Following the post-Soviet transition period, public spending on health dropped sharply, as did health care use rates. Health care use rates declined in part because formal and informal out-of-pocket expenditures had to compensate for the decrease in public spending. Like other members of the Commonwealth of Independent States, Armenia inherited an oversized health care system with widely distributed health facilities and abundant hospital beds. In the Soviet era, the organization, management, and finance of the health system was centrally coordinated through the Ministry of Health. The health system was overly oriented toward curative and hospital care, which resulted in serious inefficiencies .In the decade after independence, the government of Armenia had identified major reforms for the health care system with the objective of improving cost efficiency. The health reforms included a shift in health care financing, reorienting the system toward PHC. Two key goals were to strengthen PHC and consolidate hospitals to reduce inefficiencies and create health budget savings to be reallocated to improve the quality of health care. Armenia was the first country in the region to implement the single purchaser model. Health care providers became managerially and financially autonomous. The achievements and challenges that Armenia faced during 2004-2016 are documented in World Bank’s Project Evaluation Report published in 20 March 2019.
