Overview

Key points

• Kyrgyzstan’s health system provides a state-guaranteed package of services but the scope of publicly funded care is limited, with gaps in mandatory health insurance coverage.
  
• Spending on health per capita was the lowest in WHO’s European Region in 2021. It has also declined as a share of total government spending.
  
• Most patients make co-payments for inpatient care and for outpatient medicines, with the state covering only 50% of the price of a limited list of (some 70) medicines.
  
• 40.7% of health spending in 2021 was out-of-pocket (OOP). This reliance on OOP payments can lead to catastrophic spending.
  
• Despite efforts to ensure access to health services, there are still marked disparities between urban and rural/mountainous areas and barriers linked to cost and gaps in public coverage.
  
• There have been extensive hospital closures and reductions in hospital beds since 1997.
  
•  Longstanding reforms have boosted primary care, but it is underfunded, bypassed too often and prevention is not a strong focus.
  
• Much of the role of the Mandatory Health Insurance Fund in pooling funds and structuring health service provision is now being taken over by the Ministry of Health.
  
• Rates of doctors and nurses are low and falling. Workforce ageing and migration are major concerns.
  
•  Life expectancy has increased and maternal and infant mortality are falling (although still relatively high). The COVID-19 pandemic did lead to excess mortality, but less so than in many European countries.
  
• Rates of effective tuberculosis (TB) treatment coverage are high, but concerns related to access to diagnosis and treatment for TB and HIV/AIDS remain.
  
• Noncommunicable diseases (NCDs) are the main cause of mortality and morbidity. Main risk factors include high blood pressure, unhealthy diet, air pollution and smoking.