Since 1995 there have been wide-ranging reforms to the centralized system of health care inherited from the former Soviet Union. Staffed by a disproportionate number of specialists, and supporting a relatively high number of hospital beds, the system proved too costly and inefficient to maintain. In the period immediately following independence, financial shortages led to delayed payment, or even non-payment, of medical staff salaries; a virtual halt to investment in new medical equipment and buildings; and the emergence of a black market in pharmaceuticals. Changes in health care policy since 1995 include introduction of a health insurance system and an end to free health care outside a basic package of health benefits, as well as new systems of provider payment. The network of rural and urban primary care centers is still largely a holdover from the Soviet era, but the payment structure for services has changed. As of 1999, total health care expenditure was estimated at 2.8% of GDP.
In 1998, there were 4.7 nurses, 0.3 midwives, and 0.3 dentists per 1,000 people. As of 1999, there were a total of 246 hospitals, with 22,500 beds. In the same year, there were an estimated 4.4 physicians and 4.8 hospital beds per 1,000 people. Immunization rates for the country in 1997 were as follows: children up to one year old were vaccinated against tuberculosis, 76%; diphtheria, pertussis, and tetanus, 92%; polio, 98%; and measles, 95%.
Life expectancy in 2000 was an average of 73 years and the infant mortality rate was 17 per 1,000 live births. The total fertility rate has decreased from 2.9 children per woman of childbearing years in 1960 to 1.1 in 2000. The under five mortality rate in 1999 was 59 per 1,000 live births. The maternal mortality rate was much lower than the average in Eastern Europe. In 1995 there were 22 maternal deaths per 100,000 live births. The estimated overall mortality rate as of 2002 was 14.6 per 1,000 people. There were approximately 2,000 civil warrelated deaths in 1992. There were 72 reported cases of tuberculosis per 100,000 people in 1999. In 1995, 109 cases of measles were reported. A diphtheria epidemic has spread through the former Soviet Union. In most affected countries, the incidence rate of reported diphtheria has increased two- to tenfold every year.
As of 1999, the number of people living with HIV/AIDS was estimated at fewer than 500 and deaths from AIDS that year were estimated at fewer than 100. HIV prevalence was lower than 0.01 per 100 adults.