Azerbaijan: Mandatory health insurance extended nationwide



In the context of the European twinning operation to support the implementation of mandatory health insurance, Expertise France received an Azerbaijani delegation from 13 to 17 May. This high-level study visit follows the decision in late 2018 to extend the pilot experiment for mandatory health insurance in 3 regions of the country nationwide.

By 2020, Azerbaijan needs to set up a national mandatory health insurance system. To support the reform, Expertise France has been coordinating for almost 2 years a twinning project to build the capacities of the State Agency for Mandatory Health Insurance (SAMHI) to plan, implement and control health expenditure.

The study visit was in connection with the Government’s strong commitment to promote access for its population to affordable and high-quality healthcare. It provided the opportunity to establish a high-level dialogue between Azerbaijan and European countries: the delegation was composed of officials from the Legal Department of the Office of the President and representatives of SAMHI, which is directly under the supervision of the Office of the President.

This third and last study visit follows the announcement in late 2018 that the pilot experiment conducted up until now in 3 regions would be extended nationwide.

A successful experiment in 3 pilot regions

The experiment had been conducted since 2016 in the regions of Mingachevir and Yevlakh to raise the awareness of the population and medical staff about health insurance.

Significant results have been achieved in the two regions:

• The official salaries of medical staff have doubled;

Informal payments to doctors have fallen, which has reduced the financial barriers of beneficiaries, even the poorest, to access to healthcare;

• The productivity of health services has increased by almost 50%;

• The number of visits to health facilities and hospital admissions increased in 2017 by 40% and 17%, respectively. The difference in the consumption of health services between Azerbaijan and the standard level for EU countries has thereby been reduced.


A survey has shown that there is a general satisfaction among users with the health insurance system proposed in these two regions: the introduction of health insurance has been positively received by 84% of the population in the pilot regions and 90% of patients who had treatment were satisfied.

Following an extension of the experiment to the Yagdash region in 2018, mandatory health insurance is now going to be deployed nationwide.

A twinning to bring Azerbaijan closer to Community standards

This twinning is part of broader cooperation between Azerbaijan and the EU, which are currently negotiating a new agreement in the context of the Eastern Partnership.

The EU is developing institutional twinnings to assist its partners towards the adoption of European standards – the “Community acquis”. This cooperation mechanism between administrations allows EU Member States to mobilise their public expertise to build the capacities of partner States for the definition and implementation of their public policies.

During its visit, the Azerbaijan delegation met with the French and Belgian ministries responsible for the governance of social protection and the national institutions responsible for health insurance in France (CNAM) and Belgium (INAMI). Other meetings were organised, including with the OECD and European Commission.

Expertise France, to which the management of the twinning has been delegated by the French social ministries, has developed specific expertise in the implementation of an instrument requiring international, European and French influence. Throughout the duration of the twinning, the agency has mobilised French experts from the network of the health insurance branch of the French social security system, as well as from the French Ministry of Health. Expertise France has worked in partnership with Lithuania, which has mobilised its own network of institutions. This has been of major interest to Azerbaijan which – like Lithuania – inherited the Soviet health system “Semachko”. This partnership has provided the Azerbaijani partners with complementary support between the experience of a longstanding EU Member State with a long history of health insurance and a country with more recent experience.



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