Kyrgyzstan has completed the first-ever full application of the WHO's Universal Health Coverage Compendium to redesign an entire national benefits package. Working through a two-year evidence-informed deliberative process, the government prioritised 182 essential services - the challenge was having only US$19 per capita available to pay for them, exposing a stark contrast between ambitions and fiscal reality that many countries will recognise.
Kyrgyzstan's Benefits Package promised broad access to care, but its entitlements were never clearly defined which contributed to misaligned budgets and out-of-pocket payments that make up 38% of total health spending. Between 2023 and 2025, the Ministry of Health supported by technical experts from Radboudumc and University College London, carried out the first-ever system-wide application of the WHO Universal Health Coverage Compendium (UHCC) to redesign the Benefits Package.
The process followed an evidence-informed deliberative approach: technical working groups mapped 424 potential services against standardised WHO definitions, a 62-stakeholder workshop set eight prioritisation criteria (including cost-effectiveness, disease burden and equity), and a dedicated costing model priced every service. Deliberation identified 182 services as high priority, but Kyrgyzstan's available fiscal space for reallocation was just US$19 per capita (excluding Human Resources) , far short of what was needed.
Three financing scenarios were modelled. Fully funding all 182 priority services publicly would cost US$53.76 per capita (excl HRH). A budget-constrained package limited to 66 services would fit closer to the available envelope but would exclude major NCD, infectious disease, mental health and emergency care services - deemed politically unacceptable. A middle path (mixed public–private financing, blending public funding with existing insurance co-payment mechanisms) could preserve all 182 priority services at US$47.74 per capita, still above current fiscal space but with a smaller financing gap.
Beyond the package itself, the exercise built lasting institutional capacity: a trained cohort of experts and a reusable costing model for future revisions. The authors argue this offers a replicable model for other resource-constrained countries seeking to move from implicit to explicit, evidence-based benefit design.