Government–nonprofit partners for health sector reform in Central Asia: family group practice associations in Kazakhstan and Kyrgyzstan

Abstract

Abstract Faced with limited resources, governments in developing and transitioning countries are struggling to find the resources to provide basic health services. Increasingly, governments are turning to the private and nonprofit sectors as partners. This article examines the experience of Kazakhstan and Kyrgyzstan in creating new nonprofit organizations as part of health sector reform. Family Group Practice Associations (FGPAs) serve as intermediaries between public sector health agencies and newly created family group practices (FGPs), which are providing improved levels of primary health care. The FGPAs have helped to improve the efficiency and the effectiveness of health service delivery, and have contributed to making the top‐heavy and cumbersome health systems in both countries more flexible and responsive. Although their policy advocacy role is still relatively incipient, FGPAs provide a potential avenue for increasing external input into policy decisions. The weight of the past has made progress relatively slow, with large power differentials between the nonprofits and their government partners, a constrained legal framework for non‐governmental entities, and weak capacity among the newly created FGPAs and FGPs. Copyright © 2002 John Wiley & Sons, Ltd.

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