Comparative Study of Health Care System in Three Central Asian Countries: Kazakhstan, Kyrgyzstan, Uzbekistan / 보건행정학회지

BACKGROUND: The objectives of the study are to find out the effect of the implementing reform in three Central Asian countries, identify its impact on health status and health care delivery systems. This study address to identify strong and weak points of the health systems and provide a recommendation for further health care organization. METHODS: A comparative analysis was conducted to evaluate the effects of implemented policy on health care system efficiency and equity. Secondary data were collected on selected health indicators using information from the World Health Organization Global Health Expenditure Database, European Health Information Platform, and World Bank Open Data. RESULTS: In terms of population status, countries achieved relatively good results. Infant mortality and under-5 mortality rate decreased in all countries; also, life expectancy increased, and it was more than 70 years. Regulations of the health systems are still highly centralized, and the Ministry of Health is the main organ responsible for national health policy developing and implementation. Among the three countries, only Kyrgyzstan was successful in introducing a national health system. Distribution of health expenditure between public expenditure and out-of-pocket payments was decreased, and out-of-pocket payments were less the 50% of total health expenditure in all countries, in 2014. CONCLUSION: After independent, all three countries implemented a certain number of the policy reform, mostly it was directed to move away from the old the Soviet system. Subsequent reform should be focused on evidence-based decision making and strengthening of primary health care in terms of new public health concepts.

Development of a Play Toolkit for Supporting Infant and Toddler Development in Kyrgyzstan with a Focus on the Symbolic Functioning and Fine Motor Development of Infants 6 to 36 Months Old

PURPOSE: The study aimed to develop a play toolkit to facilitate infants' and toddlers' symbolic thought and fine motor development. METHODS: This study used a methodological study design including two phases of development and evaluation. After reviewing the play culture and developmental health issues in Kyrgyzstan through a literature review and interviews with local experts and parents, the toolkit was developed and evaluated using content validity and utilization tests. RESULTS: The toolkit was based on Westby's symbolic play and the fine motor milestones in the Bright Futures Guidelines. The Toolkits were composed of an overall suggested play schedule according to the child's age, four kinds of play props, and a utilization guidebook for parents. The play props were a felt book, sorting and assembling blocks, cup blocks, and a tangram. The guidebook contained age-appropriate operating methods and alternative ways to use the materials. CONCLUSION: A play toolkit was developed to enhance nurturing practices among parents of infants and toddlers. The findings may help facilitate effective interactions between parents and their children. Considering that nurturing care is critical for achieving better child health outcomes, enhancing parenting resources and parent-child relations could function as an effective strategy for promoting child health.

Evaluation of a Community-based Child (Infants and Toddlers) Health Promotion Pilot Project in a Migrant Village in Kyrgyzstan

PURPOSE: Children in migrant villages in Kyrgyzstan have a high incidence of anemia and need effective health promotion programs. The purpose of this study was to evaluate a pilot study of a health promotion project for infants and toddlers based on community participation.METHODS: This was a retrospective study conducted to evaluate the effectiveness of the project. The project was carried out by nurses at a public health center, community health workers, and local residents in a migrant village. After the operational system of the project was established, health assessments, child-care education, provision of vouchers for iron supplements, and activities to improve residents' awareness were conducted during 6 months among 100 children, of whom 85 were finally analyzed.RESULTS: In international health projects, close cooperation of the project team with community residents and health workers is important. Access to the community-based program was feasible in the socially and economically poor migrant village, and improvements were shown in children's anemia and awareness of health care.CONCLUSION: By focusing on the effective aspects of this preliminary project, plans to utilize community health workers and promotion strategies can be added to the main project to improve health promotion among children in this area.

Introduction of traditional medicinal plants in Kyrgyzstan / 中国中药杂志

Kyrgyzstan is a mountainous country in the northeastern part of Central Asia which shares borders to the southeast with China. Due to their extreme environment and climate, there are a diverse range of species of plants. Many of the plants used in Kyrgyz folk medicine have not been studied using modern scientific techniques. This paper introduced the basic situation of medicinal herbs in Kyrgyzstan by comparing the differences traditional use between China and Kyrgyzstan, and looked for traditional medicinal plant research to provide basis for the development and cooperation of China and Kyrgyzstan.

Epidemiology of ovarian cancer in Kyrgyzstan women of reproductive age.

The purpose of the present study was to assess the ovarian cancer incidence rate among women of reproductive age in Kyrgyzstan. Sources of data were records of all patients who were first diagnosed as suffering from ovarian cancer at reproductive age (15-49) during the period 1999-2006. Descriptive and analytical methods of onco-epidemiology were applied. It was established that the ovarian cancer incidence among general female population of reproductive age equaled 4.3+/-0.3 per 100,000 population. Incidence rate was increasing in dynamics. Average age of patients in this category was 37.9+/-0.5. Analysis of age indicators demonstrated that incidence rate was higher within later reproductive age (40-49) at 11.2+/-0.60/0000. Incidence among the two main ethnic population groups was analyzed: Kyrgyz and Russian. Whereas rates appeared to be increasing in the former, the latter demonstrated paradoxical decrease.

Epidemiology of breast cancer in females of reproductive age in Kyrgyzstan.

The goal of this research was to study breast cancer morbidity in females of reproductive age in Kyrgyzstan. Information on patients was obtained from the National Center of Oncology under the Ministry of Health and the National Statistics Committee of the Kyrgyz Republic. The research was retrospective and covered the period from 1995-2002. Cancer morbidity ratios were calculated for reproductive age according to standard methods of medico-biological statistics. The breast cancer morbidity in the country's female population was determined as 12.3+/- 0.2/100,000. The research revealed ethnic specificity: in Russians (crude rate, 32.9+/- 2.1) was higher (p<0.001), than in Kyrgyz and Uzbek females, who demonstrated equal crude incidence rates of -8.0 +/- 0.6. The dynamics over time showed increase in Kyrgyz and Uzbek females but decrease in Russians. Age ratios analysis showed higher morbidity in later reproductive age (40-49 years), with a statistically significant difference (p<0.001) between ethnic Europeans and Asians.

Ethnic and age variation of cancer of the reproductive system in women of Kyrgyzstan.

The purpose of this research was to assess the ethnic and age variation in the incidence rates of cancer of the female reproductive system (cancers of the breast, cervix uteri, corpus uteri and ovaries) in Kyrgyzstan. A retrospective approach was adopted covering the period from 1995 to 2002 with descriptive and analytical methods to estimated incidence rates in women of Russian and Kyrgyz nationalities. Values were found to be higher in Russian women but decreasing over time, while increase was observed for the Kyrgyz. Breast cancers were most common in Russian women and in their Kyrgyz counterparts cancer of the cervix uteri predominated. The data reveal age and ethnic variation in cancer localization.