INTRODUCTION The Libyan National Health System (LNHS) is debated for the paradox of its performance versus impact. It has poor performance, but the national health statistics are good and competitive. There are concerted efforts to manage health care services and to regain the lost trust. A primary health care (PHC) system that focuses on preventive and promotive care is the core focus of LNHS ...

Fragmentation in organization and discontinuities in the provision of medical care are problems in all health systems, whether it is the mixed public-private one in the USA, national health services in the UK, or insurance based one in Western Europe and Russia. In all of these countries a major challenge is to strengthen integration in order to enhance efficiency and health outcomes. This arti...

Recent experiments in the Soviet Union mirror the debates in the United Kingdom about improving incentives in health care. The most interesting innovation to emerge under perestroika is a pilot project in Leningrad and at two other sites which could radically change the financing of hospitals. Hitherto, the budget has gone from the ministry to the hospitals and to the polyclinics by bureaucrati...