Latvia

Health systems in transition
Latvia
A major population survey on corruption in the health sector, which was
conducted in 2002, reported that only 3% of patients admitted to having made
an unofficial payment for a health care service, while 14% admitted to giving
gifts to health care providers. A total of 45% of respondents rated corruption
in statutory health care services as high or very high, while 50% believed that
the corruption level had increased over the previous three years. At the same
time, respondents were divided over the issue of whether unofficial payments
to health care professionals constitute corruption, with 51% believing that
they do, and 49% believing that they do not. Most of those who believed that
unofficial payments are not corruption believed them to be an act of gratitude.
The majority of respondents (62%) stated that they would not be willing to report
a health professional who received an unofficial payment. The most common
response (51%) to what should be done to prevent unofficial payments was that
salaries of doctors should be increased. The study concludes that there is likely
underreporting of actual unofficial payments, possibly because respondents
knew it was illegal, or because they may have been afraid to do so, or because
making unofficial payments is so universal that many respondents do not think
of them as unofficial (CIET 2002).
External sources of funds
World Bank
In 1999–2004 the World Bank implemented a project involving a loan of US$
12 million for the “Latvia Health Reform Project”. The objective of the project
was to assist the Latvian Government in a major health sector restructuring
strategy, addressing a number of diverse issues. This project has formed the
basis of most of the health care services reform efforts of recent years, and is
discussed at length in Section 4.2 Planning and health information management,
Chapter 5 Physical and human resources, and Section 7.2 Analysis of recent
reforms.
World Health Organization
WHO has been active in Latvia since 1991 when Latvia first joined as a member
country. Its overall goal in Latvia is to support the Government in health sector
development, through public health policies, provision of technical leadership
and support of an intersectoral approach to health. Key areas of intervention in
the period 2004–2005 have included tobacco control; review of alcohol control
policy; development of mental health policy; intersectoral collaboration on
the prevention of road traffic accidents; strengthening of the National Baby
Friendly Hospitals initiative (in collaboration with UNICEF); updating of an
environment and health information system; an anti-violence campaign (jointly
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