School Health Services in Former Socialist Countries: Case Studies from Albania, Republic of Moldova, Tajikistan, and Ukraine

This chapter describes the evolution of school health services in Albania and three former republics of the Soviet Union: the Republic of Moldova, Tajikistan, and Ukraine. The four countries share a very similar historical and health system context in which school health services evolved. After independence in the early 1990s, the health care systems in these countries faced major financing problems with massive exodus of school health personnel. The accumulation of unresolved issues inherited from the Semashko centralized state-owned model of healthcare organization and management, exacerbated by certain aspects of health care reforms after independence triggered the need to reform school health services. Between 2007 and 2012, with WHO support these countries embarked in a process of revision of school health services. This chapter describes the step-by-step approach that these countries undertook, and its main results.