the hospital and emergency care sectors were reorganised leading to efficiency gains primary care was also strengthened with the aim of focusing more effort on preventive care population ageing and worsening rates of smoking and other key risk factors mean that more people are living with chronic disease and demands on the health system are intensifying latvia must continue to undertake reforms therefore to optimise performance of the health care system and improve peoples health key challenges in each of these areas are identified the use of such data by the oecd is without prejudice to the status of the golan heights east jerusalem and israeli settlements in the west bank under the terms of international law