The World Bank conducted a study on how efficiently Kyrgyzstan spends budget money on two important social sectors – education and health. The experts not only identified trends, but also provided recommendations for improving the situation.
The report notes that Kyrgyzstan is one of the countries in the world with the largest share of public spending on education – treasury spending is 7% of GDP or 22.5% of the state budget, which is significantly higher than in other countries with a similar level of income (which spend on education on average 16% of total government spending or 4-5% of GDP).
However, experts point out that learning outcomes remain low, and access to preschool and upper secondary education is problematic. Salaries and social security contributions make up the bulk of the education budget – up to 69% of the total education budget, while teachers’ salaries remain below the national average. There is a surplus of teachers in the system as a whole, but the suboptimal distribution of personnel by subjects and schools leads to a shortage of them in specific subjects – primarily in language and mathematics.
“Increasing the efficiency of the distribution of human resources in the education system is possible by reducing the number of non-teaching workers with vague job descriptions in preschool institutions to zero, increasing the number of teachers for primary grades, in languages and mathematics, as well as training teachers in more than one subject – especially disciplines for which there is a shortage of teachers, ”says co-author of the report Aruub Iqbal.
The republic’s health indicators have significantly improved over the past two decades, as life expectancy has increased on average from 68 to 71 years; mortality of children under 5 years of age decreased from 66 to 20 deaths per 1000 live births; maternal mortality declined over the same period from 79 to 60 deaths per 100,000 live births.
At the same time, the World Bank notes, Kyrgyzstan is facing a growing burden of noncommunicable diseases that require a different approach and strengthening primary health care (PHC). In 2018, noncommunicable diseases accounted for 83% of deaths, and one in four Kyrgyz citizens aged 30 to 70 were at risk of premature death from one of the four major noncommunicable diseases – cardiovascular disease, chronic obstructive pulmonary disease, diabetes or cancer.
“Given the current pace, there is no expectation that by 2030 the republic will reach the goal of the state health program to reduce premature mortality from major noncommunicable diseases by 30%. And this is largely due to the factors of lifestyle and behavior, ”explains Irina Postolovska, senior economist at the World Bank.
Experts recommend making healthcare a priority for the state budget in order to maintain an adequate level of spending on the fight against COVID-19, to ensure the continuity of services provided and to combat the growing trend of spending out-of-pocket of citizens. For example, by revising the program of state guarantees, revising the additional program of compulsory health insurance, as well as preventing the practice of self-prescribing drugs and unethical marketing.