Azerbaijan

Azerbaijan’s mandatory health insurance system, introduced in 2021, covers all residents. The benefits package covers emergency services, primary care, outpatient care, inpatient care, and outpatient medicines for vertical state programmes. Other outpatient medicines and dental care are not covered.

Until 2021, Azerbaijan had a highly centralized health system with limited separation between providers, purchasers, and regulators, but recent reforms have split these functions between separate institutions. The State Agency for Mandatory Health Insurance (SAMHI) oversees the mandatory health insurance system and is the public purchaser of healthcare services while the Administration of the Regional Medical Divisions (TABIB) is the main institution responsible for the public provision of health services. The Ministry of Health holds responsibility for overall policy and decision-making for the health system, managing public health centres, and supervising tertiary hospitals such as the National Centre of Oncology Research.

 After four years of piloting, mandatory health insurance was introduced as a major financing mechanism for health services in 2021, along with some earmarked taxes. However, general taxation (transfers from the State Budget) continues to be the primary source of public funds for health care. Historically, Azerbaijan’s spending on health has been low compared to other countries in the region but since the 2021 reforms health spending from public sources has increased substantially. Nevertheless, in 2021 two-thirds of health spending in Azerbaijan was in the form of out-of-pocket (OOP) payments.

 The vast majority of health providers are state-owned, although the private sector has been flourishing in recent years, providing a growing share of health services especially in the capital, Baku. These private facilities operate independently from the public system. In cities and district centres, publicly provided primary care is delivered through paediatric and adult polyclinics, while antenatal and reproductive care services are provided by female consultation centres. In urban areas, inpatient care is provided by city hospitals, which provide a wide range of specialist services.  In rural areas, primary care is provided through feldsher-midwife points, village doctor outpatient clinics and outpatient departments of small village hospitals.