Toward a More Pro-Poor and Explicit Health Benefit Package in the Kyrgyz Republic : A Critical Review of the State Guaranteed Benefit Package and Options for Its Revision

Nguyen, Ha Thi Hong ; Strizrep, Tihomir

World Bank, Washington, DC

关键词: BENEFIT PACKAGE;    UNIVERSAL HEALTH COVERAGE;    HEALTH INSURANCE;    HEALTH SYSTEM REFORM;    HEALTH SERVICE DELIVERY;   

RP-ID  :  144542

学科分类：社会科学、人文和艺术（综合）

来源: World Bank Open Knowledge Repository

【 摘 要 】

The Kyrgyz Republic has made significantsteps in reforming the health system through successiveNational Health Programs implemented over the last 20 years.One of the major achievements of such reforms was theestablishment of a single-payer national health insuranceand a basic benefit package. The State Guaranteed BenefitPackage (SGBP) provides free basic health services at theprimary care level for the whole population, and inpatientcare with nominal copayments or no fee for certain groups.Even though the principles of the SGBP contain elements ofinternational good practice, the SGBP has hardly changedsince it was established. At the same time, many changeshave taken place within and outside the health system,exerting mounting pressure for the SGBP to adapt to the newdisease burden and meet the population’s expectations withinthe context of budget constraints. The current paperprovides a critical assessment of the Kyrgyz Republic’sbasic health benefit package. It reveals a number of issuesin the actual benefits delivered to the population asopposed to the generous promise of the statutory package.Some important limitations include lack of clarity,persistent funding gap, the large number of fee exemptioncategories given the resource constraints, and at the sametime lack of an effective mechanism to protect the poor.Most importantly, there is no systematic arrangement inplace to ensure a regular evidence-based process to revisethe benefit package. The paper proposes several measuresthat could guide the process of SGBP revision, taking intoaccount the particular Kyrgyz context and building oninternational experiences. It is expected that informationfrom the paper will be useful not only for Kyrgyzstakeholders, but also for other countries in making thebenefit package an effective instrument for achievinguniversal health coverage.