Turkmenistan
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Health systems in transition
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Country overview
The health system of Turkmenistan is organized on a national basis. Whilst policy making for the health sector comes under the ambit of the Cabinet of Ministers, the Ministry of Health and Medical Industry is responsible for the actual operation of health services. In each of the country’s five velayats (regions), the velayat hakim (provincial governor), a presidential appointee, finances regional health services.
Public funds for the health system mainly come from national government revenues. National taxes (such as income tax, value added tax, excise duty and the natural resource taxes) are collected by the central government, and the revenue is distributed to velayat governments and the Ashgabat municipality. In addition, local authorities levy their own taxes and the President may allocate extra monies to the health sector. Informal payments are widespread but difficult to quantify.
Primary care facilities are distributed around the country. Polyclinics are managed by their chief physicians and have no administrative links with hospitals. Local primary care institutions perform a gatekeeper function and when necessary, they refer to an etrap (district) hospital or an affiliated hospital in cities. Hospitals are designed to provide general secondary and more specialized inpatient care and they are grouped as: rural hospitals (primary health care-based), etrap (district) hospitals, city hospitals, dispensaries (specialized hospitals), velayat (regional) hospitals and central clinical hospitals. Hospitals do not admit patients unless they are referred from primary care, except emergency cases or patients who are willing to pay.
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