WASHINGTON, June 23, 2000 - The World Bank has approved a US$63.3 million loan for a project in Bulgaria that will help the government implement a fundamental reform of its health sector, designed to improve access to quality health services and ensure financial and operational sustainability.
The Health Sector Reform Project forms an integral part of an overall Framework Program for health reform which includes substantial government investments, as well as technical assistance support from other external agencies. The program has seven components, of which the Bank is financing the following four through the project:
- Primary and Ambulatory Care Reform is designed to facilitate the sustainability of the primary and ambulatory care sector. It includes providing practice equipment for primary health care, funding physician office information systems, providing training in general practitioner practice management, funding a public information campaign to inform the public about changes in the ambulatory care system, financing a health reform investment program to provide low-interest loans for physicians, and funding a labor adjustment strategy to transition surplus physicians out of the health sector in Bulgaria.
- Hospital Care Reform is designed to facilitate reform and sustainability of the hospital care sector. It involves support for the implementation of reform of the hospital system, including funding hospital information systems, providing training in hospital management, funding a public information campaign to inform the public about changes in the hospital care system, financing a health reform investment program to provide low-interest loans to hospitals that make desired investment in new equipment and facilities, and funding a labor adjustment strategy to transition surplus hospital staff out of the health sector in Bulgaria.
- Health Financing/National Health Insurance Fund will ensure a smoothly functioning health insurance administration in Bulgaria. It will assist the National Health Insurance Fund in establishing the technological infrastructure required to operate the national health insurance system, including the extensive hardware and software systems needed, as well as the training and technical assistance required to implement and maintain them.
- Capacity Building is designed to strengthen the management and institutional capacity within the Ministry of Health, the National Health Insurance Fund, and the health system generally. It will fund project management and financial management, monitoring and evaluation activity. It will also provide funds for the general training of the National Health Insurance Fund, regional and local staff, and finance an essential public information campaign to inform Bulgarians of the significant changes that will be taking place within their health care system and advise them of how these changes will improve the overall delivery and effectiveness of health care.
The total cost of this project is US$86.96 million, including US$23.66 million from the Bulgarian government. The loan will be repayable in 20 years including a 5 year grace period at the Bank's variable spread and rate single currency loan.
Since Bulgaria joined the World Bank in 1990, commitments to the country total approximately US$1.44 billion for 23 projects.