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Linking Health, Poverty, and Economic Growth in the Russian Federation

This report discusses the interconnectedness of health, poverty, and economic growth in the Russian Federation. It emphasizes the importance of investing in health to reduce poverty and improve economic outcomes. The impact of health on productivity and GDP growth is highlighted, along with specific challenges and recommendations for the healthcare system in Russia. Regional variations, infectious diseases like AIDS, and financial reforms are also addressed.

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Linking Health, Poverty, and Economic Growth in the Russian Federation

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  1. Russian Federation:Linking Health, Poverty and Economic Growth Jack Langenbrunner The World Bank Moscow July 2004

  2. Why Invest In Health? • Poverty and Ill-health are intertwined • Poorer health outcomes in/within poorer countries • Poverty breeds ill-health (due to diet, education, transportation, etc) • Ill health keeps poor people poor • Invest in health: reduce ill health and poverty

  3. Why Invest in Health? Impact on Economic Growth • Macro-Economic Commission on Health • 10% increase in life expectancy = 0.35% growth in GDP • Productivity • 17% of productivity gains attributable to health status • Poor Outcomes • Sick leave, absenteeism, etc.

  4. Health Status Varies by Income

  5. Russia vs. Canada: Health Status

  6. Poorer Groups: More Likely to Engage in Risky Behaviors • Vodka • Cognac • Liquers • Other Spirits Several times per week or daily

  7. Russian Federation: General Health Status

  8. Probability of Russian Man Dying, Ages 15-60

  9. Re-Emergence of Infectious Diseases: AIDS • 60% 20-30 Years old • 2.3 million by 2010 • 10% drop in GDP by 2020 • Larger drops in labor supply and investments

  10. Regional Variations Growing (Infant Mortality)

  11. Finance and Delivery System: Reform Needed • Access to Services • Social Solidarity/Risk Pooling • Efficiency in Delivery • Equity • Protection of Poor and Vulnerable Groups • Pensioners

  12. Limited and Declining PublicSector Funding for Health

  13. Selected International Comparisons:Levels of Funding (% Share of GDP)

  14. Russia International Best Practice Fragmented Funding Streams Fund Rayon Budget Pooled Funds Doctor Hospital Doctor Hospital

  15. Inefficiency: Too Many Beds and Physicians

  16. Too Much Reliance on Hospital Care (admissions/1,000)

  17. Geographic Inequity: Over 7-fold Regional Variation in Funding(even after adjusting)

  18. Impact on Poor and Vulnerable Groups

  19. NOBUS Survey (1): Poor Pay More as % of Consumption

  20. NOBUS Survey (2): % of Consumption for Paid Services

  21. NOBUS Survey (3):Poor Can’t Afford to Follow Treatment Regimens

  22. Recommendations 1. Formalize informal payments • Standardized co-payment system • Explicit protections for the poor and medically vulnerable groups • Inform and educate 2. Restructure financing and delivery system • pooling, geographic formula, autonomize facilities, etc. 3. Improve Measures for Public Health • Cross sectoral strengthening • Cost-effective practices and behaviors • Increase funding for AIDS and lower price of ARVs

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