Slightly smaller than South Dakota, the Central Asian country of Kyrgyzstan is home to some 5.6 million people. Kyrgyzstan is one of the poorest countries in Central Asia. In 2013, the total gross domestic product (GDP) was 7.2 billion USD and gross national income GNI per capita was 1,200 USD in 2013, one of the lowest in the WHO European Region.
Health outcomes are poor, with Kyrgyzstanis on average living 10 fewer years than Europeans and people in the United States. Non-communicable diseases (NCDs), such as cardiovascular disease, liver disease, kidney disease and cancer, currently account for nearly 70 percent of all deaths in Kyrgyzstan each year. Cardiovascular disease is the main cause of mortality in Kyrgyzstan, accounting for more than 50 percent of all deaths. More than 18 000 people die of cardiovascular conditions every year, equivalent to 50 deaths a day. About 25% of these deaths occur in people under 64 years of age; most of these deaths are considered avoidable. Other contributing factors include a high prevalence of tobacco and alcohol use, physical inactivity, and unhealthy dietary choices. This underscores the need for strong primary care and prevention services, coupled with effective patient education and outreach programs — particularly for children and adolescents.
The HIV epidemic in Kyrgyzstan is associated with a somewhat stable number of new HIV infections reported every year during the last five years however, injecting drug use among men has largely driven the HIV epidemic in Kyrgyzstan. Although the proportion of new HIV cases found among PWID have fallen significantly over time (down to 37% of all new HIV infections reported in 2013), PWID still bear a disproportionate number of HIV infections accounting for 58% of the cumulative number of HIV cases reported Kyrgyzstan.
According to WHO’s European Observatory on Health Systems and Policies’ health system review (HiT), the country’s health system is lacking qualified health care providers. The number of health workers per population has declined significantly since the early 1990s, with levels far below the averages for the Central Asian republics and Kazakhstan (CARK), the Commonwealth of Independent States (CIS) and the CU15 (countries constituting the EU before May 2004), in particular with regard to nurses.
Safer Practices and Techniques for Blood Drawing (SAPAT) Project
Like many other low- and middle-income countries, Kyrgyzstan has had to work hard to develop a safe blood supply. Under a cooperative agreement with CDC, AIHA implemented blood safety work in multiple countries, including Kyrgyzstan. Under the Twinning Center Program, AIHA implemented additional blood safety-related activities.
AIHA took over management of the Safer Practices and Techniques for Blood Drawing (SAPAT) Project in phase two, as the first phase was managed directly by the CDC (sapat means quality in Kyrgyz language). CDC Central Asia and Atlanta continued to provide technical support and guidance. In 2014, the Ministry of Health of the Kyrgyz Republic, Project HOPE, and Becton Dickinson (BD) signed an agreement (Order No. 485) inaugurating a public-private partnership aimed at the continued improvement of blood safety in Kyrgyzstan.
The goal of the SAPAT Project was to help build the national capacity of healthcare facilities in Kyrgyz Republic to adopt injection safety practices in order to help prevent nosocomial outbreaks of HIV. Specific objectives were to:
- Establish national trainers at each of the project sites in order to serve as points of contact for their peers to seek mentorship on injection safety practices.
- Train nurses at each of the project sites in order to strengthen their capacity to provide safe injections.
- Implement the established core curriculum at each of the project sites in order to ensure retention of injection safety practices.
AIHA provided a refresher ToT to trainers from phase 1, during which CDC provided an initial training. AIHA hired a project consultant, Elena Patlai, who served as the SAPAT Coordinator and also oversaw trainings in the second phase. Trainers from the first phase of the project were able to apply their skills to practice and train other health workers across the country. The participating sites included nine territorial hospitals or city health facilities in Bishkek and two major regional centers (Osh and Chui oblasts).
To read the final closeout report from AIHA’s HIV/AIDS Twinning Center Program, click here.
Project to Strengthen Blood Services in Central Asia, Ukraine, and Cambodia
(2013 – 2017)
Under our CDC-supported Project to Strengthen Blood Services in Central Asia, Ukraine, and Cambodia, AIHA began providing technical assistance to Kyrgyzstan in 2013, focusing primarily on improving accreditation standards, clinical use of blood, local infrastructure, quality management capacity, laboratory equipment usage, donor recruitment, and applied research.
In January 2013, AIHA traveled to Kyrgyzstan to meet with CDC/Central Asia and MoH to introduce the project and agree on the preliminary plan to conduct the baseline assessment. AIHA returned in February 2013 with technical consultants from HEAP to participate in stakeholder meetings with the MoH, RBC, and OBCs, and to conduct pre-assessment visits in Bishkek and Osh.
On June 19, 2013, the MoH issued a governmental order in support of the project’s national-level baseline assessment. Subsequently, a team of international consultants conducted the assessment of the OBCs, hospitals, and AIDS Center laboratories. In November 2013, AIHA sponsored a national stakeholders meeting to present the findings and recommendations of the assessment. Attendees included representatives from the MoH, RBC, OBCs, hospitals in Bishkek, and CDC.
Based on the recommendations from the international experts, an implementation plan for 2014 was developed. Key focus areas included the reformation of the blood services and development of a VNRBD program. In addition, the development of quality standards and national regulations for the clinical use of blood became primary objectives, as outlined in the 2012-2014 Blood Service Development Program of the Kyrgyz Republic.
AIHA concluded its support to Kyrgyzstan under this PEPFAR-funded blood safety project in 2017.
To read the full closeout report for Central Asia and Ukraine, click here.