Definition of the Information Needs of the Zdravreform Program

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Dear Reader:

Enclosed is the set of 49 tables featuring health and health-related statistics for 12 regions and 80 territories of the Russian Federation. This “territorial” data set has been designed and developed at Abt Associates Inc. by a team of the staff of the ZdravReform Program (ZRP). ZRP is a long-term multidisciplinary effort, sponsored by USAID, which provides comprehensive technical support to reforms of the health services system in the New Independent States (NIS) of the former Soviet Union. This data set supplements a set of national health statistics for Russia previously released by ZRP.

The territorial data set is a product of three months of activities, led by ZRP’s Dr. Alexander Telyukov with major contributions by Victoria Goldin and Katy Miller, which included:

 definition of the information needs of the ZdravReform Program,

 conceptualization and design of the system of indicators that provides a comprehensive

view of the Russian system of health financing and service delivery,

 reconciliation of the desired format for the data with what is generated within the current

system of macro- and health sector accounting,

 selection of and subscription to sources of statistics published in Russia,

 collaboration with government agencies in Moscow on collecting and interpreting

indicators available only from professional files and data bases of

institutions, and

 converting and formatting raw data into the tables of the data set.

The ZdravReform data set is comprised of 5 sections and 12 subsections as follows:

1.Socioeconomic Profile

1.1.General Economic Indicators

1.2.Social Conditions

2.Demographic Trends

2.1.Population

2.2.Vital Statistics

3.Health Status

3.1.Morbidity

3.2.Health Risk Factors

4.Health Resources

4.1.Inpatient

4.2.Outpatient

4.3.Personnel

4.4.Utilization (not included in the current release)

5.Health Financing

5.1.Sources

5.2.Coverage

5.3.Simulations

ZRP’s design of the territorial data set seeks to facilitate statistical insights into the sustainability, equity, and efficiency status of the Russian health system. These are three key items on the agenda of the ZdravReform Program, as well as other projects of technical assistance to health reforms in Russia.

Planned additional steps for the territorial data set include:

1. Releasing the data set to prospective users in and outside Russia; arranging, both in

Washington and Moscow, computer-assisted presentations of the analytic capabilities of

the data set;

2. Holding intensive consultations with USAID, as well as experts from the World Bank,

ODA, and other major assistance institutions on the strengths, deficiencies, and

prospective applications of the data set for the purposes of international health policy

advice to agencies of the Russian Federation and the territorial governments;

3. Preparing a Methodological Guide to the tabular presentation of the data and releasing it

as an annex to the data set; in particular, the indicators included in the data set will be

defined and the statistical and analytic meaning of calculated tables explained;

4. Identifying gaps in the ZdravReform data set from the perspective of what is required by

the national health accounts as developed by the OECD and US Health Care Financing

Administration;

5. Discussing with Russian federal and territorial health officials priority needs for additional

health and health-related information and how those needs may be met by improving

and/or restructuring the domestic health information systems. Special emphasis will be

placed on amending micro-accounting practices and setting up surveys to address major

information needs to secure sustainable generation of data;

6. Pre-processing the data for subsequent analysis and modeling (sorting, graphic

interpretation, calculation of simple statistics revealing growth and/or variability trends);

7. Adding a module on cross-national comparisons;

8. Designing a Concise Health Sector Profile of a Russian Federation Territory, given that

this is the level of geographic focus of most international health projects. The Profile will

include a set of primary indicators, formats of their graphic presentation, statistics

analyzing selected raw data, and text, supplementing the tables and graphs with descriptive

material based on non-numeric information; and

9. Transforming the data set into an interactive data base.

The ZdravReform Program plans to follow this set with local health statistics for the territories designated as Geographic Focus Areas (GFAs) for its work in Russia. Currently these GFAs are four oblasts each in southwestern Siberia and central European Russia. Emphasis in the local module will be placed on the data relevant for micro-level management and analysis. In addition, ZdravReform is constructing similar data bases for other successor countries to the Soviet Union.

As we release the territorial data set for professional use by international and US assistance institutions, as well as their contractors and sub-contractors, the ZdravReform Program team would like to invite the international community to share their information, resources, methods of data collection, and techniques of analysis. Such cooperation would eliminate duplication of effort, enhance the internal efficiency of our work, and allow all to make larger contributions to health care reforms in Russia and other NIS countries.

Marty Makinen, PhDNancy R. Pielemeier, Dr PH

Program Technical DeputyProgram Director