Department of Strategy and Donor Coordination

Hospital reform focuses on decentralisation of competences and budget from the centre to regions. For this
purpose, uniform protocols and unification of diagnostic procures will be an important step next year. There
will be a unified treatment protocol in all hospitals, for each disease. Unified protocols will bring unified
prices, and treatment will cost the same in any hospital in the country.
Indicator: Infant mortality rate and maternal mortality rate
All sources of data demonstrate an encouraging improvement in the level of infant mortality over the last
decade. Nevertheless the level remains high when compared to other European countries, though it is lower
than the levels in Turkey and Macedonia.
Figure 31 shows the change in the rates of infant and maternal mortality between 2000 and 2008, based on
MoH data. Infant mortality has shown a steady improvement since 2001, and in 2008 the figure was 11.1 per
1,000 live births, against twelve per 1,000 live births in 2007. This downward trend reflects the improvements
made in the health service, doctor skills and applied technology.
Figure 31. Infant and maternal mortality rates 2000–2008
30.0
25.0
20.0
15.0
10.0
5.0
22.2
16.0
22.6
17.5
26.0
17.3
15.5
17.7
15.0 14.7
7.3
23.2
16.7
13.0
14.5
12.0
11.0
10.0
0.0
2000 2001 2002 2003 2004 2005 2006 2007 2008
Infant mortality
Maternal mortality
Source: MoH
One of the most significant indications of improved maternal health is that the maternal mortality rate has
been decreasing. Despite some fluctuations presumably due to incomplete data gathering in 2003 and 2004,
the figure has fallen to ten deaths per 100,000 live births, compared to the previous year when it had fallen
to 14.5 per 100,000. UNICEF conducted a survey (MICS) in 2006 which showed that 97.1 per cent of women
during pregnancy had received health care from competent medical staff and 43 per cent of them continued
with medical visits in the first three months following birth.
These data mean that medical care during pregnancy in particular and reproductive health in general can
be improved further. Further efforts should be invested towards pregnancies and the port-natal period by
improving hospital services and primary health care.
3.3.7 pre-university education
Indicator: Net secondary education enrolment rate: proportion of students of age 14–17 years attending
classes 9–12, by gender
Education is central to the government’s priority policies and improved considerably in 2007 and 2008. Over
this period, efforts were focused on management capacity building at the central level (MES) and the regional
level (Regional Education Directorates and Education Offices), decentralisation of education services and
enhancement of school autonomy. Reform of school staff has been developed and implementation is expected
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