1 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

2 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?

3 Survey Objective Availability survey of psychotropic medicines for patients with mental diseases within State Guarantee Benefit Programme in Talas and Batken regions of KG

4 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

5 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

6 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

7 Round table on SGBP All findings was discussed at the Round Table Mandatory Health Insurance Fund Ministry of Health CSO organisations Private sector representatives

8 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

9 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

04/02/ Chart Example

04/02/ Thank you Burul Makenbaeva CSC coalition Mobile number: Skype: mhealth2008 Website: