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CARK MCH Forum VII Annual Meeting National Health Expenditures in the Kyrgyz Republic: 

CARK MCH Forum VII Annual Meeting National Health Expenditures in the Kyrgyz Republic Dr. Gulnara Oskonbaeva Head of financial and national policy department, Ministry of Health

Indicators of health care system: 

53.5 49.9 46.5 45.9 54.7 76.4 65.0 67.4 80.1 80.1 70.1 76.4 mothers 21.2 21.7 22.6 22.7 26.2 28.2 25.9 28.1 29.1 31.9 31.5 29.7 infants 7.6 7.7 7.7 7.4 8.1 8.3 8.3 9.0 9.1 8.5 7.8 7.6 men 6.1 6.1 6.2 6.2 6.8 6.8 6.9 7.5 7.6 7.1 6.7 6.4 women 6.6 6.6 6.9 6.8 7.4 7.4 7.6 8.2 8.3 7.7 7.2 6.9 Mortality rate 68.6 68.6 68.5 68.7 67.1 66.7 66.7 66.6 65.9 67.3 68.3 68.8 Life expectancy 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991   Indicators of health care system

Health Care System:Strengths and Weaknesses: 

Health Care System: Strengths and Weaknesses Infrastructure and equipment; qualified personnel; equal access to health services; free health care system; high indicators of health sector compare to medium level of income. redundancy of personnel; excessive number of hospitals; inadequate methods of treatment; weak prophylactic and medical-sanitary care; imbalance of system of health services provision; poor coordination and doubling of services.

Health Care Reforms: «Single Payer»: 

Health Care Reforms: «Single Payer» Accumulates budgets at oblast level; Cross subsidies shift around oblast and between budget financing and tax allocations of health personnel; Needs and availability of resources are taken into consideration in resources allocation process; Administrative expenses for health management sector are reducing. Establishment of the Mandatory Health Insurance Fund

Health Care Reforms: «Single Payer»: 

Health Care Reforms: «Single Payer» Denial from financing upon number of beds and availability of personnel; Per capita funding methodology for primary health care; Payment per case treated in hospitals; Standards of expenditures for treatment per user based on selective checkup; Mechanism of co-payment by user has been introduced. Transfer to financing according to effective indicators

Health Care Reforms: «Single Payer»: 

Health Care Reforms: «Single Payer» Reduction of informal payments practice in health institutions; Increase of effectiveness in financing for health sector; Cutting down of personnel in health institutions; Increase of expenditures per health services user. First results

Financial sources of health care system: 

Financial sources of health care system national budget; categorical grants for oblasts; own means of local authorities; mandatory health insurance; co-payment and informal payments from users; programme of state investments financing from external sources.

Financial Sources of Health Care System: 

Financial Sources of Health Care System

Health Expenditures (in % to GDP): 

Health Expenditures (in % to GDP)

Inter-budget relations in financing in health system: 

Inter-budget relations in financing in health system 36.6 42.5 36.8 36.7 35.0 71.7 76.2 Local means 31.8 24.2 31.0 31.4 31.1 Categorical grants 68.4 66.7 67.8 68.2 66.1 71.7 76.2 Local budget 31.6 33.3 32.2 31.8 33.9 28.3 23.8 National budget 2001 2000 1999 1998 1997 1996 1995 Role of local authorities; Role of Ministry of Health; Role of categorical grants.

Breakdown of Expenditures of health sector:by programs : 

Breakdown of Expenditures of health sector: by programs

Breakdown of Expenditures in health care system: by budget line : 

Breakdown of Expenditures in health care system: by budget line 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Total budget expenditures 2.1 2.4 2.9 2.0 2.9 2.8 2.2 2.5 Major repairs 1.7 0.9 1.5 1.5 1.7 2.0 2.1 2.1 Purchase of equipment 3.8 5.4 5.9 5.1 6.3 8.3 9.1 9.0 Total capital expenditures 1.3 1.4 1.8 2.0 2.7 2.9 2.9 3.1 Other expenditures 2.0 1.9 2.2 2.0 1.8 1.8 2.0 2.5 Transportation expenses 21.0 20.2 21.3 14.0 15.4 13.7 15.5 12.4 Utilities 8.8 9.1 9.0 8.5 10.0 8.3 9.0 8.3 Nutritional supplies 10.3 9.4 9.3 12.0 12.0 12.7 9.8 8.4 Medical supplies, stationaries 0.3 0.2 0.4 0.3 0.3 0.2 0.2 0.2 Daily Subsistence Allowances 52.4 52.5 50.5 56.4 51.8 52.3 51.6 56.3 Salary 96.2 94.6 94.1 94.9 93.7 91.7 90.9 91.0 Total expenditures 2002 2001 2000 1999 1998 1997 1996 1995  

Breakdown of Expenditures of health care system: Mother and child protection (Bishkek city) : 

Breakdown of Expenditures of health care system: Mother and child protection (Bishkek city) 0.7 % 1909.1 0.7 % 1993.6 0.6 % 1565.9 Chui-Tokmok Baby House 0.9 % 2411.6 0.9 % 2480.7 0.7 % 1682 Center of Human Reproduction 2.9 % 7456.8 2.5 % 6837.9 2.3 % 5935.4 Institute of Obstetrics and Pediatrics 3.0 % 7827.9 2.4 % 6501.1 4.1 % 10630.4 Republican Children’s hospital 100 % 260277.5 100 % 271018 100 % 258140 Republican health institutions totally 2002 2001 2000