Modernization of Healthcare in Azerbaijan Forces People With Hearing Impairments to Cover Their Own Expenses

For Elshan Hasanov, a 46-year-old man with severe hearing impairment (fourth-degree), what should have been a straightforward process to receive government-provided hearing aids has turned into a bureaucratic nightmare involving three healthcare agencies. As a result, Hasanov is forced to pay nearly 60 manats ($35) several times a year for what used to be a free service—a cost he says is untenable on his modest disability pension.

In a letter to the news agency Turan, Hasanov explained that in 2023, the Republican Rehabilitation Center gave him two hearing aids free of charge. However, these devices require periodic calibration to match the patient’s specific hearing needs—a service that was previously handled by the Rehabilitation Center at no cost. Today, patients like Hasanov are sent to a private company, the Avaz Hearing and Speech Center, located in Baku.

The Avaz Center charges 30 manats per device for calibration, amounting to 60 manats for both hearing aids. Moreover, this adjustment must be performed every three to four months, adding up to an annual expense of 180 manats. On top of that, Hasanov had to purchase ear inserts for the hearing aids himself after neither the Rehabilitation Center nor Avaz provided them.

“I am unemployed and live solely on my pension. Paying this amount regularly is impossible for me,” Hasanov wrote.

The Privatization of Basic Services

Until 2020, the calibration of hearing aids was performed free of charge by the Rehabilitation Center. But reforms in Azerbaijan’s healthcare system, intended to modernize and improve services, have delegated this task to private companies like Avaz, passing the financial burden onto patients.

When Hasanov voiced his concerns to the Avaz Center on July 25, 2024, he was met with indifference. “Complain wherever you want,” he recalls being told.

Under Azerbaijan’s law “On the Rights of Persons with Disabilities,” individuals with disabilities are entitled to various benefits, including free healthcare services. Hasanov believes the privatization of hearing aid adjustments contradicts this law and unfairly penalizes vulnerable citizens.

Caught in a Bureaucratic Tangle

Hasanov’s efforts to resolve the issue have been met with finger-pointing between government agencies. When he complained to the Ministry of Health, he was informed that the Rehabilitation Center had been transferred to the Administration of Regional Medical Divisions (TƏBİB). Yet, TƏBİB denied responsibility, stating that the center operates under the Ministry of Labor and Social Protection. Attempts to reach the Ministry of Labor’s press service for comment have been unsuccessful.

In a statement to Turan, the Avaz Center confirmed the charges outlined by Hasanov, asserting that he had paid for legitimate services rendered. “He was not deceived. He paid for work completed by a private company,” the center said.

A Broader Problem

This case highlights a growing concern among Azerbaijan’s disabled community regarding the unintended consequences of healthcare modernization. By outsourcing simple yet essential services to private providers, the government has placed a financial strain on some of its most vulnerable citizens.

Turan’s review of Azerbaijan’s healthcare policies underscores this contradiction: Articles 29 and 30 of the country’s law on disability rights explicitly guarantee free medical services for individuals with disabilities. Yet, for Hasanov, these legal protections remain far from reality.

For now, Hasanov and others in his position are left to navigate a complex web of agencies and ministries while bearing financial burdens they can ill afford. The situation raises pressing questions about the priorities of Azerbaijan’s healthcare reforms and their impact on those they were meant to serve.