The Impact of the World Bank on Health Care Reform in Transitional Economies

Why do some countries still experience high mortality rates and low health care sector effectiveness, thirteen years after the post-communist transition? Why have some been successful at addressing their health care needs while other left their public health in decay? This study attempts to answer the puzzle by looking at the role of World Bank assistance in the health care reforms of the Central and Eastern European countries during the transition period. It does so by focusing at the type of reform undertaken by countries, as well as at the significance of the loan amount and the ability of the countries to “absorb” the loans successfully, that is, to use the resources given effectively. The results indicate that those countries that reformed earlier and developed strong institutions, were also more likely to use the World Bank loans more efficiently to reform their health care sector. Thus, the effectiveness of their health care system was higher than that of countries that undertook gradual reforms, received less World Bank assistance, and whose institutions were weak.