1. Center for investment projects Republican Center for Healthcare Development Astana 2015

2. THE PURPOSE AND OBJECTIVES The main objectives are: 1)Further improvement of the healthcare system by rationalizing the network of healthcare organizations; 2)Participation in the development of proposals for health sector investments planning, including the PPP scheme; 3)Development of PPP in the health sector The purpose of the center is to participate in the development of healthcare by rationalizing the network and planning investments, including the mechanisms of public-private partnership. HISTORY OF THE CENTER The center was established in June 2010, on the basis of LLP “Center for health investment projects management.” In April 2011, as a result of the reorganization and merger of the National information and analytical center and Institute for health development, RSE … “Republican center for healthcare development,” was established. Center for investment projects became part of it and still operates under it as a structural unit.

3. CENTER FOR INVESTMENT PROJECTS Participation in the development of proposals for rationalization of the network of healthcare organizations Provision of consultative and methodological assistance to public authorities, business communities, and other interested organizations on the issues of PPP in health sector Development of proposals for health sector investments planning, including the PPP scheme STRUCTURE OF THE CENTER Department of medical organizations network development Department of investment planning Department of public- private partnerships development

4. FUNCTIONS OF THE CENTER Center for investment projects Participation in the policy development on PPP in health sector. Analysis of the regulatory framework with the purpose of continuous improvement Consultative and methodological assistance of the regions on the issues of PPP, trust management, privatization, and development of the network of healthcare organizations. Preparation of various documents on the development of the network of healthcare organizations and draft conclusions for the concession offers and projects feasibility studies in the health sector. Analysis of the material-technical base of medical organization Implementation monitoring of the Perspective plans of the development of the network of regional healthcare organizations for 2015-2025 period. Studying of the international experience in network planning and implementation of projects in health sector. Preparation of proposals for medium and long-term investment planning. Conducting training activities and organization of meetings, conferences, seminars, etc. Media coverage of the issues related to the activities of the Center The interaction with foreign and domestic organizations working in the health sector and others.

5. Areas of activity in 2015 I. Rationalization of the network of medical organizations II. Development of the mechanisms of involvement of private investments in the health sector  Inpatient service  Outpatient service  Laboratory service  Public-private partnerships  Trust management  Privatization

6. INVESTMENT PROJECTS IN THE HEALTH SECTOR OF RK 6 Foreign companies have shown an interest for PPP and trust management projects Projects planning 2012 year – 4 PPP projects 2013 year – 43 PPP projects 2014 year – 28 PPP projects, 16 – trust management, 3 – privatization 2015 year – 22 PPP projects, 7 – trust management, 13 – privatization 13 – PHC 9 – hospitals 4 – PHC 3 – hospitals PPP, trust management, and privatization projects

7. INVESTMENT PROJECTS REALIZATION PROGRESS Privatization planned (Order of the Government of the Republic of Kazakhstan dated March 31, 2014 №280) planned (Order of the Government of the Republic of Kazakhstan dated March 31, 2014 №280) To be implemented 4 republic 19 local 3 republic 13 local Not planned projects in Akmola, Aktobe, Almaty, Karaganda, Kyzylorda, Mangistau,, North-Kazakhstani, and Pavlodar regions and in Almaty city Trust management Planned Withdrawn from implementation Implemented To be implemented 13 public facilities4 objects (Karaganda, Aktobe) 2 objects (Zhambyl, West-Kazakhstani ) 3 hospitals 4 primary health care Public-private partnership Planned Investment offer Application for funding CO, FS CP, TD, PCA 22 projects - 2 republic - 20 local 3 projects (Akmola, Aktobe) 2 projects (Almaty ) Tender for concessionaire selection 15 projects (Atyrau, east kazakhstan, Kyzylorda, Мангистауская, south kazakhstan, Astana city, Almaty city, Karaganda city) 2 projects (Kostanay) Not planned projects in Almaty city, Pavlodar, Karaganda, west kazakhstan and Zhambyl regions 1 republic, 6 local projects (Astana, Aktobe, Almaty, Pavlodar, North Kazakhstan)

8.  Suggestions for improvement of the health sector infrastructure standards, based on international practice  Recommendations on planning the restructure of the hospital network, beds, personnel and equipment  Recommendations on the development and implementation of PPP projects in healthcare  Recommendations on the staff development on the issues of hospital sector restructuring and PPP in healthcare  Investment strategies on the master plans implementation with the purpose of assessing the effectiveness and feasibility of the proposed hospital sector restructure plan  Calculation methods of repairs, building and extension constructions  International experience in planning of network restructure and PPP development, including the organization of the study tour to Australia for the staff. Knowledge and technology transfer by the Sanigest Internacional company

9.  Proposals on amendments and additions to: - Decree of the Government of the Republic of Kazakhstan on 15 December 2009 № 2131 «On approval of the state standard of the healthcare organizations network of the Republic of Kazakhstan» with the account of the recommendations on the restructuring of the hospital sector; - Decree of the President of the Republic of Kazakhstan on 5 March 2007 №294 «List of the objects that are not subject to concession».  Issued around 30 sector conclusions for investment, concession proposals, and feasibility studies of concession projects  Participation in the development of master plans on the network restructuring for 16 regions with the consulting company Sanigest Internacional  Developed and presented: - methodological guidance «Hospital sector restructuring and autonomy issues (international experience)», - projects: conception of PPP development in healthcare, health sector PPP development program, health sector PPP potential sites selection criteria, strategies for hospital sector development by levels of care in accordance with international standards until 2020  Training seminars/workshops on investment planning, including PPP and hospital sector restructure, was carried out in 16 regions. Trained approximately 1,000 people.  Workshops, roundtables on the issues of investment planning, including PPP, and discussions of the master plan projects on the network restructure was carried out in 16 regions for public health departments, local executive bodies, and health workers. The results of the Center activities (2011-2015 period)

10.  Proposals on the issues of healthcare organizations management and infrastructure development for the State program “Densaulik” were made.  Assistance in the development and approval of the perspective plans for the healthcare organizations network development for the 2015-2015 period by the regions of the Republic of Kazakhstan.  A marketing analysis of 6 healthcare facilities, proposed for the PPP realization, was carried out.  Participation in the development and reconciliation of health facilities concession project packages with the reconciliation with regional public health departments and institutions of higher education  Work on the formation of the list of sites planned for the projects realization by the means of PPP and trust management was carried out with the executive bodies of the regions and Astana and Almaty cities  Meetings with the representatives of domestic and foreign companies such as Stopharm, Stomed, «Daru» Clinic, Mediker, Neuron, Eiffage (France), KHIDI (South Korea), USAID-DELOITTE (Portugal), Agem (Spain), Heenan, Blaikie Management ltd were carried out  Online conferences by the means of G-Global platform on the topic “Development of PPP in the health sector in the Republic of Kazakhstan,” “Problem issues of PPP development in the health sector” were carried out  Analysis of the regulatory legal acts in the healthcare sector, related to the PPP, was conducted. The work resulted in proposals to amend and supplement 7 health sector regulatory legal acts that were sent to the Ministry of health and social development of the Republic of Kazakhstan.  Articles in newspapers and magazines, web sites of the RCHD, MHSD RK, e-dariger, and G-Global platform were published, as well as audio and video recordings were posted on national radio and television stations. The results of the Center activities (2011-2015 period)