Kazakhstan : Healthcare Operations and Planning Enhancement Project

Sovereign Project | 57315-001

The proposed technical assistance will support the Ministry of Health of the Republic of Kazakhstan (MOH) and Turar Healthcare with health sector planning, including sector analysis, master planning of health services, hospital infrastructure planning, project identification, and related capacity building. Improved healthcare planning will help establish an integrated, modernized, and climate-resilient health services network to achieve better quality and efficiency of public health services towards Universal Health Coverage (UHC) and Sustainable Development Goals (SDGs).

Project Details

Project Name
Healthcare Operations and Planning Enhancement Project
Project Number
57315-001
Country / Economy
  • Kazakhstan
Project Status
Active
Project Type / Modality of Assistance
  • Technical Assistance
Source of Funding / Amount
TA 10277-KAZ: Healthcare Operations and Planning Enhancement Project
Source Amount
Technical Assistance Special Fund US$ 160,000.00
Operational Priorities
  • OP1: Addressing remaining poverty and reducing inequalities
  • OP6: Strengthening governance and institutional capacity
Sector / Subsector
  • Health / Health system development

Gender
No gender elements
Description
The proposed technical assistance will support the Ministry of Health of the Republic of Kazakhstan (MOH) and Turar Healthcare with health sector planning, including sector analysis, master planning of health services, hospital infrastructure planning, project identification, and related capacity building. Improved healthcare planning will help establish an integrated, modernized, and climate-resilient health services network to achieve better quality and efficiency of public health services towards Universal Health Coverage (UHC) and Sustainable Development Goals (SDGs).
Project Rationale and Linkage to Country/Regional Strategy

The Government of the Republic of Kazakhstan has established Turar Healthcare as the National Operator with the aim of modernizing state health services. This includes plans to develop university and multidisciplinary hospitals and primary health care (PHC) facilities to be funded either by the state or as public-private partnership (PPP). The Ministry of Health of the Republic of Kazakhstan (MOH) has identified health infrastructure development as a priority and has requested ADB to assist with sector analysis, master planning, hospital design, project scoping, and related capacity building.

In 1991, the government inherited an input-driven, inefficient health system focused specialists and inpatient care. Health sector reforms initiated in 1995 led to major rationalization of hospitals and strengthening of PHC. The country achieved a universal health coverage (UHC) of 80% in 2021, which is high for the region. Social health insurance reached 84% of the population in 2020 and supports a basic benefits package. However, health indicators such as maternal and child health are not commensurate with the country's rapid economic growth of annual average of around 6% of gross domestic product in the past two decades.

While the burden of diseases is declining, demand for and cost of health services are increasing with a shift to non-communicable diseases linked to population aging, and lifestyle and environmental conditions that require a multi-sectoral approach with more effort in prevention. The health sector itself is still in transition with incomplete reforms and investment initiatives. Most hospitals and health centers in Kazakhstan are owned and operated by the public sector, and about half of these require upgrading and renovation. The health system remains biased towards specialist care and inpatient services. Access to and quality of rural health services are insufficient and challenging due to a very low rural population density of about 3 persons per km2. Health services quality is also affected by under-resourced education institutions and teaching hospitals. The country of 19 million people has 12 accredited and globally recognized medical colleges. Kazakhstan's 2020 health spending amounted to 3.8% of gross domestic product (GDP) or $342 per capita, with a government share of 66% and a modest out-of-pocket share of 27%.

As per the national "Healthy Nation project: quality and affordable healthcare for every citizen", the government prioritizes health infrastructure development along with human capital development, technological modernization, digitalization, efficiency improvements through better management, and reducing out-of-pocket expenses. Public infrastructure is to be improved in terms of bed capacity, efficiency, alignment with sustainable development goals (SDGs), and better procurement and maintenance. The government has directed the new construction of up to 5 greenfield hospitals and 300 PHC facilities, and has proposed increasing private investment in healthcare from $260 million to $1,680 million from 2020 to 2025, adding 13,000 health staff, and increasing domestic pharmaceutical production.

Construction of hospitals and PHC facilities may be using the public-private partnership (PPP) facility management model. The private group may design, finance, build, operate, and maintain the new hospital, and provide non-medical services, while the state will provide medical services. Up to September 2022, 228 PPPs were recorded in the health sector, mostly at local level, at a total cost of about $400 million. PPP projects in healthcare may be contracted through MOH for republican projects, local governments for regional projects, and Turar Healthcare. ADB has supported the planning of PPP for the Karaganda Medical University Hospital, possibly to start in 2024. The European Bank for Reconstruction and Development (EBRD) has assisted with the planning of the Kazakh National Medical University Hospital and the Kyzylorda General Hospital, but these are likely to be state-funded. Kazakhstan has retained sufficient fiscal space for public investments. However, government and private sector interests in PPP are improving.

Kazakhstan's transformation to a green economy is challenging given harsh climate conditions, environmental pollution, and high infrastructure cost per capita. The government's Concept for Transition of the Republic of Kazakhstan to Green Economy aims to address climate change and environmental issues by increasing energy efficiency, upgrading existing infrastructure, better waste management, and other measures. Hospitals are a major source of greenhouse gases and wastes. The government has access to various climate funds including climate financing from ADB.

Impact

Quality and affordable healthcare for every citizen

Project Outcome

Description of Outcome

Improved healthcare planning that will help establish an integrated, modernized, and climate-friendly health services network to achieve better quality and efficiency of public health services

Progress Toward Outcome

Implementation Progress

Description of Project Outputs

Health equipment master plans prepared.

Health human resources master plans prepared.

Status of Implementation Progress (Outputs, Activities, and Issues)
Geographical Location
Nation-wide

Summary of Environmental and Social Aspects

Environmental Aspects
Involuntary Resettlement
Indigenous Peoples

Stakeholder Communication, Participation, and Consultation

During Project Design
During Project Implementation

Contact

Responsible ADB Officer
Chin, Brian
Responsible ADB Department
Sectors Group
Responsible ADB Division
Human and Social Development Sector Office (SG-HSD)
Executing Agencies
Ministry of Health

Timetable

Concept Clearance
-
Fact Finding
-
MRM
-
Approval
31 Jan 2024
Last Review Mission
-
Last PDS Update
02 Feb 2024

Funding

TA 10277-KAZ

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
31 Jan 2024 - 31 Jan 2024 31 Dec 2024 - -
Financing Plan/TA Utilization
ADB Cofinancing Counterpart Total
Gov Beneficiaries Project Sponsor Others
160,000.00 0.00 0.00 0.00 0.00 0.00 160,000.00
Cumulative Disbursements
Date Amount
02 Feb 2024 0.00

Project Data Sheets (PDS) contain summary information on the project or program. Because the PDS is a work in progress, some information may not be included in its initial version but will be added as it becomes available. Information about proposed projects is tentative and indicative.

The Access to Information Policy (AIP) recognizes that transparency and accountability are essential to development effectiveness. It establishes the disclosure requirements for documents and information ADB produces or requires to be produced.

The Accountability Mechanism provides a forum where people adversely affected by ADB-assisted projects can voice and seek solutions to their problems and report alleged noncompliance of ADB's operational policies and procedures.

In preparing any country program or strategy, financing any project, or by making any designation of, or reference to, a particular territory or geographic area in this document, the Asian Development Bank does not intend to make any judgments as to the legal or other status of any territory or area.

None currently available.


Safeguard Documents See also: Safeguards
Safeguard documents provided at the time of project/facility approval may also be found in the list of linked documents provided with the Report and Recommendation of the President.

None currently available.


Evaluation Documents See also: Independent Evaluation

None currently available.


Related Publications

None currently available.


The Access to Information Policy (AIP) establishes the disclosure requirements for documents and information ADB produces or requires to be produced in its operations to facilitate stakeholder participation in ADB's decision-making. For more information, refer to the Safeguard Policy Statement, Operations Manual F1, and Operations Manual L3.

Requests for information may also be directed to the InfoUnit.

Tenders

Tender Title Type Status Posting Date Deadline
Healthcare Operations and Planning Enhancement (HOPE) Project - Health Human Resources Development Expert Individual - Consulting Closed
Consulting Services Firm Firm - Consulting Closed

Contracts Awarded

Contract Title Approval Number Contract Date Contractor | Address Executing Agency Total Contract Amount (US$) Contract Amount Financed by ADB (US$)
Capacity Development Technical Assistance Technical Assistance 10277 24 Apr 2024 management4health GmBh (GERMANY) | Hebelstr. 11, Frankfurt Am Main, Hessen 60318, Germany Ministry of Health 149,554.00

Procurement Plan

None currently available.