Health and child survival
Kyrgyzstan has achieved a significant progress in reducing child mortality, but challenges still remain.
The challenge
Kyrgyzstan has achieved a significant progress on child survival: mortality rate of children under five decreased from 65 in 1990 to 21 in 2016 per 1,000 live births according to UN Inter-Agency Group for Child Mortality Estimation (UN IGME). Kyrgyzstan is one of the 24 low middle-income countries and 64 countries in the world that has reached MDG4. The death of newborns has halved since 1990: from 24 to 12 per 1,000 live birth.
Also, wealth, education and rural-urban related equity gaps have been reduced: the vaccination coverage by polio, pentavalent vaccines is higher among the poorest quintiles and the frequency of seeking care is also higher among the poorest quintiles.
‘We don’t forget these cases. When we save a child’s life, we feel such joy; the child’s family becomes our family,’
says Dr. Arstanbek Karybekov.
However, many challenges still remain. The rate of child mortality in rural areas is 1.6 times higher than in cities. The system of provision health services is underdeveloped. Neonatal, infant and under-five mortality in the poorest quintile are higher than in richest quintile.
While transmission of HIV to newborns was reduced, the proportion of women among people affected by HIV also increased between 2011 and 2013, from 30 per cent to 42 per cent.
51 per cent of new HIV cases registered in 2014 were among women of reproductive age.
Several bottlenecks affect health outcomes and hamper further progress: health-care services and life-saving interventions for mothers, children and adolescents often provided based on outdated methods, which are not patient-centred. There are significant gaps in the continuum of care provided to adolescent, pregnant and women in the delivery, newborn and children due to overall weak integration within the health system.
‘We had big problems here before we started working with UNICEF. We didn’t have modern equipment, doctors were not trained to resuscitate children,’
says Dr. Ainura Uzakbaeva, deputy director of the Republican Infections Hospital in Bishkek.
Health managers and service providers lack sufficient competencies and skills to provide quality health services to sick children, children with developmental delays, and to inform caregivers in timely seeking support from health providers. Outflow of health workers due to low financial motivation, limited quality of infrastructure, absence of essentially needed equipment, high out of pocket payments and high price of medicines are another reasons for an access barriers to health services.
The solution
UNICEF draws on robust evidence to demonstrate that investing in the early years is one of the smartest investments a country can make to break the cycle of poverty, address inequality, boost productivity, and reduce the burden of non-communicable diseases and poor mental health.
UNICEF supports the Government of Kyrgyzstan to improve child survival with through identification of the critical health system bottlenecks in effective coverage, access and demand for the evidence-based mother child health interventions.
By making investment in primary care facilities and hospitals in the most disadvantaged areas – infrastructure, equipment, medicines, and skills of health workers - we would contribute to the improvement the access to quality health care to the most vulnerable women and children.
The focus of the capacity building should be on the health management, referral, quality and care of the newborns and children as these remains a major skills gap for frontline midwives and nurses, and impact on the major mortality burden for young children.
UNICEF supports digitalization of health information and innovation in referrals. These will include improving home visiting of newborns, identification of delay and difficulties in the development of young children, improvement of data flow; modelling a telemedicine services and referral system for pregnant women and newborns and young children with complications.
UNICEF provides technical assistance on policy review and development to appropriate national government agencies on key policies that will further advance gains on universal health coverage (UHC) and child mortality reduction.
Building on previous experience, UNICEF provides support in strengthening Village Health Committees and other multi-sectoral platforms for engagement in dialogues on health needs of the community.
Empowering communities to increase demand for health services
UNICEF will help to increase awareness and create demand for immunization and perinatal/child health services among vulnerable groups who are not currently accessing the services.
Resources
These resources represent just a small selection of materials on health produced by UNICEF and its partners in Kyrgyzstan. The list is regularly updated to include the latest information.
“Adolescent Health Kyrgyzstan”, S.Lehtimaki. Mission report, UNICEF Kyrgyzstan, 2016.
“Introduction of 24 hour pediatric hospitalization practice in republic of Kyrgyzstan.” Promising practice, Tightwads, 2017
