Improving Financial Protection and Quality of Care (Contribution to a World Bank Hybrid Trust Fund)

Project completed

Kosovo has initiated a wide-ranging health sector reform, a cornerstone of which is the introduction of the mandatory health insurance. Given the complexity of the reforms, technical support will be crucial in assisting an effective implementation. Moreover, a better informed targeting of public subsidies will protect poor people from either foregoing health care or being impoverished due to out of pocket payments for health care in case of ill health.

Country/region Topic Period Budget
Health systems strengthening
01.09.2013 - 31.08.2023
CHF  2’240’000

Kosovo has some of the worst health outcomes in Europe. The reforms initiated by the Ministry of Health (MoH) intend to address shortcomings in the financing and management of health services. The introduction of the mandatory health insurance has the potential to raise more revenues, while the establishment of purchasing contracts with institutions presents an opportunity to improve both the quality of care and the efficiency with which the limited resources are used.


The overall goal of the Trust Fund is to support the design, implementation and monitoring of health sector reforms to make quality health care more accessible and affordable for all citizen of Kosovo.

Target groups

MoH and other relevant stakeholders will be assisted in designing and implementing the health sector reforms. While the poor will benefit from better targeting of public subsidies, the general population in Kosovo shall benefit from improvements in service delivery due to the implementation of reforms.

Medium-term outcomes

Outcome 1: An improved procurement system for drugs and medical supplies is established and functional.

Outcome 2: An improved poverty targeting mechanism is established and safeguards the poor from the impoverishing impact of health spending.

Outcome 3: Performance based hospital payment systems introduced with the mandatory health insurance.



Expected results:  

· Pharmaceutical procurement policies and practices are assessed and recommendations to improve the system are provided to MoH;

· Prioritization mechanisms for medicines and supplies assessed and support to improve the system provided to MoH;

· Shortfalls of the poverty targeting mechanism identified and respective institutions supported to introduce a Management Information System (MIS) for better targeting public subsidies. 

· Provide support to implement Diagnosis Related Groups (DRGs) and performance-based payments with hospitals.


Results from previous phases:  

During the preparatory phase of the TF, the WB supported MoH in developing the Health Insurance Law, as well as subsequent by-laws, secondary legislation and preparatory work for the introduction of the mandatory health insurance. In addition, current pharmaceutical procurement systems were assessed, key gaps identified, and specific recommendations on oncology drugs utilization provided to MoH.

Directorate/federal office responsible SDC
Credit area Swiss cooperation with Eastern Europe
Project partners Contract partner
International Financial Institution (IFI)
  • World Bank - International Development Association

Coordination with other projects and actors

WB KHP, LuxDev, SCO’s forthcoming AQH project

Budget Current phase Swiss budget CHF    2’240’000 Swiss disbursement to date CHF    2’237’250
Project phases

Phase 1 01.09.2013 - 31.08.2023   (Completed)