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Eastern Europe and Central Asia - P4H Network

The Eastern Europe and Central Asia (EECA) Region

The P4H Network covers countries of Eastern Europe and Central Asia. This region includes the Commonwealth of Independent States: Armenia, Azerbaijan, Belarus, Kazakhstan, Kyrgyzstan, the Republic of Moldova, the Russian Federation, Tajikistan, Turkmenistan, Uzbekistan and Ukraine. The EECA region also includes Estonia, Georgia, Latvia, Lithuania, and Mongolia.

Rationale for regional collaboration

The legacy of health care and social health protection in the EECA region is rooted in the common background of socially oriented and centrally planned health and social protection systems. Under this type of system, countries provided free health care to all their citizens fully subsidized by state budgets. These countries also had subsidized contributory social security and welfare systems. However, the quality of health care was affected by resource limitations. 

The political and economic reforms and transitions from a centrally planned to market economy in the early 1990s have resulted in fundamental changes to social health protection (SHP) and health financing (HF) arrangements. Known as transitional economies, the EECA countries and the entire region uniquely showcase different reforms and policy approaches. 

The P4H Network provides a platform for regional knowledge exchange through its governance structure with a dedicated space for collaboration. Kazakhstan and the Russia Federation joined the P4H Network in 2017, creating collaborations with each other and through P4H regional activities and networking. Recently, other member states of the EECA region, including Azerbaijan, Kyrgyzstan, Tajikistan and Uzbekistan, actively participated in regional events and activities. 

Diversity of CIS regional collaboration and networking

P4H-facilitated regional events are supported by regional and country government representatives.  The highlight of such dynamic exchanges was the 2022 webinar series entitled “Social Health Protection and Health Financing Reforms in Countries,” supported by the ILO and WHO. The participation of government officials from Azerbaijan, Kazakhstan, Kyrgyzstan, Tajikistan and Uzbekistan reflected the value of the collaboration.

Collaborations in the EECA region also support country-based events and international conferences organized by national governments. One example was the P4H Network-supported Health Financing Conference in Astana in 2018. The conference hosted an expert brainstorming exercise that provided guidance to Kazakstan’s launching of its largest SHP reform. Similarly, the National Forum of Healthcare Managers, also held in Astana in 2022, and supported by the P4H Network, provided a discussion platform for a post-reform reflection of the recently launched social health insurance system. 

The EECA region uses the P4H Network’s X account and The launching of a dedicated digital space for the region and of the EECA newsletter in Russian in January 2022 were milestones that marked a new level of collaboration in the region. For example, there is interest in conducting a cross-country comparison of effects of SHP reform among countries in the EECA region, with a focus on mandatory social health insurance. Plans also include establishing a P4H Network sub-regional hub and the Leadership for UHC (L4UHC) programme. As part of this strategy, one of the L4UHC modules was organized in Kazakhstan.

In October 2019, the government of Kazakhstan hosted the 16th P4H Steering Group Meeting. Kazahkstan currently holds one of the 15 voting seats in the P4H Steering Group, representing the EECA region.  

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