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Montenegro: Montenegro Health Profile 2012

2012/03/20

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Montenegro Health Profile 2012

The health care system is organised as an unique health care region and is based dominantly on the public sector. Public health care institutions are organized through a network of primary, secondary and tertiary health care consisting of eighteen medical centres, seven general hospitals, three special hospitals, the Clinical Centre of Montenegro, the Institute for Health and the Pharmaceutical Institute of Montenegro. The private sector, not yet integrated in the health care system, comprises a larger number of medical centres, dental centres, wholesale medicines and pharmacies.
The existing health care resources, within the framework of the public sector indicate that the accessibility and development of health care infrastructure, especially with regard to the number of beds and number of doctors is at the same level as more developed countries.

The mortality rate of newborn babies in the Republic of Montenegro, is a very significant indication of the state of health of the population and development of health care services, as well as being an indicator for socio-economic, educational, cultural and other social development, has a negative trend, from 10.90‰ in 2000 it grew to 14.61 for 1.000 newborn babies in 2001.
The life expectancy in Montenegro is 75.2 years (71.5 years for men and 78.7 years for women). Of the total population figure 8.3% is over 65 years of age and 28.6% of the population is 19 years of age or under, thus an ageing population is noticeable.
From the total number of deceased persons in the Republic during 2001, 91.33% died due to consequences from the above five groups of diseases, while 8.67% refers to the remaining groups of diseases.
The most common causes of death are: heart disease, lung disease, brain blood vessel disease, ischaemic heart disease, malignant tumours of the throat and lungs, diabetes, injuries to the head, neck, chest and stomach, chronic disease of the respiratory tract, as well as malignant neoplasm of the breast, large intestine, stomach and anus and liver disease, there were 3.540 or 65% deaths due to the above 10 diagnoses.

Financing health care
Organization and financing health care in Montenegro is founded on the dominant role of the public sector to provide and ensure resources for health care and services. Namely, financing health care is based on the method of compulsory health insurance (German – Bismarck method). Contributions are paid according to employee gross earnings, according to present legal regulations in the amount of 15% of employee earnings (proportional 50:50 employee and employer), as well as the self-employed. The Pension and Disabled Persons' Fund assigns resources for pensioners, while the employment Agency, that is Budget, pays unemployment contributions.
 
According to current health and health insurance Laws, categorization of the population has been carried out on the basis of which rights to health insurance and compulsory contribution payments have been established.
In the structure of the Fund’s revenue source for the year 2000, contributions on employee and self-employee earnings made up 78%, and contributions for pensioners was 16.6% of total revenue. Revenue from the Budget for the unemployed, from farmers, revenue from interest, from gifts and aid, and other revenue represented less than 5.0% of the total Fund revenue. Simultaneously, health care spending in Montenegro amounts to 6.1% GDP
 
  • The health system, although organized on the basis of primary health care does not function in an  coordinated and integrated manner;
  • - Health institutions primarily aim to offer curative protection to citizens, and much less as preventative for the entire population;
  • - There is variance between established rights in health insurance and financial abilities to provide for them;
  • - Unrealistic expectations of the health care system by citizens and health care employees
  • - Inadequate method of allocating resources with the priorities and health care levels;
  • - Inadequate payment method for health care services and unclear methods for financing health care institutions;
  • - Health care is not programmed in accordance with the requirements, priorities and specific needs, particularly at local level;
  • - Large number of non medical employees and inadequate composition of health care workers, particularly in specific segments of healtcare;
  • - Lack of a national medicines’ policy and the irrational use of medicines;
  • - Health care management is not suitable for the modern concept of health system organization, especially in view of systems planning;
  • - Record keeping and the reporting system regulated by law are of poor quality and quite outdated;
  • - Lack of quality health information system and other mechanisms for better management;
  • - No level of the health care system carries out control of the scope and the quality of registered data;
  • - System control and development of quality health care is not developed;
  • - insufficient motivation to provide quality services, and employees are poorly paid;
  • - Existence of informal payments
  • - There is evident stagnation of the state of health of the population, parallel with a decrease to social and living standards.
     
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