Health Facilities Autonomy

Strong management and leadership’s capacity of decision-makers and health managers is central for a successful health reform. The project strengthens the health management system by modernizing continuous skills development and by updating regulations towards a transparent and competency based appointment as well as performance assessment of health managers.



Country/region Topic Period Budget
Health education
Health systems strengthening
01.08.2020 - 31.10.2024
CHF  2’800’000

Over the last 20 years, health reforms in the Kyrgyz Republic have achieved considerable results in terms of health outcomes (mortality from cardiovascular diseases decreased by 0.9%, tuberculosis mortality rate reduced by 20.2%, and infant mortality rate reduced by 3%), access to health services, and financial protection.However, the improvement of quality of medical care remains a challenge. To implement the health reform the sector needs qualified managers and strong leadership. The selection and recruitment of health managers lacks competition, transparency and a competency-based approach. In addition, the continuous education on health management is outdated and not adapted to theongoing reforms in the sector.


The health management system in Kyrgyzstan is well regulated and functional.

Target groups

1. The population of Kyrgyzstan will benefit from quality of care provided by effectively managed health facilities.

2. Health managers (354) and their deputies (450).

3. Ministry of Health, Center for Health System Development and Academic Institutions.



Medium-term outcomes

Outcome 1 : Qualified health managers perform their tasks effectively


Expected results:  

1. A competency-based system for selecting, appointing and supporting health managers is renewed and sustained

2. The system of continuous knowledge and skills development of health managers is upgraded

3. The Association of Health Managers is established and operationalized




Results from previous phases:  


The project has been working on the optimization of the internal processes (finance, human resource and facility management) of health facilities and capacity development of health managers with the aim to improve efficiency and quality of services at pilot facilities. There are several successful measures introduced. One of them is the creation of the emergency care department united with the ambulance and day care. Thanks to this, the hospitalization rate considerable reduced and patients could have services within 24 hours. Also online registration of patients in the Primary Health Care system were introduced, which allowed for targeted per capita payment by the Health Insurance System. A new staffing norm based on performance increased the motivation of the medical personnel to work more effectively and with increased payment. To scale up these optimizations the health managers need to be trained and coached and respective training modules for health managers need to be developed.


Directorate/federal office responsible SDC
Credit area Swiss cooperation with Eastern Europe
Project partners Contract partner
International or foreign NGO
Private sector
  • Other international or foreign NGO North
  • Foreign private sector North

Other partners

Euro Health Group in partnership with the local nongovernmental organization “Health System Initiatives”



Coordination with other projects and actors

One of the objectives of the Health Strategy 2030 refers to the improvement of the capacity of health managers in effective management. The project has strong synergies with the Swiss funded health projects such as Health Budget support through SWAp in Kyrgyzstan, Effective management and prevention of NCDs and Medical Education Reforms.

Budget Current phase Swiss budget CHF    2’800’000 Swiss disbursement to date CHF    2’759’980
Project phases Phase 2 01.08.2020 - 31.10.2024   (Current phase) Phase 1 01.08.2013 - 30.06.2020   (Completed)