Over the previous decade, the Kyrgyz health system has gone through a school of perseverance.
Today, one can say with confidence that as a result of the “Manas” National Health Care Reform Program (1996-2005), we not only maintained the state health care system but also introduced new fundamental principles for its continued development with focus on the needs of our population, achievement of equity principles, reduction of financial burden, quality improvement and accessibility of medical services.
Without revolutionary changes introduced in the health system -- establishment of family medicine institute, restructuring of health care delivery, introduction of mandatory health insurance system, implementing progressive provider payment methods, and since 2001, the single payer system and the basic benefit package -- the new horizons targeted in the “Manas-Taalimi” National Health Reform Program for 2006-2010 would not be achievable.
When the “Manas-Taalimi” National Program was being developed, the population rebelled against lawlessness, high level of poverty and corruption. The revolution in March 2005 became a turning point in the Kyrgyz health care system.
With the technical support of the World Health Organization and DFID, the best specialists of our Republic were invited to develop the new program to further reform the health system in consultation with health professionals and civil society. A balanced assessment of the results of the “Manas” National Program was conducted, positive experiences and lessons learnt were carefully studied, and remaining problems were comprehensively analyzed.
The result of this collaborative effort became the “Manas-Taalimi” National Program presented in this book. The Program defines key priorities for the further development of the health system for the next five years. The main directions are: (i) contributing to poverty reduction; (ii) achieving fairness in population access to health services and elimination of differences between urban and rural areas; (iii) increasing efficiency of the proposed measures for significant improvement in the quality of health services, and the influence of these achievements for population health and achievement of the health Millennium Development Goals.
The Program gives great importance to the role of citizens, local communities, local self-governments in decision-making over issues of health protection and health promotion, formation of healthy lifestyle and health culture.
An important factor in the achievement of health sector goals is effective management, capacity building, strengthening cross-sectoral interaction and coordination of donor support.
In consultations with the donor community, the principles of a sector-wide approach (SWAp) were introduced for the implementation of the Program. The SWAp is a new form of interaction between the Kyrgyz Republic Government and donors. It allows increasing the effectiveness of resource use on the basis of coordination and harmonization of the activities of the government, donors and civil society.
As a distinctive feature of the SWAp, donor funds will be channeled to support the state health care budget for the first time using standard budget procedures but not to specific projects. Such an approach to program implementation is used for the first time in the post-soviet area and it reflects a high degree of trust in our Republic.
Thanks to the budget developed for 2006 within the SWAp, implementation of a number of measures included into “Manas-Taalimi” National Health Reform Program has already started.
A distinctive feature of the “Manas-Taalimi” Program is that the government’s obligations are supported with financial resources and real mechanisms to achieve set goals. This inspires and increases the responsibility of the entire health sector towards the citizens.
I am certain that this new phase of health system development in the Kyrgyz Republic will be supported by all health professionals.
On behalf of the medical community I would like to thank the President and the Government of the Kyrgyz Republic and the donor community for the trust rendered and assure that all our power and knowledge will be targeted to the benefit of the people.
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