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Background: There is a health crisis in Turkmenistan similar to, but more severe than, in other Central Asian countries. This paper asks whether the health crisis in Turkmenistan is attributable to the consequences of the dictatorship under president Niyazov, who died in 2006. Methods: The basis for this paper was a series of semi-structured in-depth interviews with key informants complemented by an iterative search of internet sites, initially published as a report in April 2005, and subsequently updated with feedback on the report as well as a comprehensive search of secondary information sources and databases. Results: This paper describes in depth three areas in which the dictatorship in Turkmenistan had a negative impact on population health: the regime's policy of secrecy and denial, which sees the "solution" to health care problems in concealment rather than prevention; its complicity in the trafficking of drugs from Afghanistan; and the neglect of its health care system. Conclusion: The paper concludes that dictatorship has contributed to the health crisis facing Turkmenistan. One of the first tests of the new regime will be whether it can address this crisis. [ABSTRACT FROM AUTHOR]

The article provides information about the book "Implementing Health Sector Reform in Central Asia," edited by Zuzana Feachem, Martin Hensher and Laura Rose includes papers from a health policy seminar held in Ashgabat, Turkmenistan in June 1996. Fourteen conference papers consider issues in restructuring health-sector financing and health-care delivery in Central Asia, and Central Asian countries' experiences with the implementation of health sector reforms. Papers discuss health reform in Central Asia; integrated cost-effective health care; the rationalization and management of hospitals; financing health care; reforming medical-care-provider payment systems in Central Asia; the political and administrative environment in Central Asia and implications for health sector reform; trends in health reform in Kazakhstan; the rationalization of health care infrastructure in Kyrgyz Republic; health care policy and strategy during the transition period in Tajikistan; implementing the state program on health in Turkmenistan; health system reform in Uzbekistan; implementing primary health care reform in Romania; planning the implementation of health sector reform in Central Asia; and the role of the World Bank in facilitating health sector reform.

Background Health 2020 is the regional health policy framework of the World Health Organization (WHO) Regional Office for Europe. The goals of Health 2020 are to improve health and well-being, reduce health inequalities and strengthen public health. To gain insight into the Health 2020 targets needing extra attention in coming years, we assessed progress under Health 2020 in the WHO European Region. Methods Quantitative methods were used to assess progress in 50 out of 53 Member States of the WHO European Region in 2005, 2010 and 2015. The 16 quantitative Health 2020 indicators were rescaled from 1 to 100, with 1 indicating poor performance and 100 indicating good performance. The geometric mean of all 16 rescaled indicators was taken by Health 2020 target to compose a Health 2020 index. Results The Health 2020 index (2015) ranged from 82.8 in Sweden to 30.0 in Turkmenistan. A clear east-west gradient was observed in the WHO European Region, with countries in western parts performing relatively better than countries in eastern parts. Indicators with the largest increase between 2005 and 2015 were premature mortality, mortality external causes, life expectancy and infant mortality. However, all quintiles showed a decline on overweight. Conclusions The Health 2020 index gives a relative overview regarding the past and present performance on the Health 2020 policy framework of countries in the WHO European Region. Although improvements have been observed between 2005 and 2015, challenges remain to improve health for all in the context of the United Nations 2030 Agenda for Sustainable Development. [ABSTRACT FROM AUTHOR]