Duration: 2014-2017

Implementing Partner: Globally, HFG is implemented by a consortium led by Abt Associates.

Key Partners: Mandatory Health Insurance Fund, Ministry of Health

Activity Locations: National

Activity Goal

USAID’s Global Health Bureau launched the Health Finance and Governance Project (HFG) to build stronger health systems that deliver the life-saving services their citizens need, when and where they can access them, and at affordable prices.

In Kyrgyzstan, HFG is providing technical assistance to support the country in developing a hospital payment system for tuberculosis, such that the purchaser side of the TB health financing system will support improved effectiveness and efficiency in TB care.

Activity Major Focus Areas

For the past 20 years, USAID, together with the SWAp development partners, have supported the Government of Kyrgyz Republic in strengthening the health care system in the country. As a result, Kyrgyz Republic now has the most advanced health financing system in the FSU outside the Baltic countries; it is viewed as international best practice. However, the current TB hospital financing system continues to provide an incentive to fill hospital beds; this is in direct contradiction to the new, nationally-approved Clinical Practice Guidelines which call for full outpatient treatment for nearly all TB patients, in line with the WHO’s evidence-based recommendations.

In order to address this, HFG’s Kyrgyzstan TB activity will focus specifically on the following:

• Technical assistance to the Mandatory Health Insurance Fund (MHIF) to design, development, and implementa-tion of a new TB hospital payment system for the country

• Collaboration with other donors to develop a strategy in the context of Den Sooluk Health Sector Strategy/Sector Wide Approach (SWAp) to improve quality and further integrate TB services into PHC by improving the relationship between health financing and service delivery including both the new TB hospital payment system and PHC per capita payment system in order to increase sustainability

Activity Expected Impact and Achievements:

Design, development and implementation of a new TB hospital payment system will change the financial incentives for TB care, to support implementation of the national Clinical Practice Guidelines, which are in line with WHO recommendations.  This will support the move to fully outpatient treatment for most TB patients, both reducing cost and contributing to improved treatment outcomes.