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Papers by Ieva Bikava

Research paper thumbnail of Perspective Chapter: Shifting toward Value-Based Healthcare – Lessons Learned in the Context of Breast Cancer Treatment

IntechOpen eBooks, May 31, 2024

Research paper thumbnail of Latvijas veselības politikas reforma no 1990. līdz 2020. gadam vēsturiskā institucionālisma skatījumā. Promocijas darba kopsavilkums

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

Development of the Health politics as well as implementation of different changes in health polic... more 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 hea...

Research paper thumbnail of Latvijas veselības politikas reforma no 1990. līdz 2020. gadam vēsturiskā institucionālisma skatījumā. Promocijas darbs

Veselības politikas reforma veselības aprūpes sistēmā Latvijā ir aktuāla kopš neatkarības atgūšan... more Veselības politikas reforma veselības aprūpes sistēmā Latvijā ir aktuāla kopš neatkarības atgūšanas 1990. gadā, kad, atjaunojot Latvijas neatkarību, tika uzsākta veselības reforma, īstenojot veselības aprūpes modeļa maiņu. Politisko pārmaiņu veiksmīga izstrāde, pieņemšana un ieviešana ir viena no būtiskākajām valsts pārvaldes funkcijām. Veselības politikas un īstenoto reformu pamatpostulāti demokrātiskās valstīs šo 30 gadu laikā bijuši nemainīgi – nodrošināt iedzīvotājiem pieejamu, efektīvu un modernu veselības aprūpi. Arī reformu uzdevumi bijuši nemainīgi: nodrošināt iedzīvotājiem veselības aprūpes pieejamību atbilstoši mūsdienu pasaules standartu prasībām un pieejamā finansējuma iespējām, uzlabot veselības aprūpes pārvaldību, nodrošinot labāko izmaksu efektivitātes modeli. Tomēr, kā rāda veselības politiku raksturojošie rādītāji, Latvijā joprojām nav sasniegti veselības politikai izvirzītie mērķi, īstenojot reformu un mainot veselības aprūpes modeli, bet salīdzinošajos rādītājos v...

Research paper thumbnail of Evaluation of healthcare policy in Latvia

SHS Web of Conferences, 2018

Performance of healthcare system of Latvia has been criticised for several years, due to the prob... more Performance of healthcare system of Latvia has been criticised for several years, due to the problems of accessibility, weak efficiency and insufficient funding. Politicians, foreign and local experts all agree upon the need of reforms to improve the performance of the healthcare system. The aims are defined in long-term policy documents, but there are no defined tasks to be made and aims to be achieved in mid-term and short-term policy. The aim of the research was to make evaluation of performance of Latvia healthcare system as well as evaluation according to “Health 2020” framework recommendations. The results showed that changes in the healthcare system in Latvia are made on ‘ad-hoc’ basis without a strategic long-term plan, and despite the fact that guidelines on the public health refear to “Health 2020”, the changes that are made and reforms that are planned are not in compliance with “Health 2020”. Work on social determinants (equity, universal coverage, accessibility) hasn’t ...

Research paper thumbnail of Interest group impact on E-health implementation in Latvia

SHS Web of Conferences, 2018

Democratic state governance should provide the society with mechanisms to impact policy developme... more Democratic state governance should provide the society with mechanisms to impact policy development and implementation. Society members are presented by interest groups that can use internal and external ways to have impact on the government and reform implementation processes. This article represents research that was made on E-health implementation in Latvia – identifying main obstacles and reasons of delayed implementation, and analyses active interest groups and their impact on the implementation process. The research results showed that the main reason of delayed implementation was poor governance from the responsible authority and lack of interest group involvement in the reform development and implementation process.

Research paper thumbnail of Drošas attālinātās konsultācijas medicīnā – pieredze un iespējas: I daļa

Research paper thumbnail of Latvijas veselības aprūpes finansēšanas modeļa maiņas lietderības novērtējums

Rīgas Stradiņa universitāte, 2017

Research paper thumbnail of Youth - foundation for future of civic society in Latvia: how to empower and stimulate youth to become politically active?

Research paper thumbnail of Attālinātas konsultācijas kardioloģijā - PSKUS pieredze un iespējas

Attālinātās konsultācijas kardioloģijā – PSKUS pieredze un iespējas, 2021

fakultātes profesors, Latvijas Zinātņu akadēmijas korespondētājloceklis Aktualitāte Attālinātas k... more fakultātes profesors, Latvijas Zinātņu akadēmijas korespondētājloceklis Aktualitāte Attālinātas konsultācijas kā daļa no telemedicīnas var uzlabot pakalpojumu pieejamību pacientiem, nodrošināt ārstu-speciālistu elastīgāku darba laiku un uzlabot pieejamību, veicināt savlaicīgāku diagnostiku un pacientu uzraudzību, kā arī mazināt pacientu atkārtotu hospitalizāciju. Attālinātas konsultācijas var palīdzēt novērst nevajadzīgas klātienes vizītes, kā arī izgaismot pacientus, kuriem ir steidzami nepieciešama klātienes vizīte. Tomēr pastāv virkne škēršļu attālinātu konsultāciju izmantošanā, kas saistīti ne vien ar tehnoloģisko nodrošinājumu, bet arī ar speciālistu un pacientu gatavību izmantot šādus pakalpojumus, pacientu vecumu un digitālām prasmēm, pakalpojuma sniegšanas un apmaksas kārtību, kā arī neskaidrībām par attālinātu vizīšu tehnisko un klīnisko kvalitāti, drošību, privātumu un uzskaiti.

Research paper thumbnail of Cooperation and Collaboration Impact on Policy Development: HIV/AIDS Policy in Latvia

Sociology Study, 2019

This article describes a case study of trends of governance approach implementation in the health... more This article describes a case study of trends of governance approach implementation in the health policy development and implementation process in Latvia, in the state in transition, or "new democracy". Latvia became an independent democratic state in 1991, regaining its freedom after being part of the Soviet Union for 50 years. As the three Baltic States (Latvia, Lithuania, and Estonia) had a common history and starting point in the health reform implementation, the data of Human Immunodeficiency Virus (HIV) incidence and implemented policy steps were analyzed and compared of all the three states. The research provides insight into the HIV/Acquired Immune Deficiency Syndrome (AIDS) situation in Latvia from the time when the first patient was diagnosed till nowadays, describing the initiatives that were implemented to combat the spread of HIV infection and analyze the impact of different stakeholders in the policy development and implementation process. Although the main reform implementation actors in Latvia were Non-Governmental Organizations (NGOs) or patient organizations by performing cooperation and collaboration with all the actors involved in the policy development and implementation process, more profound investigation reveals that major impact came from "old democracies", international and global organizations as well as from physicians and commercial powers by providing a suitable environment for the reform development.

Research paper thumbnail of Telemedicine and Health Policy Changes in Response to Restrictions Related to COVID-19 Pandemics in Latvia

Research paper thumbnail of Latvia’s Doctors Experience on Providing Remote Consultations During COVID-19 Pandemics

Research paper thumbnail of Path Dependency and Institutional Inertia in Health Politics in Latvia

THE 63rd INTERNATIONAL SCIENTIFIC CONFERENCE OF DAUGAVPILS UNIVERSITY, 2021

Research paper thumbnail of Governance - the Key Factor of E-Health Implementation in Latvia

5th International Multidisciplinary Scientific Conference on Social Science and Arts SGEM2018. Conference Proceedings, 2018

The idea of implementation of Electronic Health Record systems on national scale “e Health” has s... more The idea of implementation of Electronic Health Record systems on national scale “e Health” has started in all three Baltic States at the same time, in 2003. But the progress of the system development is very different – Estonia had started mandatory use of e Health in 2009, Latvia on 2018, but the Lithuania is still on its way.
The research involved analyze of e-Health development and implementation process in Latvia and comparison with Estonia, with the aim to discover the differences and identify hindering factors.
The main conclusion obtained after the research was that the key factor of implementation differences was the disparity in governance process and performance.

Keywords: Health Governance, Healthcare reforms, Change implementation in Healthcare

Research paper thumbnail of The voice of society in healthcare politics in Latvia

SHS Web of Conferences

It is impossible to imagine contemporary democracy without society participation in the process o... more It is impossible to imagine contemporary democracy without society participation in the process of developing regulations and implementation of changes that have a significant impact on society. The opinion of the society is represented by social communities, interest groups, and other non-governmental organizations, which unite people with similar views and ideas and serves as a representative of common opinion to government. The principles of good governance demand cooperation and collaboration with society in all phases of developing, implementing and assessing changes in any policy. The article represents the research on evaluation of cooperation and collaboration practice, as well as an assessment of used lobbying strategies and evaluation of their results in Healthcare politics in Latvia. The research is based on in-depth interviews with the representative of main actors presenting the NGO sector, as well as the representatives of the Ministry of Welfare. The research results ...

Research paper thumbnail of Health care accessibility and disparities in medical staff availability in Latvia

SHS Web of Conferences

The Health care accessibility for inhabitants, especially in rural regions, is related to the pro... more The Health care accessibility for inhabitants, especially in rural regions, is related to the problem of the medical staff availability in state and municipal hospitals and ambulatory institutions as well as for General Practitioners. Despite the fact, that there are two state Universities – University of Latvia and Rıga Stradiņš University, as well as colleges, that educate medical staff – there is a lack of human resources in health care institutions in Latvia. The Ministry of Health and municipalities had several initiatives to solve this problem – changes in regulations for Residency students, programme financed by European Funds with obtainable funding in the amount of 10 million euro, as well as different stimuli and programmes from municipalities. The research explores the current situation with staff availability and, basing on interviews and outcomes, analyzes the effectiveness of the available programmes to attract human resources, and predict the impact and outcomes of th...

Research paper thumbnail of How will future health policy impact on regional disparities and healthcare in Latvia

SHS Web of Conferences

Latvia is a country with high level of regional disparities and as researches have approved – inc... more Latvia is a country with high level of regional disparities and as researches have approved – income, education, and environment significantly affect the status of people's health. The reforms in healthcare have been carried out under the flags of accessibility, efficiency, effectiveness, and quality since 1991. Some groups support the idea that the state should take over almost all services, the others claim that more responsibilities should be transferred to the private sector, and dispute on service provider network and financing system. In accordance with the coalition theory and legislation of Latvia, the initiators and designers of the structural reforms are politicians, elected by the citizens. In theory, every politician represents the political party with its ideology and vision that is expressed in the Programme of the party. Due to Parliament elections in 2018, to understand which way the country will go, and how the chosen strategy will impact on the regional dispari...

Research paper thumbnail of Cooperation and Collaboration Impact on Policy Development: HIV/AIDS Policy in Latvia

Sociology Study

This article describes a case study of trends of governance approach implementation in the health... more This article describes a case study of trends of governance approach implementation in the health policy development and implementation process in Latvia, in the state in transition, or "new democracy". Latvia became an independent democratic state in 1991, regaining its freedom after being part of the Soviet Union for 50 years. As the three Baltic States (Latvia, Lithuania, and Estonia) had a common history and starting point in the health reform implementation, the data of Human Immunodeficiency Virus (HIV) incidence and implemented policy steps were analyzed and compared of all the three states. The research provides insight into the HIV/Acquired Immune Deficiency Syndrome (AIDS) situation in Latvia from the time when the first patient was diagnosed till nowadays, describing the initiatives that were implemented to combat the spread of HIV infection and analyze the impact of different stakeholders in the policy development and implementation process. Although the main reform implementation actors in Latvia were Non-Governmental Organizations (NGOs) or patient organizations by performing cooperation and collaboration with all the actors involved in the policy development and implementation process, more profound investigation reveals that major impact came from "old democracies", international and global organizations as well as from physicians and commercial powers by providing a suitable environment for the reform development.

Research paper thumbnail of Perspective Chapter: Shifting toward Value-Based Healthcare – Lessons Learned in the Context of Breast Cancer Treatment

IntechOpen eBooks, May 31, 2024

Research paper thumbnail of Latvijas veselības politikas reforma no 1990. līdz 2020. gadam vēsturiskā institucionālisma skatījumā. Promocijas darba kopsavilkums

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

Development of the Health politics as well as implementation of different changes in health polic... more 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 hea...

Research paper thumbnail of Latvijas veselības politikas reforma no 1990. līdz 2020. gadam vēsturiskā institucionālisma skatījumā. Promocijas darbs

Veselības politikas reforma veselības aprūpes sistēmā Latvijā ir aktuāla kopš neatkarības atgūšan... more Veselības politikas reforma veselības aprūpes sistēmā Latvijā ir aktuāla kopš neatkarības atgūšanas 1990. gadā, kad, atjaunojot Latvijas neatkarību, tika uzsākta veselības reforma, īstenojot veselības aprūpes modeļa maiņu. Politisko pārmaiņu veiksmīga izstrāde, pieņemšana un ieviešana ir viena no būtiskākajām valsts pārvaldes funkcijām. Veselības politikas un īstenoto reformu pamatpostulāti demokrātiskās valstīs šo 30 gadu laikā bijuši nemainīgi – nodrošināt iedzīvotājiem pieejamu, efektīvu un modernu veselības aprūpi. Arī reformu uzdevumi bijuši nemainīgi: nodrošināt iedzīvotājiem veselības aprūpes pieejamību atbilstoši mūsdienu pasaules standartu prasībām un pieejamā finansējuma iespējām, uzlabot veselības aprūpes pārvaldību, nodrošinot labāko izmaksu efektivitātes modeli. Tomēr, kā rāda veselības politiku raksturojošie rādītāji, Latvijā joprojām nav sasniegti veselības politikai izvirzītie mērķi, īstenojot reformu un mainot veselības aprūpes modeli, bet salīdzinošajos rādītājos v...

Research paper thumbnail of Evaluation of healthcare policy in Latvia

SHS Web of Conferences, 2018

Performance of healthcare system of Latvia has been criticised for several years, due to the prob... more Performance of healthcare system of Latvia has been criticised for several years, due to the problems of accessibility, weak efficiency and insufficient funding. Politicians, foreign and local experts all agree upon the need of reforms to improve the performance of the healthcare system. The aims are defined in long-term policy documents, but there are no defined tasks to be made and aims to be achieved in mid-term and short-term policy. The aim of the research was to make evaluation of performance of Latvia healthcare system as well as evaluation according to “Health 2020” framework recommendations. The results showed that changes in the healthcare system in Latvia are made on ‘ad-hoc’ basis without a strategic long-term plan, and despite the fact that guidelines on the public health refear to “Health 2020”, the changes that are made and reforms that are planned are not in compliance with “Health 2020”. Work on social determinants (equity, universal coverage, accessibility) hasn’t ...

Research paper thumbnail of Interest group impact on E-health implementation in Latvia

SHS Web of Conferences, 2018

Democratic state governance should provide the society with mechanisms to impact policy developme... more Democratic state governance should provide the society with mechanisms to impact policy development and implementation. Society members are presented by interest groups that can use internal and external ways to have impact on the government and reform implementation processes. This article represents research that was made on E-health implementation in Latvia – identifying main obstacles and reasons of delayed implementation, and analyses active interest groups and their impact on the implementation process. The research results showed that the main reason of delayed implementation was poor governance from the responsible authority and lack of interest group involvement in the reform development and implementation process.

Research paper thumbnail of Drošas attālinātās konsultācijas medicīnā – pieredze un iespējas: I daļa

Research paper thumbnail of Latvijas veselības aprūpes finansēšanas modeļa maiņas lietderības novērtējums

Rīgas Stradiņa universitāte, 2017

Research paper thumbnail of Youth - foundation for future of civic society in Latvia: how to empower and stimulate youth to become politically active?

Research paper thumbnail of Attālinātas konsultācijas kardioloģijā - PSKUS pieredze un iespējas

Attālinātās konsultācijas kardioloģijā – PSKUS pieredze un iespējas, 2021

fakultātes profesors, Latvijas Zinātņu akadēmijas korespondētājloceklis Aktualitāte Attālinātas k... more fakultātes profesors, Latvijas Zinātņu akadēmijas korespondētājloceklis Aktualitāte Attālinātas konsultācijas kā daļa no telemedicīnas var uzlabot pakalpojumu pieejamību pacientiem, nodrošināt ārstu-speciālistu elastīgāku darba laiku un uzlabot pieejamību, veicināt savlaicīgāku diagnostiku un pacientu uzraudzību, kā arī mazināt pacientu atkārtotu hospitalizāciju. Attālinātas konsultācijas var palīdzēt novērst nevajadzīgas klātienes vizītes, kā arī izgaismot pacientus, kuriem ir steidzami nepieciešama klātienes vizīte. Tomēr pastāv virkne škēršļu attālinātu konsultāciju izmantošanā, kas saistīti ne vien ar tehnoloģisko nodrošinājumu, bet arī ar speciālistu un pacientu gatavību izmantot šādus pakalpojumus, pacientu vecumu un digitālām prasmēm, pakalpojuma sniegšanas un apmaksas kārtību, kā arī neskaidrībām par attālinātu vizīšu tehnisko un klīnisko kvalitāti, drošību, privātumu un uzskaiti.

Research paper thumbnail of Cooperation and Collaboration Impact on Policy Development: HIV/AIDS Policy in Latvia

Sociology Study, 2019

This article describes a case study of trends of governance approach implementation in the health... more This article describes a case study of trends of governance approach implementation in the health policy development and implementation process in Latvia, in the state in transition, or "new democracy". Latvia became an independent democratic state in 1991, regaining its freedom after being part of the Soviet Union for 50 years. As the three Baltic States (Latvia, Lithuania, and Estonia) had a common history and starting point in the health reform implementation, the data of Human Immunodeficiency Virus (HIV) incidence and implemented policy steps were analyzed and compared of all the three states. The research provides insight into the HIV/Acquired Immune Deficiency Syndrome (AIDS) situation in Latvia from the time when the first patient was diagnosed till nowadays, describing the initiatives that were implemented to combat the spread of HIV infection and analyze the impact of different stakeholders in the policy development and implementation process. Although the main reform implementation actors in Latvia were Non-Governmental Organizations (NGOs) or patient organizations by performing cooperation and collaboration with all the actors involved in the policy development and implementation process, more profound investigation reveals that major impact came from "old democracies", international and global organizations as well as from physicians and commercial powers by providing a suitable environment for the reform development.

Research paper thumbnail of Telemedicine and Health Policy Changes in Response to Restrictions Related to COVID-19 Pandemics in Latvia

Research paper thumbnail of Latvia’s Doctors Experience on Providing Remote Consultations During COVID-19 Pandemics

Research paper thumbnail of Path Dependency and Institutional Inertia in Health Politics in Latvia

THE 63rd INTERNATIONAL SCIENTIFIC CONFERENCE OF DAUGAVPILS UNIVERSITY, 2021

Research paper thumbnail of Governance - the Key Factor of E-Health Implementation in Latvia

5th International Multidisciplinary Scientific Conference on Social Science and Arts SGEM2018. Conference Proceedings, 2018

The idea of implementation of Electronic Health Record systems on national scale “e Health” has s... more The idea of implementation of Electronic Health Record systems on national scale “e Health” has started in all three Baltic States at the same time, in 2003. But the progress of the system development is very different – Estonia had started mandatory use of e Health in 2009, Latvia on 2018, but the Lithuania is still on its way.
The research involved analyze of e-Health development and implementation process in Latvia and comparison with Estonia, with the aim to discover the differences and identify hindering factors.
The main conclusion obtained after the research was that the key factor of implementation differences was the disparity in governance process and performance.

Keywords: Health Governance, Healthcare reforms, Change implementation in Healthcare

Research paper thumbnail of The voice of society in healthcare politics in Latvia

SHS Web of Conferences

It is impossible to imagine contemporary democracy without society participation in the process o... more It is impossible to imagine contemporary democracy without society participation in the process of developing regulations and implementation of changes that have a significant impact on society. The opinion of the society is represented by social communities, interest groups, and other non-governmental organizations, which unite people with similar views and ideas and serves as a representative of common opinion to government. The principles of good governance demand cooperation and collaboration with society in all phases of developing, implementing and assessing changes in any policy. The article represents the research on evaluation of cooperation and collaboration practice, as well as an assessment of used lobbying strategies and evaluation of their results in Healthcare politics in Latvia. The research is based on in-depth interviews with the representative of main actors presenting the NGO sector, as well as the representatives of the Ministry of Welfare. The research results ...

Research paper thumbnail of Health care accessibility and disparities in medical staff availability in Latvia

SHS Web of Conferences

The Health care accessibility for inhabitants, especially in rural regions, is related to the pro... more The Health care accessibility for inhabitants, especially in rural regions, is related to the problem of the medical staff availability in state and municipal hospitals and ambulatory institutions as well as for General Practitioners. Despite the fact, that there are two state Universities – University of Latvia and Rıga Stradiņš University, as well as colleges, that educate medical staff – there is a lack of human resources in health care institutions in Latvia. The Ministry of Health and municipalities had several initiatives to solve this problem – changes in regulations for Residency students, programme financed by European Funds with obtainable funding in the amount of 10 million euro, as well as different stimuli and programmes from municipalities. The research explores the current situation with staff availability and, basing on interviews and outcomes, analyzes the effectiveness of the available programmes to attract human resources, and predict the impact and outcomes of th...

Research paper thumbnail of How will future health policy impact on regional disparities and healthcare in Latvia

SHS Web of Conferences

Latvia is a country with high level of regional disparities and as researches have approved – inc... more Latvia is a country with high level of regional disparities and as researches have approved – income, education, and environment significantly affect the status of people's health. The reforms in healthcare have been carried out under the flags of accessibility, efficiency, effectiveness, and quality since 1991. Some groups support the idea that the state should take over almost all services, the others claim that more responsibilities should be transferred to the private sector, and dispute on service provider network and financing system. In accordance with the coalition theory and legislation of Latvia, the initiators and designers of the structural reforms are politicians, elected by the citizens. In theory, every politician represents the political party with its ideology and vision that is expressed in the Programme of the party. Due to Parliament elections in 2018, to understand which way the country will go, and how the chosen strategy will impact on the regional dispari...

Research paper thumbnail of Cooperation and Collaboration Impact on Policy Development: HIV/AIDS Policy in Latvia

Sociology Study

This article describes a case study of trends of governance approach implementation in the health... more This article describes a case study of trends of governance approach implementation in the health policy development and implementation process in Latvia, in the state in transition, or "new democracy". Latvia became an independent democratic state in 1991, regaining its freedom after being part of the Soviet Union for 50 years. As the three Baltic States (Latvia, Lithuania, and Estonia) had a common history and starting point in the health reform implementation, the data of Human Immunodeficiency Virus (HIV) incidence and implemented policy steps were analyzed and compared of all the three states. The research provides insight into the HIV/Acquired Immune Deficiency Syndrome (AIDS) situation in Latvia from the time when the first patient was diagnosed till nowadays, describing the initiatives that were implemented to combat the spread of HIV infection and analyze the impact of different stakeholders in the policy development and implementation process. Although the main reform implementation actors in Latvia were Non-Governmental Organizations (NGOs) or patient organizations by performing cooperation and collaboration with all the actors involved in the policy development and implementation process, more profound investigation reveals that major impact came from "old democracies", international and global organizations as well as from physicians and commercial powers by providing a suitable environment for the reform development.