Publication: Toward a More Pro-Poor and Explicit Health Benefit Package in the Kyrgyz Republic: A Critical Review of the Stated Guaranteed Benefit Package and Options for Its Revision
Loading...
Published
2019-06-21
ISSN
Date
2019-07-16
Author(s)
Editor(s)
Abstract
The Kyrgyz Republic has made significant steps in reforming the health system through successive National Health Programs implemented over the last 20 years. One of the major achievements of such reforms were the establishment of a single-payer national health insurance and a basic benefit package. The State Guaranteed Benefit Package (SGBP) provides free basic health services at the primary care level for the whole population, and inpatient care with nominal co-payments or no fee for certain groups. Even though the principles of the SGBP contain elements of international good practice, the SGBP has hardly changed since it was stablished. At the same time, many changes have taken place within and outside the health system, exerting mounting pressure for the SGBP to adapt to the new disease burden and meet population’s expectations within the context of budget constraints. The current paper provides a critical assessment of the Kyrgyz Republic’s basic health benefit package. It reveals several issues in the actual benefits delivered to the population as opposed to the generous promise of the statutory package. Some important limitations include lack of clarity, persistent funding gap, large number of fee exemption categories given the resource constraints and at the same time lack of an effective mechanism to protect the poor. Most importantly, there is no systematic arrangement in place to ensure a regular evidence-based process of the benefit package revision. The paper proposes several measures that could guide the process of SGBP revision, considering the Kyrgyz context and building on international experiences. It is expected that information from the paper will be useful not only for the Kyrgyz stakeholders but also other countries in making the benefit package an effective instrument for achieving universal health coverage.
Link to Data Set
Citation
“World Bank. 2019. Toward a More Pro-Poor and Explicit Health Benefit Package in the Kyrgyz Republic: A Critical Review of the Stated Guaranteed Benefit Package and Options for Its Revision. © World Bank. http://hdl.handle.net/10986/32106 License: CC BY 3.0 IGO.”
Digital Object Identifier
Associated URLs
Associated content
Other publications in this report series
Journal
Journal Volume
Journal Issue
Collections
Related items
Showing items related by metadata.
Publication Toward a More Pro-Poor and Explicit Health Benefit Package in the Kyrgyz Republic(World Bank, Washington, DC, 2019-10)The Kyrgyz Republic has made significant steps in reforming the health system through successive National Health Programs implemented over the last 20 years. One of the major achievements of such reforms was the establishment of a single-payer national health insurance and a basic benefit package. The State Guaranteed Benefit Package (SGBP) provides free basic health services at the primary care level for the whole population, and inpatient care with nominal copayments or no fee for certain groups. Even though the principles of the SGBP contain elements of international good practice, the SGBP has hardly changed since it was established. At the same time, many changes have taken place within and outside the health system, exerting mounting pressure for the SGBP to adapt to the new disease burden and meet the population’s expectations within the context of budget constraints. The current paper provides a critical assessment of the Kyrgyz Republic’s basic health benefit package. It reveals a number of issues in the actual benefits delivered to the population as opposed to the generous promise of the statutory package. Some important limitations include lack of clarity, persistent funding gap, the large number of fee exemption categories given the resource constraints, and at the same time lack of an effective mechanism to protect the poor. Most importantly, there is no systematic arrangement in place to ensure a regular evidence-based process to revise the benefit package. The paper proposes several measures that could guide the process of SGBP revision, taking into account the particular Kyrgyz context and building on international experiences. It is expected that information from the paper will be useful not only for Kyrgyz stakeholders, but also for other countries in making the benefit package an effective instrument for achieving universal health coverage.Publication Toward Universal Coverage in Health : The Case of the State Guaranteed Benefit Package of the Kyrgyz Republic(World Bank, Washington DC, 2013-01)In this case study the paper describes the evolution of the Kyrgyz health care system and discusses challenges in ensuring universal access to basic health care services. Section one provides an overview of the Kyrgyz health system and of the national health care reform programs that started in 2001 with Manas (2001-2005) and which have been continued with Manas Taalimi (2006-2011), and the recently adopted Den Sooluk (2012-2016). Section two provides a detailed discussion of the SGBP that follows a universal approach as it applies to all citizens, and describes the management of public funds and the information environment of the State Guaranteed Benefit Package (SGBP). Section three draws lessons from Kyrgyz national health reforms for universal health coverage for other countries with very limited public resources, widespread poverty, and high levels of corruption. Section four discusses the remaining challenges for universal health coverage for the poor and how the provision of good-quality care forms an important part of the agenda for the recently adopted Den Sooluk program.Publication Kyrgyz Republic : Enhancing Pro-poor Growth(Washington, DC, 2003-09-01)The goal of this report has been to assist the Kyrgyz authorities in designing and implementing their National Poverty Reduction Strategy (NPRS). An interim report focusing on the relation between growth and poverty, with detailed analysis o f transmission mechanisms in labor market and agricultural sector was presented to the authorities in August 2002. The interim report delivery was driven by the schedule of NPRS preparation. This final poverty assessment report expands the interim report by addressing key additional issues in the links between poverty and key public services such as energy, health, education, and social protection. The process o f producing this report has involved close collaboration with Natstatcom, training Kyrgyz researchers on poverty analysis, and commissioning eleven independent researchers to write background papers on various aspects o f poverty in the Kyrgyz Republic whose findings have been Incorporated selectively in this report. Analysis in this report goes through the year 2001, but collaborative work between the Bank and Kyrgyz teams on poverty diagnostics and assessment is an ongoing process.Publication Explicit Health Guarantees for Chileans : The AUGE Benefits Package(World Bank, Washington DC, 2013-01)This paper focuses on recent and significant health reform implemented in 2005, known as Universal Access with explicit guarantees (Acceso Universal con Garantias Explicitas - AUGE or GES), which mandated SHI insurers to adopt a broad benefits package defined via explicit legal guarantees for all beneficiaries. This innovative reform is a policy reaction to that which previously existed in Chile and which is widespread in many developing countries, whereby the health rights of citizens remain largely undefined or implicit. Limited public resources imply in those countries that access to health care is rationed through queues, patient deflection, legal or under-the-table user fees, and low-quality care. This paper describes the AUGE reform, its implementation, and the functioning of AUGE for the poor and for non-poor citizens. This paper is organized as: section two provides a brief historic overview of health coverage in Chile's SHI system. Section three describes the SHI system in existence today. Section four describes the services offered and mechanisms in place to cover the poor under SHI, while section five spells out the benefits of SHI. Section six introduces the AUGE health reform of 2005, which sought to broaden and make explicit the rights of all SHI beneficiaries. Section seven offers information about the flows and magnitudes of health financing in SHI. Section eight focuses on the system used by Fonasa to target the poor. Section nine explains how Fonasa manages AUGE. Section ten comments on the information environment of AUGE. Section eleven addresses the equity and fiscal implications of expanding the AUGE benefits. Finally, section twelve proposes a pending policy agenda related to the coverage of the poor under SHI and the definition and management of benefits.Publication Making the New Indonesia Work for the Poor(Washington, DC, 2006-11)Indonesia stands at the threshold of a new era and at an important juncture of its history. After the historic economic, political and social upheavals at the end of the 1990s, Indonesia has started to regain its footing. The country has largely recovered from the economic and financial crisis that threw millions of its citizens back into poverty in 1998 and saw it regress to a low-income status. Recently, it has once again crossed the threshold, making it one of the world's emergent middle-income countries. Likewise, poverty rates that increased by over one-third during the crisis fell back to pre-crisis levels in 2005, despite rising somewhat in 2006 largely driven by hefty rice price increases in late 2005 and early 2006. Meanwhile, politically and socially Indonesia has seen some major transformations: it is now a country with a vibrant emergent democracy, a newly decentralized government, and far greater social openness and public debate. The purpose of this report is to identify the nature and key constraints to poverty reduction in today's Indonesia and to provide concrete recommendations on how Indonesia can move forward to achieve its poverty reduction objectives. It aims to contribute to the policy debate and decision-making process in Indonesia by putting forth: (i) new and more comprehensive analysis of empirical poverty diagnostics; and (ii) suggestions on concrete policies and programs for a strategic action-plan to achieve Indonesia's stated poverty-reduction objectives. This report lays out how Indonesia can better align policies and programs to achieve the key poverty indicators in which Indonesia is lagging and that are identified by planning documents such as the National Strategy for Poverty Reduction (SNPK) and Medium-Term Development Plan (RPJM).
Users also downloaded
Showing related downloaded files
Publication International Financial Reporting Standards : A Practical Guide, 5th Edition(World Bank, 2009)The publication of this fifth edition coincides with the convergence in accounting standards that has been a feature of the international landscape since the global financial crisis of 1998. The events of that year prompted several international organizations, including the World Bank and the International Monetary Fund, to launch a cooperative initiative to strengthen the global financial architecture and to seek a longer-term solution to the lack of transparency in financial information. A conscious decision has been made to focus on the needs of executives and financial analysts in the private and public sectors who might not have a strong accounting background. This publication summarizes each standard so managers and analysts can quickly obtain a broad overview of the key issues. Detailed discussion of certain topics has been excluded to maintain the overall objective of providing a useful tool to managers and financial analysts. In addition to the short summaries, most chapters contain basic examples that emphasize the practical application of some key concepts in a particular standard. This text provides the tools to enable an executive without a technical accounting background to: (1) participate in an informed manner in discussions relating to the appropriateness or application of a particular standard in a given situation, and (2) evaluate the effect that the application of the principles of a given standard will have on the financial results and position of a division or of an entire enterprise.Publication Mining Royalties : A Global Study of Their Impact on Investors, Government, and Civil Society(Washington, DC: World Bank, 2006)Mineral sector regulatory and fiscal systems have been undergoing major reforms across the globe. This book focuses on information and analysis relating to mineral royalties. It provides a general discussion of the concepts behind mining taxation, a guide to royalties, examples of royalty calculations and the ways in which these interact with other forms of taxation, as well as financial effects on investments under varying conditions. Primary information includes royalty legislation from over forty nations. The book discusses implications for investors and governments of various tax regimes and provides specific country case examples. A chapter is included on transparency, governance, and management of revenue streams. The appendices, in the second volume, contain brief summaries and selected statutes relating to royalties in a broad cross-section of nations around the world; sample spreadsheets of the results of mine models that were analyzed; and examples of administrative and distributional approaches to collecting royalties.Publication Digital Progress and Trends Report 2023(Washington, DC: World Bank, 2024-03-05)Digitalization is the transformational opportunity of our time. The digital sector has become a powerhouse of innovation, economic growth, and job creation. Value added in the IT services sector grew at 8 percent annually during 2000–22, nearly twice as fast as the global economy. Employment growth in IT services reached 7 percent annually, six times higher than total employment growth. The diffusion and adoption of digital technologies are just as critical as their invention. Digital uptake has accelerated since the COVID-19 pandemic, with 1.5 billion new internet users added from 2018 to 2022. The share of firms investing in digital solutions around the world has more than doubled from 2020 to 2022. Low-income countries, vulnerable populations, and small firms, however, have been falling behind, while transformative digital innovations such as artificial intelligence (AI) have been accelerating in higher-income countries. Although more than 90 percent of the population in high-income countries was online in 2022, only one in four people in low-income countries used the internet, and the speed of their connection was typically only a small fraction of that in wealthier countries. As businesses in technologically advanced countries integrate generative AI into their products and services, less than half of the businesses in many low- and middle-income countries have an internet connection. The growing digital divide is exacerbating the poverty and productivity gaps between richer and poorer economies. The Digital Progress and Trends Report series will track global digitalization progress and highlight policy trends, debates, and implications for low- and middle-income countries. The series adds to the global efforts to study the progress and trends of digitalization in two main ways: · By compiling, curating, and analyzing data from diverse sources to present a comprehensive picture of digitalization in low- and middle-income countries, including in-depth analyses on understudied topics. · By developing insights on policy opportunities, challenges, and debates and reflecting the perspectives of various stakeholders and the World Bank’s operational experiences. This report, the first in the series, aims to inform evidence-based policy making and motivate action among internal and external audiences and stakeholders. The report will bring global attention to high-performing countries that have valuable experience to share as well as to areas where efforts will need to be redoubled.Publication Commodity Markets Outlook, October 2025(Washington, DC: World Bank, 2025-10-29)Commodity prices are expected to decline by about 7 percent overall this year, reflecting subdued global economic activity, elevated trade tensions and policy uncertainty, ample global supply of oil, and weather-related supply shocks. In 2026, commodity prices are forecast to fall by a further 7 percent, a fourth consecutive year of decline, as global growth remains sluggish and the oil market oversupplied. Energy price movements are envisaged to continue contributing to global disinflation in 2026. Metals and minerals prices are expected to remain stable in 2026, while agricultural prices are projected to edge down, primarily due to strong supply conditions. Precious metals prices are expected to rise another 5 percent, after a historically large, investment-driven rally of about 40 percent in 2025. Risks to the commodity price projections are tilted to the downside. Key downside risks include weaker-than-expected global growth, a longer-than-assumed period of economic policy uncertainty, and additional oversupply of oil. Upside risks include intensifying geopolitical tensions, the market impact of additional oil sanctions, supply reductions stemming from additional trade restrictions, unfavorable weather conditions, faster-than-expected rollout of new data centers. Commodity price volatility in recent years has revived interest in supply management via international commodity agreements. Historical experience, however, shows that the most effective policy is to promote diversification, innovation, transparency, and market-based pricing—measures that build lasting resilience to commodity price volatility.Publication Global Economic Prospects, June 2025(Washington, DC: World Bank, 2025-06-10)The global economy is facing another substantial headwind, emanating largely from an increase in trade tensions and heightened global policy uncertainty. For emerging market and developing economies (EMDEs), the ability to boost job creation and reduce extreme poverty has declined. Key downside risks include a further escalation of trade barriers and continued policy uncertainty. These challenges are exacerbated by subdued foreign direct investment into EMDEs. Global cooperation is needed to restore a more stable international trade environment and scale up support for vulnerable countries grappling with conflict, debt burdens, and climate change. Domestic policy action is also critical to contain inflation risks and strengthen fiscal resilience. To accelerate job creation and long-term growth, structural reforms must focus on raising institutional quality, attracting private investment, and strengthening human capital and labor markets. Countries in fragile and conflict situations face daunting development challenges that will require tailored domestic policy reforms and well-coordinated multilateral support.