Quo vadis SANEPID? A cross-country analysis of public health reforms in 10 post-Soviet states

Abstract

Background: The public health systems of the post-Soviet states have evolved from the san-epid system, which dominated public health practice throughout the former Soviet Union. Since independence, reforms have taken different directions. This article provides a cross-country comparison of public health reform processes and contents in 10 post-Soviet states.

Methods: The study is descriptive and comparative, based on a literature review of the major health databases, the Health Systems in Transition (HiT) volumes and grey literature. Search terms included terms on public health, the san-epid services and organizational reforms in one or several post-Soviet states.

Results: Public health reforms have varied greatly: some countries have preserved the san-epid structure, some have built structures in addition to the san-epid system, and others have set up a new public health infrastructure. Traditional "functions" of the former san-epid system, such as vaccination, are still more advanced, while health promotion and intersectoral collaboration are less developed.

Conclusion: Critical self-evaluation, implementation of performance measurement and rigorous external research will prove essential in identifying strengths and weaknesses of past reforms and learning for the future.