Budget Support to the health SWAp in the Kyrgyz Republic
Health sector reform is a priority of the Kyrgyz Government. Considerable improvements of the health status of the population were achieved in the last years. Yet, additional efforts have to be done to improve cost-effectiveness of the health system. The Kyrgyz Government approved its Health Strategy 2030, in view to strengthen primary health care, improve the quality of services and promote public health. The project will support the implementation of the Health Strategy by providing funding and technical assistance to the Government.
Health systems strengthening
Primary health care
Public finance management
Public sector policy
- World Bank - International Bank for Reconstruction and Development
- World Health Organization
As a result of 23 years of reforms in the Kyrgyz health sector, considerable successes have been achieved. The population enjoys a langer life expectancy: from 66.5 years in 1996 to 71.0 years in 2016, due partly to the significant progress in reducing under five mortality from 65.8 deaths per 1,000 live births in 1990 to 21.1 in 2016. In 2015, the country was declared as having achieved the Millennium Development Goal 4 - reduction by 2/3 mortality among children under five.
Yet, the reform agenda remains unfinished and universal entitlement to the benefits package guaranteed by the State does not fully translate into effective universal access to quality services and to a general improvement of the health of the population. In addition, the burden of non-communicable diseases is on the rise, and cardiovascular diseases are the main cause of death, accounting for 48% of all deaths in 2017.
Despite the fact that access to health services is widespread, the quality of care remains weak due to still poor performance of the health system. Against this background, the Kyrgyz Government designed and approved its new Health Strategy 2030 to improve quality of care by addressing the main weaknesses and gaps in the health system.
|Objectives||The overall goal of the project is to ensure equitable access to quality health services in Kyrgyzstan by complementing the government funding for the health sector. By supporting the implementation of the Health Strategy 2030, SDC, jointly with Germany and the World Bank, will contribute to strengthening a system centered on people and focusing on the needs of the population. This system will ensure public health and deliver quality services, which aim at maximum improvement of health of the population and reducing health inequalities.|
- The population of the Kyrgyz Republic is the end beneficiary.
- Medical personnel (family doctors and nurses) of the Primary Health Care system.
- Staff of the Ministry of Health and Mandatory Health Insurance Fund.
Based on the Health Strategy 2030, the project focuses on strengthening the Primary Health Care system with a focus on the following three areas:
- Result area 1: lntegrating mechanisms into service delivery (at the level of health facilities) for sustainable quality improvement.
- Result area 2: Strengthening strategic purchasing (financing of medical services) for the quality of care.
- Result area 3: Strengthening health sector stewardship and governance for quality improvement.
Donors' co-financing of the Health Strategy 2030 will be done through pooled funding and applying the Program for Result instrument. With this instrument, the instalments will be provided based on the achievement of indicators called Disbursement Linked lndicators.
Primary Health Care (PHC) system improvement indicators or Disbursement Linked Indicators (DLI):
• DLI 1: A national e-platform for c:ollecting and reporting quality of care indicators from PHC facilities is established and functioning
• DLI 2: A national in-service training e-platform is established and functioning
• DLI 3: Number of pregnant women who received hemoglobin test and microscopic urine analysis during the first trimester in a public PHC facility
• DLI 4: Number of diabetic patients (type I and II) who received HbA1C test at least once a year in a PHC facility
• DLI 5: The benefit package (SGBP) is revised to improve effective coverage for priority conditions at the primary care level
• DLI 6: The provider payment mechanism for PHC is revised to improve quality and effective coverage for priority services
• DLI 7: The Additional Orug Package (drugs for major chronic diseases provided for free) for insured population is revised and its budget is increased to improve effective coverage for priority conditions at the primary care level
• DLI 8: Price regulation mechanisms for the Additional Drug Package for insured population are developed and implemented
• DLI 9: A unit fully designated to quality improvement (QI unit) is established within the Ministry of Health and functioning
Results from previous phases:
- Significant improvement of health indicators: infant and maternal mortality, incidence of tuberculosis;
- lncreased state financing to the health sector up to 11-13% of total government expenditure;
- Strang donor coordination and alignment on the Government strategy.
|Directorate/federal office responsible||
Swiss cooperation with Eastern Europe
International Financial Institution (IFI)
United Nations Organization (UNO)
|Coordination with other projects and actors||
Synergies with other Swiss projects:
- Effective manageent and prevention of non-communicable diseases;
- Medical Education Reforms;
- Health Facilities Autonomy;
- Capacity Building in Public Finance Management project (SECO-funded)
Development Partners Coordination Council and Joint Annual Reviews are key platforms of steering of the Health Strategy 2030 and coordination.
|Budget||Current phase Swiss budget CHF 9'700'000 Swiss disbursement to date CHF 3'040'000 Total project since first phase Budget inclusive project partner CHF 35'900'000|
|Project phases||Phase 5 01.05.2019 - 30.04.2022 (Current phase) Phase 4 15.10.2012 - 30.06.2019 (Completed)|