Kyrgyzstan has set out on an bold path of well being system reforms to enhance entry to Primary Health Care (PHC) providers for its folks. A brand new WHO/Europe research sheds mild on the present state of PHC financing in Kyrgyzstan and provides 6 coverage recommendations to strengthen it and promote extra environment friendly public spending in PHC. 

Evidence demonstrates that PHC is the best and cost-effective strategy to delivering well being care providers to folks and reaching common well being protection (UHC). Kyrgyzstan is transferring on this path – relying on sustained help from the Government and from improvement companions – via the nationwide well being technique for 2019–2030 “Healthy person — prosperous country” and a dedication of funds to boost entry to PHC. 

At a nationwide coverage dialogue on 26 September 2023, the Mandatory Health Insurance Fund, leaders of public well being establishments, improvement companions, representatives of the Ministry of Health and its knowledgeable group answerable for creating the motion plan for the 2024–2030 nationwide well being technique reviewed the motion factors outlined in Strengthening major well being care financing: coverage issues for Kyrgyzstan and reached consensus on the necessity to incorporate the recommendations into the upcoming 7-year motion plan. 

Bolstering PHC spending

Notably, the nation has prioritized PHC spending inside its well being price range and spends about 1% of its gross home product (GDP) on PHC, which is on par with different nations with an analogous monetary profile. Despite these efforts, the research reveals that per-capita public spending on PHC in Kyrgyzstan stays among the many lowest within the WHO European Region. 

“Kyrgyzstan’s strides to move towards UHC, despite budget constraints, are commendable. However, the study shows untapped potential to extract more value and optimize its health spending systems even further,” famous Liviu Vedrasco, WHO consultant in Kyrgyzstan.

Budget constraints will not be the only real problem confronted by Kyrgyzstan. The coverage paper factors out that enhancing the PHC fundamental advantages bundle, price range allocation mechanisms, and the cost mannequin can result in extra environment friendly use of well being care sources.

Enhancing fairness and effectivity

The coverage paper additionally suggests particular actions to enhance how PHC providers are structured and delivered to make them extra environment friendly, accessible and honest for everybody.

These actions embrace streamlining the present PHC organizational mannequin to be higher aligned with the inhabitants’s well being wants, and revising the fundamental advantages bundle to make it universally accessible to the complete inhabitants, in addition to aligned with scientific tips. This means making certain the supply and affordability of medicines and increasing entitlement to incorporate the complete inhabitants, as the present mannequin could depart sufferers weak to paying out of pocket for well being providers.

“This is Kyrgyzstan’s moment to adopt strategic actions that can address gaps in PHC financing and strengthen its health system financing,” mentioned Triin Habicht, Senior Health Economist on the WHO Barcelona Office for Health Systems Financing. “This study offers a blueprint of actionable opportunities to achieve this goal.” 

Redesigning PHC supplier funds

The research additionally requires redesigning the PHC cost mannequin to align it higher with coverage targets. The present mannequin doesn’t think about components akin to age and gender, and there aren’t any mechanisms to make sure that the cost fee displays the true prices of delivering the providers included in the advantages bundle. The authors suggest conducting a PHC costing research to raised perceive the prices related to delivering PHC providers.

Additionally, it stays unclear whether or not funds to suppliers bear in mind funding wants in distant areas. To enhance rural amenities and appeal to folks to work there, investing in each bodily and digital infrastructure for PHC is crucial. With household docs ageing, it’s essential to draw younger professionals to begin working in PHC settings.

To deal with these points, the research suggests:

•  adjusting PHC financing in distant places, as a measure to make rural well being care amenities extra enticing to sufferers and employees;
• drawing on experiences and classes realized from the earlier implementation of a profitable PHC efficiency cost system; and
• introducing an upgraded efficiency cost system for PHC groups to incentivize steady enchancment in managing precedence PHC-sensitive circumstances.

The research additionally highlights the vital want for improved monitoring mechanisms to make sure accountability and transparency, advocating for long run contracts to satisfy the event wants of PHC. 

Technical help and financing for the research

The coverage paper Strengthening major well being care financing: coverage issues for Kyrgyzstan acquired technical help and monetary help from WHO underneath a biennial collaborative settlement for 2021–2022 between the Ministry of Health of the Kyrgyz Republic and the Swiss Agency for Development and Cooperation (SDC) in Kyrgyzstan inside the WHO/SDC challenge “Support for the implementation of the State Program for the Protection of Public Health and the Development of the Health System ‘Healthy person – prosperous country’ for 2019–2030”.