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)

Discussion of draft report on M&E of medical education reforms

On December 23, 2015 the discussion of draft report on monitoring and evaluation of reforms in undergraduate, postgraduate and continuous medical education (2015-2017) took place in the HPAC office. The working group members participated in the discussion, namely, representatives of the MoH, medical educational institutions, staff members of NGO “The initiatives in medical education” and PF “Health Policy Analysis Center”. The objective of the discussion was to familiarize the participants with the preliminary findings obtained within the frames of M&E of medical education system reforms as well as to get feedback and comments so as to finalize the report and present it to broader audience.

Evaluation of nurses’ role in management of NCDs

Health Policy Analysis Center conducted evaluation of nurses’ role in management of some non-communicable diseases (specifically, diabetes, hypertension, COPD, palliative care) with financial support from Swiss Embassy in the Kyrgyz Republic and the Reforms in Medical Education in the Kyrgyz Republic Project.

The purpose of this study was to evaluate role of nurses in care delivery to patients with some non-communicable diseases as well as barriers preventing the involvement of nurses in the process of effective management of patients with some NCDs.

The research objectives included the following:

• Evaluation of existing family doctors’ and nurses’ role and practice in NCD management (diabetes, hypertension, COPD, palliative care) in health organizations;

• Review of family doctors’ and nurses’ activity arrangement within NCD management and identification of barriers to extend role of nurses in management of some NCDs based on views of doctors, patients and nurses;

• Evaluation of nurses’ knowledge and skills and related gaps at the level of education;

• Identification of family doctors’ and nurses’ needs and the areas requiring further efforts and needed interventions to efficiently manage NCDs and increase the role of nurses in NCD management.

Based on the obtained findings, the preliminary report including recommendations has been developed for consideration of stakeholders.