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Anar Ulikpan , PhD student, School of Population Health, University of Queensland, Australia

Different aid engagement, different health system outcomes: Two decades of transition for the Central Asian Post-Soviet states. Anar Ulikpan , PhD student, School of Population Health, University of Queensland, Australia

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Anar Ulikpan , PhD student, School of Population Health, University of Queensland, Australia

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  1. Different aid engagement, different health system outcomes: Two decades of transition for the Central Asian Post-Soviet states AnarUlikpan, PhD student, School of Population Health, University of Queensland, Australia TolibMirzoev, Nuffield Centre for International Health & Development, Leeds Institute of Health Sciences, University of Leeds Eliana Jimenez, School of Population Health, University of Queensland, Australia Asmat Malik, Integrated Health Services, Islamabad, Pakistan Peter S Hill, School of Population Health, University of Queensland, Australia

  2. HISTORICAL BACKGROUND

  3. Single country dominance

  4. Collapse of the Soviet Union

  5. Methods Documentary Review: • Extensive document review (English, Russian, and Mongolian) • Pubmed, Scopus, ProQuest and Google Scholar • Institutional websites (ODI, WHO, WB, UN agencies) • Grey literature Key informant interview: • In-depth interviews were conducted with 11 key informants with experiences in Kyrgyzstan, Mongolia and Uzbekistan Participatory observations: • Two authors 10-12 years experience in participating in the policy development process in Mongolia and Tajikistan

  6. Least studied (0.16-1.71 publn/100.000 popn) • Language barrier • Overlooked by international community

  7. Limitations • Few published evidences • Limited access to study countries information • Key informants: secondary source

  8. Health sector in crisis during 1990s • Sharp fall of GDP by 40-60% (except Uzbekistan as 15%) • Health spending fall to 1.1%-3.4% as percentage of GDP • Key health indicators declined • Introduction of social health insurance and user fees • Profound “revolution” at every level of the system • Arrival of new donors (financial, technical, policy support)

  9. From single country dominance to Multi-actor relationship

  10. World Bank United States Japan • Kazakhstan Kyrgyzstan Mongolia Tajikistan European Union Asian Development bank • Turkmenistan • Uzbekistan UN agencies Nordic countries South Korea

  11. Net ODA received per capita in selected Post-Soviet Central Asian countries

  12. Uniqueness of aid relationship • Not too many donors • New as an aid recipient • No longstanding culture of aid coordination

  13. Differing paths and destiny Kyrgyzstan Mongolia Tajikistan Turkmenistan Uzbekistan

  14. Geopolitics play • Rich natural resources • Geo-strategically favourable position between the three giants

  15. These countries are neglected in development discussions despite their growing inequality in health and poverty

  16. Where to from here? • New aid relationships offer new opportunities for both donors and recipients • Fewer partners do not necessarily mean less fragmentation

  17. Where to from here? • Aid modalities must reinforce ownership and sustainability • Always consider factors beyond the health

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