Most transition countries in South East Europe have attempted to reform their health systems by moving away from centralized planning to greater use of the market mechanism. Yet, many reform initiatives have been based on ideology rather than on evidence. Reforms have aimed at reducing hospital expenditure and strengthening primary care. Where capitation systems have been introduced, their effect on incentives and quality is contested. The efficiency of health systems is also damaged by the misallocation of resources towards hospital and curative care, and an over-emphasis on inpatient stays. The financing of health systems relies to a large degree on health insurance, but this is sometimes subject to corruption and inefficiencies. Public health is adversely affected by the stresses of rapid social change and lifestyle choices. The response of public health institutions and programmes to these challenges has been patchy and ineffective in many countries and is further challenged by the effects of the global economic crisis on health systems. These issues raise many questions concerning the effects of health reforms on efficiency, effectiveness, and equity which will be debated and discussed at the workshop.