Better non-communicable disease outcomes: challenges and opportunities for health systems. Kyrgyzstan Country Assessment: Focus on cardiovascular disease

Melitta Jakab, Barton Smith, Nina Sautenkova, Aida Abdraimova, Adyl Temirov, Ryskul Kadyralieva, Suyumjan Mukeeva, Larissa Murzakarimovna

Cardiovascular mortality in Kyrgyzstan has decreased over the past seven years in part due to impressive health system reforms. However, moving towards the 25 by 25 targets and addressing the sizeable gender gap in premature mortality present a significant challenge. While Kyrgyzstan has made some strides in implementing anti-smoking policies, reducing the harmful effects of alcohol, and strengthening nutrition policies, there are still great opportunities through better enforcement and monitoring of legislation. Significant challenges also remain for coverage of core individual services especially in the effective diagnosis and management of key cardiovascular disease conditions, such as hypertension, and diabetes. The report identifies key health system challenges that prevent greater coverage of core NCD interventions and services and proposes three strategic directions to accelerate gains in CVD outcomes.

Better non-communicable disease outcomes: challenges and opportunities for health systems(PDF-1)

Analysis of stroke diagnosis verification in patients that died at home

Turgunbayev D.D., Artykbayev A.Sh., Kadyrova N., Abdraimova А., Urmanbetova А.

Kyrgyzstan has the highest mortality rate caused by cerebrovascular diseases in the European region, exceeding the figures for Kazakhstan, Russia, Moldova, CIS, EU – C and EU – A in more than 10-times. Stroke is one of the major death causes that stipulate low life expectancy in the Kyrgyz Republic. Analysis of RHIC statistical data indicates that stroke-related mortality exceeds morbidity rates. Currently, there is no appropriate stroke diagnostics (computer tomography and/or magnetic resonance imaging (CT/MRI)), so according to the HPAU’s study of 2007 the share of patients that had CT/MRI in regions was 16% and it included only patients treated in Bishkek. Therefore, stroke diagnostics is currently mainly based on methods of clinical examination of patients and doctor’s personal experience. Therefore, the study was aimed at verification of stroke diagnosis in persons that died at home, in other words, in outpatient setting on the basis of clinical documentation analysis.   

Analysis of “stroke” diagnosis verification in patients that died at home(PDF-1)

Cost estimation of medicinal treatment of hypertension in the Kyrgyz Republic with the view of creating possible drug supply mechanisms ensuring free-of-charge HTN treatment

Abdraimova A., Urmanbetova A., Borchubaeva G., Azizbekova J.

Hypertension is the leading cause of mortality and disability in Kyrgyzstan among other cardio-vascular diseases. It was demonstrated that share of hypertension combined with hyperlipidemia and coronary heart disease that contribute to mortality and disability rates from CVDs measures up to 80% . Hypertension incidence continues to grow reaching from 30.1% in adult population to 34.1% in the age group of 18+ . Den Sooluk Health Reform  Program segregates measures on improvement of hypertension detection and control into separate group of performance indicators on CVD which in combination with other performance indicators are expected to lead to annual 1% reduction in CVD mortality rates. Kyrgyzstan has made tremendous efforts to improve primary health care. Hypertension control was emphasized in this process as one of the monitored conditions. In addition, State-guaranteed Benefit Package (SGBP) and Additional Drug Package for insured population at outpatient level were designed to ensure affordability of health services on detection and treatment of various conditions including hypertension. The focus of this research was to study the issue of affordability of antihypertensive drugs, i.e. cost of drug therapy, since effective hypertension control can improve health outcomes by reducing acute CVD cases such as stroke and myocardial infarction and be cost-effective for the health system by reducing hospitalization rates.

Cost estimation of medical treatment of hypertension in the Kyrgyz Republic with the view of creating possible drug supply mechanisms ensuring HTN treatment for free(PDF-1)