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Access to medicines for patients with mental health diseases within

State Guarantee Benefit Programme in Talas and Batken

regions of KG

Makenbaeva B.

Mhealth,

Bishkek, Kyrgyz Republic

November 2009 – March 2010

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Introduction

• 87% of mental health care budget is used in hospitals (at the second and tertiary public health care levels)

• State Guarantee Benefit Programme (SGBP) at the outpatient level was implemented in 2006 was the first step to bring closer the mental health service to communities:

– There is a List of medicines for reimbursement – Integration SGBP with Outpatient Drug Benefit

Package for insured citizens

However, do all patients have access to medicines?

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Survey Objective

Availability survey of psychotropic medicines for patients with

mental diseases within State Guarantee Benefit Programme in Talas and Batken regions of KG

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Coverage geography and survey materials and methods

• Semi-structure interview of physicians, nurses, patients, family members, heads of health facilities and pharmacists

•Review of normative acts (legislation) concerning patients with mental diseases

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Outcomes (1)

• A shortage of qualified psychiatrists at the primary health care level

• Lack of documents of vulnerable groups is also an obstacle to gaining access to benefit drug provision because it is required a document certifying the identity of the patient to obtain benefit prescriptions

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Outcomes (2)• Lack of pharmacy network in rural

areas• Obsolete level of drug reimbursement

• Pressure law enforcement and inspection organizations on pharmacies and health workers to monitor psychotropic medicines and opioids

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Round table on SGBP• All findings was discussed at the Round

Table

• Mandatory Health Insurance Fund

• Ministry of Health

• CSO organisations

• Private sector representatives

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Recommendations (1)

• Improving management of patients with mental diseases at the outpatient level

• Improving the awareness of population on their rights within State Guarantee Benefit Program through the collaboration with NGO and mass media

• Mandatory Health Insurance Fund needs to review the reference prices and update the list of medicines for reimbursing

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Recommendations (2)

• Holding regular meetings with representatives of local governments, inspection units, NGO and pharmaceutical suppliers to solve common issues together

• Local governments should help to vulnerable groups in acquiring the documents that certify the identity, especially for disabled mental health persons

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Chart Example

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Thank you

• Burul Makenbaeva • CSC coalition • Email: mhealth@inbox.ru• Mobile number: +996 550 913 484• Skype: mhealth2008• Website: http://www.mhealth.in.kg