The Future of Health Care in the Kurdistan Region—Iraq

The Future of Health Care in the Kurdistan Region—Iraq: Toward an Effective, High-Quality System with an Emphasis on Primary Care

Melinda Moore
C. Ross Anthony
Yee-Wei Lim
Spencer S. Jones
Adrian Overton
Joanne K. Yoong
Copyright Date: 2014
Published by: RAND Corporation
Pages: 250
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  • Book Info
    The Future of Health Care in the Kurdistan Region—Iraq
    Book Description:

    Presents the results of a yearlong analysis of the health care system in the Kurdistan Region of Iraq, with a focus on primary care. The authors project future supply and demand for health services, describe the strengths of the health care system in the Kurdistan Region as well as the challenges it faces including financing issues, and discusses what strategies can be pursued to move toward a more effective and higher-quality health care system.

    eISBN: 978-0-8330-8632-7
    Subjects: History, Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-ii)
  2. Preface
    (pp. iii-iv)
  3. Table of Contents
    (pp. v-viii)
  4. Figures
    (pp. ix-x)
  5. Tables
    (pp. xi-xii)
  6. Executive Summary
    (pp. xiii-xxviii)
  7. Acknowledgments
    (pp. xxix-xxx)
  8. Abbreviations
    (pp. xxxi-xxxiv)
  9. CHAPTER ONE Introduction
    (pp. 1-4)

    As economic development improves the length and quality of life in countries around the world, many countries face the challenges of modernizing their health care system in response to evolving health needs and evolving best practice. Evolving health needs encompass the demographic and health transitions from high birth and death rates and predominance of health problems typical of developing countries (communicable diseases, maternal and perinatal conditions) to lower birth and death rates and health problems typically predominant in industrialized countries (noncommunicable diseases and injuries). At the same time, new technologies and attention to health service quality have supported modernization of...

  10. CHAPTER TWO Current Health Care System in the Kurdistan Region—Iraq and Vision for the Future
    (pp. 5-28)

    As the KRG looks to the future, it has many policy choices and opportunities to adapt and modernize its health care system. In a Twenty-First-Century model of care, we believe primary care is a cornerstone for providing health services and for serving as a point of referral for more specialized services. In this chapter we provide an overview of the current health system in the Kurdistan Region, describe characteristics of a well-integrated health system based on the latest research, and describe the role of primary care in such a system. We believe that a primary care orientation and the potential...

  11. CHAPTER THREE Projecting Future Health Care Utilization
    (pp. 29-42)

    To assist the KRG in planning for the future, we have developed projections of future health care utilization. By projecting both future demand (e.g., utilization) for services and planned future supply (e.g., hospitals, PHCs, and manpower), we can determine whether the projected supply is sufficient to meet future demand. We can then alter the models to see whether, under various scenarios, the gap between future supply and demand grows or lessens. We can also examine whether the KRG’s investment policies in health care are likely to allow it to meet the goals and objectives it has laid out for itself...

  12. CHAPTER FOUR Health Care Financing: Overview and Lessons
    (pp. 43-64)

    One of the most important foundations of a national health system is the means by which it is financed. Financing is a critical defining factor that is central to achieving all other public and private health goals and objectives.

    This chapter responds to the specific request of the KRG’s Minister of Planning to review the basic tenets of health care financing and to suggest a future road map to help guide KRG policy development in this area. Although we provide an overview of the KRG health care financing system, we do not investigate or analyze it in detail, nor do...

  13. CHAPTER FIVE Organization and Management of Primary Care Services
    (pp. 65-94)

    The KRG primary health care system already possesses key strengths on which to build. However, health leaders and clinical providers at all levels also face significant challenges to improve health care delivery and health outcomes. Improving the organization and management of primary care services is a particular priority highlighted by the Minister of Health and other KRG authorities. Such improvements underpin the entire health care system in Kurdistan, and will continue to do so in the future.

    In this chapter, we discuss recommendations for activities to be undertaken in the next two to three years to improve the organization and...

  14. CHAPTER SIX Health Workforce
    (pp. 95-120)

    Many studies have demonstrated that the size and qualifications of a country’s health workforce are clearly related to health outcomes. For example, WHO (2009a) has documented a positive correlation between the density of health workers and health outcomes, including maternal, infant, and child survival rates. Inherent to such statistics is the assumption of appropriately trained and qualified professionals. Studies have shown that physician quality (and the quality of physician training) is a critical element in providing quality health care. For example, a recent Cochrane review of 30 trials of physician training found that conducting educational meetings increased rates of compliance...

  15. CHAPTER SEVEN Health Information Systems
    (pp. 121-156)

    A health care system depends on data to inform wise investments in policies and programs and to monitor their implementation. Ideally, data are processed into information of sufficient scope, detail, quality, and timeliness to confidently manage health care services at all levels. It is clear that KRG policymakers wish to have such data, but it is equally clear that a “culture of data for action”—where data collection, processing, analysis, presentation, and use are routine and relatively easy—remains undeveloped.

    In this chapter we describe two broad types of health information systems, both of which primarily serve managers at the...

  16. CHAPTER EIGHT Summary and Conclusions
    (pp. 157-162)

    RAND spent the past year analyzing the Kurdistan health system, with special attention to primary care. Our first objective was to make recommendations that would enable policymakers to improve the quality, access, and efficiency of primary care. Another objective was to model demand for health services. At the request of the Minister of Planning, RAND also reviewed the basic principles of health care finance and the research needed to address financing reform. This report describes our modeling effort (in Chapter Three) and our overview of financing issues (in Chapter Four), but it focuses in particular on the first objective (Chapters...

  17. APPENDIX A Graphs of Modeling Results from Chapter Three
    (pp. 163-168)
  18. APPENDIX B Monitoring Progress in Health Service Delivery
    (pp. 169-172)
  19. APPENDIX C Human Resource Indicators
    (pp. 173-174)
  20. APPENDIX D KRG Health Care Congress Presentation: Financing
    (pp. 175-186)
  21. APPENDIX E KRG Health Care Congress Presentation: Primary Care
    (pp. 187-202)
  22. APPENDIX F KRG Health Care Congress Presentation: Quality
    (pp. 203-212)
  23. References
    (pp. 213-216)