Health Policy Manag.  2019 Sep;29(3):342-356. 10.4332/KJHPA.2019.29.3.342.

Comparative Study of Health Care System in Three Central Asian Countries: Kazakhstan, Kyrgyzstan, Uzbekistan

• Dronina Y
• Nam EW

• KMID: 2460882
• DOI: http://doi.org/10.4332/KJHPA.2019.29.3.342

Abstract

BACKGROUND
The objectives of the study are to find out the effect of the implementing reform in three Central Asian countries, identify its impact on health status and health care delivery systems. This study address to identify strong and weak points of the health systems and provide a recommendation for further health care organization.
METHODS
A comparative analysis was conducted to evaluate the effects of implemented policy on health care system efficiency and equity. Secondary data were collected on selected health indicators using information from the World Health Organization Global Health Expenditure Database, European Health Information Platform, and World Bank Open Data.
RESULTS
In terms of population status, countries achieved relatively good results. Infant mortality and under-5 mortality rate decreased in all countries; also, life expectancy increased, and it was more than 70 years. Regulations of the health systems are still highly centralized, and the Ministry of Health is the main organ responsible for national health policy developing and implementation. Among the three countries, only Kyrgyzstan was successful in introducing a national health system. Distribution of health expenditure between public expenditure and out-of-pocket payments was decreased, and out-of-pocket payments were less the 50% of total health expenditure in all countries, in 2014.
CONCLUSION
After independent, all three countries implemented a certain number of the policy reform, mostly it was directed to move away from the old the Soviet system. Subsequent reform should be focused on evidence-based decision making and strengthening of primary health care in terms of new public health concepts.

Keyword

Health policy; Health care system; Kazakhstan; Kyrgyzstan; Uzbekistan

MeSH Terms

Asian Continental Ancestry Group*
Decision Making
Delivery of Health Care*
Global Health
Health Expenditures
Health Policy
Humans
Infant
Infant Mortality
Kazakhstan*
Kyrgyzstan*
Life Expectancy
Mortality
Primary Health Care
Public Health
Social Control, Formal
United Nations
Uzbekistan*
World Health Organization