Operationalizing the Health and Education Millennium Development Goals in Central Asia: Kyrgyz Republic Health and Education Case Studies
Lead Author: Sarbani Chakraborty
June 2005
Without concerted action, the Kyrgyz Republic is not likely to attain the health and education MDGs. The objective of this report is to present a generic framework for analysis and policy action for attainment of the MDGs in the Kyrgyz Republic and other Central Asian countries. The framework takes into account that economic growth alone is insufficient for attaining the MDGs, and there is a need to focus on scaling-up the delivery of known technical interventions. In addition, the framework recognizes that while many sectoral reforms could improve welfare, focusing on those at the lower end of the distribution tail is critical for achieving the MDGs. The framework emphasizes four key areas of intervention that apply across Central Asian countries.
1. The General Framework for Achieving the Millennium Development Goals in Central Asia
The framework focuses on the service delivery aspects of achieving the MDGs and emphasizes: a) monitoring outcomes to identify groups that are not achieving MDGs, b) identifying interventions that are effective in raising MDG performance, c) targeting interventions to groups that are not meeting MDGs, and d) strengthening incentives to service providers and users to raise MDG outcomes for these groups.
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2. The Framework for Operationalizing MDGs in the Kyrgyz Republic
The Kyrgyz Republic was chosen to illustrate the MDG framework because prior analytical and project work provide a relatively rich base of knowledge and experience and because there is significant government ownership of the key principles involved in the approach. The case studies aim to bring together relevant existing sector knowledge and lessons of experience in order to derive the options for moving ahead more aggressively on MDG attainment in the health and education sectors.
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3. Education Case Study
The unfinished MDG education agenda in the Kyrgyz Republic involves raising attendance in basic education, raising education quality in the lowest performing schools, and raising secondary enrollments and attendance. Adopting a performance-based approach to the education MDG would require a paradigm shift for the Government and the public, including a shift in focus to the lowest-performing schools, teachers, and students, rather than the high performers.
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4. Health Case Study
There are significant disparities in MDG health outcomes by region, urban and rural areas, and among the poor and the non-poor in the Kyrgyz Republic. Globally, there is good evidence based on service delivery interventions as effective for achieving the health MDGs. Ninety percent of these interventions can be provided through primary care and public health services. To accelerate progress on the MDGs, there is a need to focus on scaling-up service delivery of effective health interventions, especially among groups with worse MDG health outcomes, targeting budget allocations for cost-effective health interventions and introducing a results-based monitoring framework for the MDGs integrated into the National Poverty Reduction Strategy.
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