Health Policy Reform in Latvia from 1990 to 2020 in Perspective of Historical Institutionalism. Summary of the Doctoral Thesis

Abstract

Development of the Health politics as well as implementation of different changes in health policy in Latvia has been a topical issue since the year 1990, when Latvia regain its independency from USSR. Successful development, acceptance and implementation of the policy change is one of the most significant functions of public administration. Analysis of the basic values and ideas of the health policy in health care in democratic states during the last 30 years has been not changed: to ensure health system that provides health care accessibility to citizens. By this providing accessibility in terms of geographical as well as timely and affordably way, at the same time providing appropriate quality in compliance with the contemporary worldwide standards as well as according to available funding, developing the model that provides that the money is used in the most effective and efficient way. According to the indicators of the health system performance – in Latvia the goals of the health reform by changing the healthcare providing model, has not been achieved, and in comparison to other EU states, Latvia is lagging far behind the other states, even the neighboring countries – Estonia and Lithuania, with whom Latvia was in the same starting positions at the year 1990. The objective of the thesis “Health Policy Reform in Latvia from 1990 to 2020 in Perspective of Historical Institutionalism” is to analyze healthcare reform of Latvia in the period form 1990 to 2020 from the perspective of Historical Institutionalism and to provide answers to three research questions: 1) what changes in health policy were implemented in the scope of the reform; 2) what objectives of the reform were achieved; 3) why the achievement of the goals were delayed in reforming health policy of Latvia in the period from 1990 to 2020. First chapter provides description of the Historical Institutionalism – theoretical approach that is chosen as the basis for this research. The second chapter provides contextual description and research methodology. The third chapter provides the analysis of the health reform analyse, consisting of two parts. The first characterizes changes in health policy that were implemented during the reform and their outcomes. The second part analyses the policy process in order to identify hindering factors in reform implementation process. Conclusion chapter provides the summary of the research results and observations.