Public Health Services in Azerbaijan with Emphasis on Some Select Neurological Disorders
Sevinj Hamidova*
Department of Neurology, Stroke and Headache centers in Grand Hospital, Europe
Submission: August 02, 2018; Published: November 28, 2018
*Corresponding author: Sevinj Hamidova, Department of Neurology, Stroke and Headache centers in Grand Hospital, Baku, Europe.
How to cite this article: Sevinj H. Public Health Services in Azerbaijan with Emphasis on Some Select Neurological Disorders. Open Access J Neurol Neurosurg. 2018; 9(3): 555762. DOI: 10.19080/OAJNN.2018.09.555762.
Opinion
Azerbaijan is a small developing country situated in the Caucasus Region in South East Asian, with a population of 9 million people. The country has experienced and continues to face much of the economic and health problems most developing nations are struggling with. For decades and decades, Azerbaijan was under the grip and influence of the Soviet Union, and all social and economic sectors as well as the health care system was under a command and control system.
Malnutrition in the countryside has always been a problem, but basic vaccinations for children and hygienic practices for the public including basic therapies against infectious diseases were offered even though they did not include therapies and health education for mental disorders. In general family health was emphasized with children and mother’s clinics in regional and provincial areas with some basic opportunities for reference centers. Mental and most neurological disorders were not addressed at all and funding for these types of health care was not available.
It was left to families to take care of the patients, and this created major problems and much agony. Doctors were seen as an arm and subjects of the government apparatus, they were not compensated well, and morale and professionalism were very low. There was no private system to speak of. After the collapse of the Soviet Union and with the emergence of a sovereign Azerbaijan Republic, there are many improvements but still we have a long way to go and major neurologic and mental disorders like autism, depression and dementia are on the rise with little remedies and solutions. Private clinics and health insurances are available now even though very much catering to the ones with financial means! The gap between the rich and the poor in terms of health care provision is getting bigger and bigger, but now the government has a health care system that tries to deliver care based on studied and researched national needs and humanitarian considerations. Many non- governmental and church organizations play role in delivering services now particularly to the poor and the marginalized groups. Clearly all of these changes and introductions are very much embraced, and they seem to work well. This is a positive development in health care delivery system in Azerbaijan. New technologies are being introduced, more funds and medical trainings updating one’s knowledge are being offered, and the morale and compensation of doctors are improving greatly. All of these changes have helped in managing and improving hospitals, patient care, significantly reduced child and maternal mortality rates, increased hygienic practices, and decreased the incidence of controllable infectious diseases through vaccinations and health education. But health care is expensive and much still remains to be done [1].
But new challenges in neurological disorders such as autism, depression and dementia with our elderly citizens are emerging at an alarming rate. Both the society and the government seem to be ill equipped to handle this. According to scant official data, 4000 children suffer from autism in the major centers of Azerbaijan. Autistic children often need intensive therapy, and meeting those need is especially challenging for parents in Azerbaijan, where the disorder is not well understand and minimal resources are available. Until 2011 there was not Autism Center in Azerbaijan [2].
Now there is one Autism Psychological Assistance Center in Baku to help children with autism to achieve some gains in their abilities. In Azerbaijan, lack of counselors and lack of proper and appropriate training, and lack of autism services nation-wide, are forcing many families (those that have the resources) to seek care abroad. Dementia and depression are also the other two major illnesses that are increasing rapidly. As more and more urbanization takes place, many socio-economic factors, unemployment, stress factors and life difficulties in general are creating fertile grounds for depression, particularly in the urban centers and in the very rural poor. Many patients of mental illness do not seek medical attention because of the cultural and tradition view of mental diseases since such things are thought God’s punishment to bad people and people do not want to be seen as such!! We are also seeing more dementia cases in our elders and with the initiation and implementation of programs in physical activity, mental and social stimulation, healthy diet, managing high blood pressure, and avoiding smoking and alcohol, one can reduce risk of vascular dementia and Alzheimer’s disease. There is an awareness of this, but programs need to be put in place to help people protect themselves from these debilitating diseases with no cure. Azerbaijan has introduced a lot of improvements in health care, but much remains to be done. Public health/medical care is an expensive activity and it still is a big challenge [3].