New ways of paying for primary health care discussed in Belarus

Decision-makers from the health and finance ministries of Belarus, as well as representatives of the regional health executive committees met in Minsk on 1–2 March 2011 to identify ways to further strengthen the financing of primary care units in order to improve their performance. Experts from WHO/Europe and the European Observatory on Health Systems and Policies contributed to this policy dialogue, hosted by the Ministry of Health.

The dialogue included a review of the current status of and developments in reforming primary health care in the country, a discussion of specific payment mechanisms and an exploration of the experience of other countries in the WHO European Region.

Based on these discussions, participants assessed the country’s policy options to improve the motivation and retention of health care staff working in urban outpatient clinics and rural primary health care centres. Thy identified two priorities:

  • further refining the standard capitation rate (the fixed amount given to a doctor to provide health care for each patient) to allocate financial resources to the regional and district level; and
  • providing financial and other incentives for clinical staff to improve their efficiency and the quality of services.


Improving the health system

Strengthening primary health care is a central component of improving the performance and cost–effectiveness of health systems in many central and eastern European countries. Belarus is committed to reforming and strengthening its primary care provision, as part of its goal of ensuring equity and universal access to health care.

Through the implementation of per capita financing for health care services since 2004, more resources have been directed towards primary health care, but it is still unappealing for doctors and patients. While salaries remain low, the bureaucratic workload for primary care professionals has increased in recent years. A review of the concept of primary care is needed in the light of the public health challenges that Belarus faces.