.
Assistance provided by UN Child and Population Fund, UNICEF, World Bank, WHO and other international entities should specifically be mentioned. It is no coincidence that improvement and development of the information system in the Azerbaijani Public Healthcare system has been reflected in 3 state programs. Translation of diseases, international classification of cosmologic units into Azerbaijani, conducting wide range of trainings in various regions on the professional training of physicians on the information system, improvement of general record and registration system are just part of the works done recent years.
Projects such as wide application of computer and other instrumental examination methods in the diagnostics and treatment of various diseases in the up-to-date public health, modern methods of treatment of diseases, treatment algorithms, preparation for extraordinary situations, regular professional trainings of physicians in Azerbaijan and well-known medical centres abroad have also been implemented.
As our independent republic revives, borders between countries become transparent, science, economic relations grow, and the integration of the Azerbaijani Public Health into the international world increases and relations become wider. Globalization of the public health in XXI Century is unavoidable. In addition to learning a lot from the world public health, we want to inform the international community of the reforms we have carried out in Azerbaijan.
Starting from the end of 2005, the International Relations Department of the Ministry of Health of the Azerbaijan Republic started reinstatement of relations with international entities, donor institutions, and diplomatic missions acting in Azerbaijan, as well as with other ministries of our state in order to represent the public healthcare of Azerbaijan beyond our borders.
This has been reflected in Order No.146 of Mr. Ogtay Shiraliyev, the Minister of Health of the Azerbaijan Republic, “On Programs implemented together with UN Child Fund, World Health Organization and other international organizations” dated December 01, 2005.
In the implementation of “Reduction of poverty and economic development” State Program, along with social and economic issues, reforms in the public health have been given a special attention in Azerbaijan. Implementation of the reforms related to the public health and regulation of these reforms in compliance with world standards are included in the Regulations of the International Relations Department.
Assistance of UN Child and Population Fund, UNICEF, World Bank, USAID, WHO and other entities that act in the sphere of public healthcare in Azerbaijan should specifically be mentioned.
Projects that have been implemented by these institutions jointly with the Ministry of Health are as follows:
• Project for development of initial healthcare services
• Reproductive Wellbeing and family Medicine project
• Demography and Health Summary in Azerbaijan project
• Struggle against Measles and German Measles Project
• Development of Emergency Project
• Rescue of Children Project
• Rescue of Children Project
• Reproductive Wellbeing and family Medicine project
• Demography and Health Summary in Azerbaijan project
• Strengthening of medical service in the regions of Azerbaijan
• Statistics on the child death under the age of 5
• World Health Organization
• Public Health Policy Project
• New ICD 10 cosmologic code determination
• Struggle Against Tobacco Project
• Struggle Against Tuberculosis Project
• Struggle Against Malaria Project
• Struggle Against AIDS Project
• World Bank
• Reforms in Public Health Innovation Project
• PHRD Project for Reforms in the Public Health system
Moreover, projects of UN Food Program Fund, Doctors without Border, International Medical Corpus, Red Cross Federation and other well-known institutions and funds have been continuing their projects. Activity of each project within these program projects, as well as activities related to the participation of national specialists in conferences and the Department has coordinated seminars.
Relations with health organizations of other countries have been strengthened through the help of embassies of foreign countries acting in Azerbaijan and the Ministry of Foreign Affairs.
Embassies of Turkey, Russia, Egypt, Iran, Ukraine, Great Britain, USA and others may be shown as an example.
The State Agency for Compulsory Medical Insurance was established by the Order of the President of the Republic of Azerbaijan dated December 27, 2007. According to the Decree of the President of the Republic of Azerbaijan No. 765 dated February 15, 2016, the body was launched. The ‘State Agency for Compulsory Medical Insurance’ was establshed as a legal entity of public law on the basis of the State Agency for Compulsory Medical Insurance under the Cabinet of Ministers of the Republic of Azerbaijan having the legal status of an “Executive Authority Body”. The ‘State Agency for Compulsory Medical Insurance’ is a state body envisaging the following activity directions: to participate in the formation of a unified policy in the field of compulsory health insurance and ensure the implementation of this policy, to carry out compulsory medical insurance of the population and to ensure the financial sustainability of compulsory medical insurance, to take measures to create equal conditions for the population in the use of medical services within the framework of compulsory medical insurance, to make compulsory medical insurance accessible to all, to increase the quality and efficiency of medical services in order to protect the health of the population, to ensure the development of compulsory health insurance.
The Service Package of compulsory health envisages the number of medical services included in the package to 3,000. The “service envelope” (basic benefits package) includes primary care, emergency care, specialized outpatient care, laboratory services, physiotherapy, invasive radiology, and inpatient care.
First, the compulsory health insurance has been launched as a pilot in two regions (Mingachevir and Yevlakh region since 2016); then a third region (Agdash region since 2018) joined. Since January 2, 2020, 24 more regions we covered by health care services under compulsory health insurance scheme. Finally, only since April 1, 2021, compulsory health insurance covers 100% of regions of the country.
According to the Decree of the President of the Republic of Azerbaijan dated December 20, 2018, the Agency established the “Medical Territorial Units Management Association” (MTUMA) public legal entity. Medical institutions included in the state health system under the Ministry of Health of the Republic of Azerbaijan (with certain exceptions) were subordinated to MTUMA since January 2020.
The provision of medical facilities under the auspices of MTUMA with the necessary conditions and equipment continued in 2020. Thus, medical institutions were provided with 5,300 computers, 2,260 printers and 6,100 barcode devices and other technical equipment. In addition, 14 medical facilities are provided with a fiber-optic network.
In December 2019, in connection with the detection of diseases caused by the new coronavirus, doctors and specialists working in the field of health care faced issues related to the clinical examination and emergency diagnosis of patients.
From the very first days of the pandemic Azerbaijan has taken practical measures to minimize negative impact of the COVID-19 on the population and to keep the situation under control. Within short period of time, 13 modular hospitals and one regular hospital were built. Total number of beds designated to treat COVID patients throughout the country is more than 10 000.
At the same time, the socio-economic stimulus package worth almost $2 billion has been released in order to support COVID-affected people and business.
Azerbaijan has very fruitful cooperation with the World Health Organization. Last year, the World Health Organization hailed Azerbaijan as an exemplary country in fighting the pandemic.
Azerbaijan has always propagated the importance of demonstrating a committed global solidarity to overcome the pandemic. In its capacity, as the chair of the Non-Aligned Movement, Azerbaijan has initiated a number of global initiatives, in particular the holding of the Summit of the Non-Aligned Movement in May 2020, and convening the Special Session of the United Nations General Assembly at the level of the heads of state and government in December 2020 which was supported by more than 150 States.
Azerbaijan has made voluntary financial contributions to the World Health Organization in the amount of $10 million and provided humanitarian and financial assistance to more than 30 countries with regard to coronavirus.
In order to prevent the spread of the coronavirus pandemic in the country, a registration program was established in a short time. As part of the fight against the pandemic, the country's coronavirus testing centers and modular hospitals, as well as specially allocated medical facilities have been provided with computers, printers, barcodes and other technical equipment, as well as software. Electronic registration posts have been set up in 61 medical institutions. 42 laboratories for coronavirus testing have been fully automated and the results have been processed electronically. An SMS notification system has been set up for citizens to get acquainted with the results of coronavirus tests.
As in all spheres of life in the country, the reforms, development and progress in the field of health care, carried out in accordance with the new economic system, are gaining new momentum.