From implicit to explicit: an evidence-informed deliberative process for health benefits package revision using the WHO UHC Compendium in Kyrgyzstan

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BACKGROUND: Translating universal health coverage (UHC) commitments into explicit, evidence-informed benefits packages remains a challenge for many resource-constrained health systems. This paper describes the methods and findings of a full-system benefits package revision applying the WHO Universal Health Coverage Compendium (UHCC) within an evidence-informed deliberative process (EDP) to redesign the State-Guaranteed Benefits Programme in Kyrgyzstan. METHODS: The revision was carried out using the UHCC, following an EDP. The UHCC provided standardised service definitions and resource requirements for analysis. An assessment and appraisal process incorporated technical analysis and governance oversight through the Health Policy Council. The costing methodology estimated input costs per service and multiple financing scenarios were developed with decision-makers to explore coverage-cost trade-offs. RESULTS: The revision was conducted over 2023-2025, with the Health Policy Council endorsing key methodological decisions. Technical evidence on cost, impact and equity was generated for all services. Through deliberative appraisal, 182 services were prioritised as essential. With an available fiscal space of US$19 per capita, only 66 essential services could be financed under fully public funding. A mixed public-private financing scenario maintained comprehensive essential service coverage while reducing public costs. CONCLUSION: Kyrgyzstan's experience demonstrates that comprehensive, evidence-informed revision of benefits package is feasible in resource-constrained settings when supported by political commitment, strong governance, global tools, structured deliberation and integrated costing. Use of the WHO UHCC enabled standardised service definitions. The approach offers practical lessons for countries seeking to institutionalise priority setting and strengthen progress towards UHC.

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