The United Nations (UN) in Kyrgyzstan

World Health Organization (WHO)

The objective of WHO is the attainment by all peoples of the highest possible level of health. Health, as defined in the WHO Constitution, is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. A specialized agency of the United Nations with 191 Member States, WHO promotes technical cooperation for health among nations, carries out programmes to control and eradicate diseases and strives to improve the quality of human life.

WHO has four main functions:

to give worldwide guidance in the field of health
to set global standards for health
to cooperate with governments in strengthening national health programmes
to develop and transfer appropriate health technology, information and standards.

WHO was established in 1948, with its headquarters in Geneva, Switzerland. WHO realizes its activity by three main authorities: the World Health Assembly, the Executive Committee and the Secretariat.

Fifty years of existence of the WHO may seem a long time to individuals, but it is a short spell in human history. For two centuries it was known that smallpox could be prevented, but only in the twentieth century was a coalition organized by the WHO able to do something definite about it. With political will, commitment and a willingness to work together there is no reason why this success cannot be continued.

Taking into account the regional priorities in health care and ensuring a closer connection with national health care needs, the WHO’s activities are implemented by both headquarters and its six Regional Offices. Each regional office has its own programme geared to the health problems of the countries it serves.

WHO IN KYRGYZSTAN

Kyrgyzstan became a member of the World Health Organization in 1992. Based on the agreement between the Government of the Kyrgyz Republic and the WHO Regional Office for Europe approved by Governments of other Central Asian Republics, the WHO Information Centre for health for Central Asian Republics has been functioning in Bishkek since September 1993. Since 1994, the WHO Liaison Office is in operation, representing the WHO in Kyrgyzstan.

WHO country presence calls for a three-pronged strategy:

Servicing specific country needs;
Providing managerial integration of the WHO’s technical contributions
Ensuring political and diplomatic leverage to effectively represent WHO in the field, with Development and implementation of outcomes oriented programs.

In 1996, the government adopted the MANAS National Health Care Reform Program, which was developed with considerable support from WHO. This was constituted as a 10-year program of comprehensive reform of the organization, financing and content of the health system. The broad aim was to adjust the system to the economic realities of a transitional and post-transitional country, and to replace certain outmoded practices inherited from the Soviet Union with modern, evidence-based practices. It also aimed to shift from the highly specialized Soviet model to a system based and led by primary care.

A number of priority areas of cooperation between WHO/EURO and Kyrgyz Republic have been agreed on, including Health Policy development, Infrastructure and system development, Technical interventions and Public Health Initiatives (2002-2003). The main activities of current cooperation are as follows:

POLICY DEVELOPMENT

Support for MANAS Health reform project via the DFID-funded HPAP project (to create an improved and sustainable health policy process by strengthening the link between policy analysis and policy reform and development). The project has two main activity areas: (1) strengthening capacity for commissioning and implementing policy-relevant research, and (2) implementation of research, technical assistance and policy advice to the MOH.
Support for the development of the national policy on SA prevention with participation of the main stakeholders (MoH, State Commission on Drug control, UNODC, SOROS, NGO’s).
Support to development of National policies and preparation of action plan for tobacco control, implementing FCTC process in the country, activities the World No Tobacco Days (31 May), activities of the Don’t Be Duped Project, social surveys “Youth and smoking” and “Tobacco consumption”.

INFRASTRUCTURE AND SYSTEM DEVELOPMENT

Implementation of drug policy to ensure access and rational drug use by development and implementation clinical protocols, provision of evidence based information of drugs via support for the national Drug Information Centre.
Advise and technical support provided on implementation of PHC reform focusing on development of higher medical education (implementation the new Module system, since 2001), family nursing, capacity building (24 fellowships in the area of RH, Healthy schools, Health economics, Health Management, Malaria prevention, Observatory Course, EPI etc. were provided in 2002-2003) as part of the MANAS health reform project.
Advice and technical support on strengthening health information systems as part of MANAS health reform in the area of development and maintaining of national health Data Base, updating and disseminating health care indicators package (DPS), implementation of WHO definitions of Live Births.
Advice and support on strengthening national capacities of health services for emergency preparedness by strengthening the emergency services within the MoH, delivering the equipment and communication devices, strengthening the information data base and the early warning system. In 2000 WHO LO established the Drug Store within the Department of Drug supply and medical techniques for WHO Emergency health Kits.
Support to reforms of San.Epid System, public health development by implementation of Hospital Infections and Waste Management strategies. The new Decree was adopted by the MoH on preventive measures on Hospital infections and Hospital Waste management and Calendar plan of Actions.
Support on strengthening malaria control. The main activities in the area of malaria control were focused on training of specialists on oblast and rayon level, strengthening technical capacities of appropriate services, support for conducting field monitoring in risk areas, translation and printing materials on RBM. WHO Malaria Field Office was established in 2003 to fight against malaria and prevent malaria cases.

TECHNICAL INTERVENTIONS

Advice and support on implementation of IMCI (implementing in three pilot rayons) and PEPC (in 2 pilot oblasts) strategies to improve the situation with IMR and MMR and child health.
Advice and support on implementation of RH strategy (rapid assessment on safe motherhood needs in the Kyrgyz Republic, Cervical Cancer Screening in one pilot rayon of Naryn oblast and #2 outpatient department in Bishkek) was conducted and the results performed in September 2003
Support to strengthen the national strategy on health promotion (development of the national concept of Health Promotion, implementation Healthy schools strategy in few pilot schools).
Support for implementation of communication project for health promotion, including strengthening capacities of the national health communication. Network and provision of Mass Media by evidence based information.
Support on implementation of syndrome approach and treatment at national and oblast level on HIV/AIDS and STI, including blood safety (support to STI Clinic for treatment commercial sex workers, dissemination of the experience to other regions, implementation STI treatment guidelines, surveys, launching the 2nd generation surveillance system). WHO provides strong technical support to the Government with implementation of Global fund program.
Monitoring and evaluation of DOTS implementation and capacity building by support to the monitoring of DOTS on central level
Support on capacity building, monitoring and evaluation of EPI supports national immunization Programme (2001-2005) and developing immunization schemes, safety immunization practice, cold chain revision, developing financial sustainability plans, vaccine independency etc. Kyrgyzstan was successful in implementation Polio, Measles/Rubella and Rubella Co’s.
Support for implementation of the National Mental Health Programme WHO provides support to the country in implementation of the National Mental Health programme.

In 2001 with the WHO support Kyrgyzstan developed the new strategic document “Health Care in Kyrgyzstan in 21 century”. This document meets future health challenges and seeks to create the conditions where people have, as a fundamental human right, the opportunity to reach and maintain the highest attainable level of health. Novelty of the document consists in use of new methods:

The “course towards life” approach which means consideration of all events of life in interrelation, instead of considering its separate fragments;
Orientation to provision of healthy environment with wide involvement of the interested parties at all levels –house/family, school, place of work and residence;
Intersectoral approach aimed at improvement of factors (determinates), establishing health;
Development of outcomes oriented programs;

The success of the reform process in Kyrgyzstan was recognized internationally and reforms were defined as a model for other countries. It became real due to the joint efforts and partnership of the international organizations, high political commitment of political leaders in Kyrgyzstan in promoting health care issues.

For more information you can visit www.who.dk

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