Social Health Insurance Project: Improving Access, Quality, Efficiency and Financial Protection

Abstract*

The objective of the Social Health Insurance Project: Improving Access, Quality, Efficiency and Financial for Kazakhstan is to improve accessibility, quality, and efficiency of health service delivery, and reduce financial risks to the population that are caused by serious health problems. There are three components to the project, the first component being supporting implementation of the national mandatory Social Health Insurance system. This component... Show More

Development Objective

The proposed Project Development Objective is to improve accessibility, quality, and efficiency of health service delivery, and reduce financial risks to the population that are caused by serious health problems.

Key Details

Project Details

Project ID
P152625
Status
Closed
Team Leader
Carlos Bortman , Baktybek Zhumadil
Borrower 2
Republic of Kazakhstan

Country
Kazakhstan
Disclosure Date
December 10, 2014
Approval Date
(as of board presentation)
April 27, 2016
Effective Date
June 27, 2017

Total Project Cost 1
US$ 90.00 million
Implementing Agency
Ministry of Health,Ministry of Health
Region
Europe and Central Asia
Fiscal Year 3
2016

Commitment Amount
US$ 80.00 million
Environmental Category
C
Last Update Date
March 28, 2024
Closing Date
March 31, 2022

Consultant Services required
Yes
Last Stage Reached
BANK APPROVED

Notes
1. Total project cost includes funding from World Bank and non-bank sources in US$ millions. Active and Closed projects show current commitments. Proposed (pipeline) and dropped projects show the forecast amount. The commitment amount for projects in the pipeline is indicative and may be modified during the project preparation.
2. Borrower refers to the Borrower of a Loan or Recipient of a Grant.
3. ”Fiscal Year” is the fiscal year in which the project was approved (or dropped if the status is dropped). The World Bank's fiscal year is from July 1 - June 30. For example, a fiscal year of 1996 corresponds to July 1, 1995 - June 30, 1996.

Sectors

Themes

FY17 - Human Development and Gender

FY17 - Disease Control0%
- FY17 - Pandemic Response1%
FY17 - Health Systems and Policies100%
- FY17 - Health System Strengthening100%

Project Map

Interactive Map

Finances

Financing Plan (US$ Millions)

Financier	Commitments
Borrower/Recipient	10.00
International Bank for Reconstruction and Development	80.00

Total Project Financing (US$ Millions)

Product Line	IBRD/IDA
IBRD Commitment	80.00
IDA Commitment	N/A
IBRD + IDA Commitment	80.00

Lending Instrument
Grant Amount	N/A
Total Project Cost**	90.00

Summary Status of World Bank Financing (US$ Millions) as of March 31, 2025

No data available.

Detailed Financial Activity as of March 31, 2025

Download:

Period	Financier	Transaction Type	Amount (US$)
Dec 21, 2020	IBRD-86170	Loan Disb	969,667.44
Dec 21, 2020	IBRD-86170	Loan Disb	28,658.58
Jun 15, 2021	IBRD-86170	Loan Disb	433,200.00
Jun 15, 2021	IBRD-86170	Loan Disb	1,435,984.90
Mar 19, 2021	IBRD-86170	Loan Disb	330,000.00
Apr 6, 2021	IBRD-86170	Loan Disb	143,000.00
May 5, 2021	IBRD-86170	Loan Disb	584,300.00
Apr 15, 2021	IBRD-86170	Int Charges	214.35
Apr 15, 2021	IBRD-86170	Int Charges	1,459.24
Apr 15, 2021	IBRD-86170	Int Charges	64,822.61
Apr 15, 2021	IBRD-86170	Int Charges	133,729.11
Apr 26, 2021	IBRD-86170	Loan Disb	155,000.00
Jun 28, 2021	IBRD-86170	Loan Disb	15,091.83
Jun 17, 2021	IBRD-86170	Loan Disb	4,148,878.00
Jul 8, 2021	IBRD-86170	Loan Disb	577,000.00
Sep 22, 2021	IBRD-86170	Loan Disb	1,976,653.20
Oct 15, 2021	IBRD-86170	Int Charges	52,848.56
Oct 15, 2021	IBRD-86170	Int Charges	179,976.42
Oct 15, 2021	IBRD-86170	Loan Repay	2,011,866.40
Aug 6, 2021	IBRD-86170	Loan Disb	477,362.47
Aug 6, 2021	IBRD-86170	Loan Disb	450,932.25
Oct 15, 2021	IBRD-86170	Int Charges	110.65
Oct 15, 2021	IBRD-86170	Int Charges	315.68
Nov 30, 2021	IBRD-86170	Loan Disb	121,572.96
Oct 15, 2020	IBRD-86170	Int Charges	226.83
Oct 15, 2020	IBRD-86170	Int Charges	2,236.16
Oct 15, 2020	IBRD-86170	Int Charges	79,395.68
Oct 15, 2020	IBRD-86170	Int Charges	159,204.88
Jul 16, 2020	IBRD-86170	Loan Disb	590,000.00
Jul 21, 2020	IBRD-86170	Loan Disb	2,624,266.80
Sep 22, 2020	IBRD-86170	Loan Disb	236,000.00
Sep 22, 2020	IBRD-86170	Loan Disb	795,471.60
Aug 4, 2020	IBRD-86170	Loan Disb	240,000.00
Jun 13, 2018	IBRD-86170	Loan Disb	41,100.00
Aug 22, 2018	IBRD-86170	Loan Disb	446,883.10
Dec 11, 2018	IBRD-86170	Loan Disb	707,000.00
Feb 15, 2019	IBRD-86170	Loan Disb	143,000.00
Feb 15, 2019	IBRD-86170	Loan Disb	42,200.00
Dec 17, 2018	IBRD-86170	Loan Disb	179,000.00
Nov 26, 2018	IBRD-86170	Loan Disb	80,100.00
Oct 15, 2023	IBRD-86170	Int Charges	1,065,441.20
Oct 15, 2023	IBRD-86170	Int Charges	19,662.41
Oct 15, 2023	IBRD-86170	Loan Repay	2,191,261.00
Apr 15, 2024	IBRD-86170	Int Charges	12,161.43
Apr 15, 2024	IBRD-86170	Int Charges	1,085,268.20
Apr 15, 2024	IBRD-86170	Loan Repay	2,191,261.00
Apr 27, 2016	IBRD-86170	Loan Commitment	80,000,000.00
Oct 15, 2022	IBRD-86170	Loan Repay	2,191,261.00
Oct 15, 2022	IBRD-86170	Int Charges	1,430.66
Oct 15, 2022	IBRD-86170	Int Charges	542,699.06
Jul 31, 2022	IBRD-86170	Loan Cancel	1,952,098.50
Apr 15, 2023	IBRD-86170	Loan Repay	2,191,261.00
Apr 15, 2023	IBRD-86170	Int Charges	1,016.17
Apr 15, 2023	IBRD-86170	Int Charges	39,326.16
Apr 15, 2023	IBRD-86170	Int Charges	920,291.50
Oct 12, 2021	IBRD-86170	Loan Disb	47,000.00
Nov 10, 2021	IBRD-86170	Loan Disb	96,000.00
Sep 14, 2021	IBRD-86170	Loan Disb	32,200.00
Aug 20, 2021	IBRD-86170	Loan Disb	806,822.00
Aug 20, 2021	IBRD-86170	Loan Disb	85,500.00
Aug 20, 2021	IBRD-86170	Loan Disb	131,802.77
Apr 15, 2022	IBRD-86170	Int Charges	187,009.78
Apr 15, 2022	IBRD-86170	Loan Repay	2,191,261.00
Apr 15, 2022	IBRD-86170	Int Charges	712.00
Apr 15, 2022	IBRD-86170	Int Charges	2,031.22
Apr 15, 2022	IBRD-86170	Int Charges	23,494.50
Dec 9, 2021	IBRD-86170	Loan Disb	165,000.00
Dec 28, 2021	IBRD-86170	Loan Disb	-51,977.08
Jan 12, 2022	IBRD-86170	Loan Cancel	34,400,000.00
Dec 11, 2020	IBRD-86170	Loan Disb	397,232.88
Dec 11, 2020	IBRD-86170	Loan Disb	754,167.30
Oct 4, 2018	IBRD-86170	Loan Disb	69,930.00
Oct 16, 2018	IBRD-86170	Loan Disb	240,000.00
Oct 15, 2018	IBRD-86170	Int Charges	17.82
Oct 15, 2018	IBRD-86170	Int Charges	140.39
Oct 15, 2018	IBRD-86170	Int Charges	98,938.50
Oct 15, 2018	IBRD-86170	Int Charges	14,489.26
Oct 15, 2017	IBRD-86170	Int Charges	157,806.70
Nov 6, 2017	IBRD-86170	Loan Disb	90,000.00
Jul 17, 2017	IBRD-86170	Fee Charges	200,000.00
Feb 20, 2018	IBRD-86170	Loan Disb	37,000.00
Apr 24, 2018	IBRD-86170	Loan Disb	46,600.00
Mar 28, 2018	IBRD-86170	Loan Disb	33,500.00
Apr 15, 2018	IBRD-86170	Int Charges	99,543.35
Apr 15, 2018	IBRD-86170	Int Charges	1,464.15
Dec 22, 2017	IBRD-86170	Loan Disb	80,200.00
Feb 17, 2021	IBRD-86170	Loan Disb	54,000.00
Dec 23, 2020	IBRD-86170	Loan Disb	806,000.00
Dec 3, 2020	IBRD-86170	Loan Disb	749,137.00
Dec 23, 2020	IBRD-86170	Loan Disb	355,000.00
Dec 23, 2020	IBRD-86170	Loan Disb	399,888.56
Dec 8, 2020	IBRD-86170	Loan Disb	459,000.00
Dec 8, 2020	IBRD-86170	Loan Disb	776,856.25
Dec 8, 2020	IBRD-86170	Loan Disb	388,027.70
Mar 3, 2021	IBRD-86170	Loan Disb	67,000.00
Dec 21, 2020	IBRD-86170	Loan Disb	648,953.20
Dec 21, 2020	IBRD-86170	Loan Disb	1,086,574.50
Dec 21, 2020	IBRD-86170	Loan Disb	461,858.84
Dec 21, 2020	IBRD-86170	Loan Disb	573,579.30
Dec 21, 2020	IBRD-86170	Loan Disb	985,000.00
Nov 24, 2020	IBRD-86170	Loan Disb	616,000.00
Oct 21, 2019	IBRD-86170	Loan Disb	292,241.00
Feb 10, 2020	IBRD-86170	Loan Disb	83,200.00
Mar 12, 2020	IBRD-86170	Loan Disb	80,400.00
Mar 23, 2020	IBRD-86170	Loan Disb	138,000.00
Dec 20, 2019	IBRD-86170	Loan Disb	912,070.00
Dec 20, 2019	IBRD-86170	Loan Disb	1,760,000.00
Apr 8, 2020	IBRD-86170	Loan Disb	46,000.00
Feb 24, 2020	IBRD-86170	Loan Disb	529,000.00
Apr 23, 2020	IBRD-86170	Loan Disb	243,902.45
May 6, 2020	IBRD-86170	Loan Disb	1,865,000.00
Apr 15, 2020	IBRD-86170	Int Charges	87,011.69
Apr 15, 2020	IBRD-86170	Int Charges	139,694.52
Jul 27, 2020	IBRD-86170	Loan Disb	821,560.00
Jun 25, 2020	IBRD-86170	Loan Disb	106,250.00
Jun 26, 2020	IBRD-86170	Loan Disb	2,699,245.80
Oct 7, 2020	IBRD-86170	Loan Disb	957,000.00
Jun 26, 2020	IBRD-86170	Loan Disb	-2,577,169.50
Mar 6, 2019	IBRD-86170	Loan Disb	43,000.00
Jul 9, 2019	IBRD-86170	Loan Disb	326,400.00
Jul 9, 2019	IBRD-86170	Loan Disb	796,695.00
Jun 26, 2019	IBRD-86170	Loan Disb	73,050.00
Apr 19, 2019	IBRD-86170	Loan Disb	762,000.00
May 22, 2019	IBRD-86170	Loan Disb	170,890.19
May 16, 2019	IBRD-86170	Loan Disb	252,000.00
Apr 15, 2019	IBRD-86170	Int Charges	201.28
Apr 15, 2019	IBRD-86170	Int Charges	73,487.30
Apr 15, 2019	IBRD-86170	Int Charges	44,813.14
Apr 15, 2019	IBRD-86170	Int Charges	2,571.40
Apr 15, 2019	IBRD-86170	Int Charges	22,632.58
Nov 15, 2019	IBRD-86170	Loan Disb	1,155,000.00
Aug 9, 2019	IBRD-86170	Loan Disb	176,211.61
Aug 13, 2019	IBRD-86170	Loan Disb	1,562,000.00
Oct 15, 2019	IBRD-86170	Int Charges	1,083.22
Oct 15, 2019	IBRD-86170	Int Charges	93,339.67
Oct 15, 2019	IBRD-86170	Int Charges	93,647.78
Oct 15, 2019	IBRD-86170	Int Charges	86.62
Jul 16, 2018	IBRD-86170	Loan Disb	42,200.00
May 25, 2018	IBRD-86170	Loan Disb	39,300.00
Jan 30, 2018	IBRD-86170	Loan Disb	7,000.00
Aug 17, 2018	IBRD-86170	Loan Disb	52,800.00
Jun 1, 2018	IBRD-86170	Loan Disb	717,628.60
Sep 20, 2018	IBRD-86170	Loan Disb	54,850.00

Footnotes

Ratings

IMPLEMENTATION RATINGS

Name	Review	Date
Progress towards achievement of PDO	Moderately Satisfactory	2022-03-31
Project Management	Moderately Unsatisfactory	2022-03-31
Overall Implementation Progress (IP)	Moderately Unsatisfactory	2022-03-31
Procurement	Moderately Unsatisfactory	2022-03-31
Counterpart Funding	Moderately Satisfactory	2022-03-31
Financial Management	Satisfactory	2022-03-31
Monitoring and Evaluation	Satisfactory	2022-03-31

COMPLETION RATINGS

INDICATOR	IMPLEMENTATION COMPLETION & RESULTS REPORT: 09-28-2022
Outcomes	Moderately Satisfactory
Risk to Development Outcome
Bank Performance	Substantial
Borrower Performance
Government Performance
Implementing Agency

INDEPENDENT EVALUATION RATINGS

INDICATOR	ICR REVIEW: 11-07-2023	PROJECT PERFORMANCE ASSESSMENT REPORT:
Outcome Rating	Moderately Unsatisfactory	N/a
Risk To Development Outcome		N/a
Bank Performance	Moderately Satisfactory	N/a
Borrower Performance		N/a
Government Performance		N/a
Implementing Agency		N/a
Icr Quality	Substantial	N/a
M&e Quality	Substantial	N/a

Results Framework

PROJECT DEVELOPMENT OBJECTIVE INDICATORS

INDICATOR		BASELINE	CURRENT	TARGET

Increase public expenditure share for PHC + consultation and diagnostic care + outpatient drugs Value 35.00 48.80 40.00
Date September 18, 2015 March 25, 2022 June 30, 2021
Comment

Percent of all surgeries included in the “outpatient elective surgeries” list performed as outpatient surgeries in project-supported hospitals and outpatient facilities	Value	5.00	31.40	40.00
	Date	September 18, 2015	March 25, 2022	June 30, 2021
	Comment

Percent of all contracted inpatient services subject to technical audit (annually) Value 20.00 56.80 30.00
Date September 18, 2015 March 25, 2022 June 30, 2021
Comment
SHIF is fully functional based on predefined criteria Value No Yes Yes
Date September 18, 2015 March 25, 2022 June 30, 2021
Comment

Proportion of the bottom 40% of households spending 10% and more on health services and non-food goods in the health sector out of total expenditure on paid services and non-food goods	Value	10.50	24.60	12.80
	Date	June 30, 2016	March 25, 2022	March 31, 2022
	Comment

INTERMEDIATE RESULTS INDICATORS

INDICATOR		BASELINE	CURRENT	TARGET

Percent of population for whom SHIF received SHI contributions/subsidies Value 0.00 91.40 86.00
Date September 18, 2015 March 25, 2022 March 31, 2022
Comment
Number of fully functional regional PHC excellence centers Value 0.00 17.00 17.00
Date September 18, 2015 March 25, 2022 June 30, 2021
Comment

Number of regions implementing disease management programs with evidence-based effectiveness, including incentives for health providers and patients	Value	2.00	17.00	17.00
	Date	September 18, 2015	March 25, 2022	June 30, 2021
	Comment

Achievement of key benchmarks for functioning social health insurance system Value No Yes Yes
Date September 18, 2015 March 25, 2022 June 30, 2021
Comment

Number of educational programs developed and implemented in medical education institutions based on competence-based approach and professional standards through strategic partnerships	Value	1.00	21.00	21.00
	Date	September 18, 2015	March 25, 2022	March 31, 2022
	Comment

Key adjustments in the contracting methods are adopted to include incentives for providers to improve quality Value No Yes Yes
Date September 18, 2015 March 25, 2022 June 30, 2021
Comment
Unified register of human resources for health implemented Value No No Yes
Date September 18, 2015 March 25, 2022 June 30, 2021
Comment
Health personnel receiving training (number) Value 0.00 10074.00 9800.00
Date September 18, 2015 March 25, 2022 March 31, 2022
Comment
Health facilities constructed, renovated, and/or equipped (number) Value 0.00 119.00 250.00
Date September 18, 2015 March 25, 2022 June 30, 2021
Comment
Percentage of patients reporting improved health services Value n/a 49.2% +10% over baseline
Date September 18, 2015 March 25, 2022 June 30, 2021
Comment
Increase in transparency, credibility, and effectiveness of the complaints handling system Value 0.00 87.10 60.00
Date September 18, 2015 March 25, 2022 June 30, 2021
Comment
Number of new clinical protocols developed for intensive care in obstetrics and for neonatology Value 0.00 5.00 2.00
Date January 1, 2017 March 25, 2022 December 31, 2020
Comment

Increase public expenditure share for PHC + consultation and diagnostic care + outpatient drugs	Value	35.00	48.80	40.00
	Date	September 18, 2015	March 25, 2022	June 30, 2021
	Comment

Percent of all contracted inpatient services subject to technical audit (annually)	Value	20.00	56.80	30.00
	Date	September 18, 2015	March 25, 2022	June 30, 2021
	Comment

Percent of population for whom SHIF received SHI contributions/subsidies	Value	0.00	91.40	86.00
	Date	September 18, 2015	March 25, 2022	March 31, 2022
	Comment

Percentage of patients reporting improved health services	Value	n/a	49.2%	+10% over baseline
	Date	September 18, 2015	March 25, 2022	June 30, 2021
	Comment