Key points ● Kyrgyzstan’s health system provides a state guaranteed package of services but there are gaps in population coverage and the scope of publicly funded care is limited. ● The COVID-19 pandemic disrupted access to essential health services and led to excess mortality, but less so than in many other European countries, and maternal mortality increased only marginally in the first year of the pandemic. ● Government spending on health as a share of total public spending has declined, with an increasing share of government spending going to other sectors. ● Most patients have to make co-payments for inpatient care and only 50% of the so-called basic price of a limited list of (some 70) outpatient medicines is covered. ● Private out-of-pocket (OOP) spending accounted for 40.7% of health spending in 2021. This reliance on OOP payments can lead to catastrophic and impoverishing health spending. ● Despite efforts to ensure access to health services, there are still marked disparities in provision between rural/mountainous areas and urban areas, and barriers linked to cost and gaps in mandatory health insurance coverage. ● Rates of routine childhood vaccinations used to be traditionally high but have been impacted by the COVID-19 pandemic. ● Access to diagnosis and treatment for HIV/AIDS and tuberculosis (TB) remain public health concerns. ● Kyrgyzstan faces high rates of premature mortality due to noncommunicable diseases (NCDs). ● The population is at risk from high blood pressure, dietary risks, air pollution and smoking, with men more likely to engage in behavioural risk factors (such as smoking and alcohol consumption). ● Rates of health workers per population have declined and the ageing and migration of the health workforce are major concerns.