Public health reforms in Estonia: impact on the health of the population

doi:10.1136/bmj.331.7510.210

BMJ 2005;331:210-213 (23 July), doi:10.1136/bmj.331.7510.210

Education and debate

Public health reforms in Estonia: impact on the health of the population

Kaja Põlluste, assistant professor of health care management¹, Georg Männik, member of managing board², Runo Axelsson, professor of health management³

¹ Department of Public Health, University of Tartu, Ravila 19, 50411 Tartu, Estonia, ² ERGO Insurance Co, Estonia, ³ Nordic School of Public Health, Gothenburg, Sweden

Correspondence to: K Põlluste kaja.polluste@ut.ee

The first 150 words of the full text of this article appear below.

Introduction

The health of the population has worsened in most countriesin central and eastern Europe during the transition period,but little has been written about the reforms in the field ofpublic health during this time, and little evidence has beenpresented on the links between these reforms and the healthof the population.

We describe public health reforms in Estonia, focusing on theinstitutional structure, the reform rationale, the specificproposals and reform processes, the achievements and limitations,and the wider impact of the reforms.¹ To describe trends inthe health of the population, we use life expectancy, infantmortality, rate of abortions per 100 live births, morbidityrates (tuberculosis, HIV, sexually transmitted diseases), andthe level of individual risk factors (smoking, diet, alcoholconsumption). The study is based mainly on an analysis of previouslypublished reports and official statistics.

Institutional structure

After the political changes in the beginning of the . . . [Full text of this article]

The reform rationale

The reform proposals and processes

Achievements and limitations

Impact of reforms

Conclusions

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