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WEEKLY NEWSLETTER
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Kyrgyzstan
Index
Kyrgyzstan inherited the Soviet system of free universal health care,
which in Kyrgyzstan's case generally provided sufficient numbers of
doctors, nurses, and doctor's assistants, as well as medical clinics and
hospitals. However, since 1991 citizens often have received inadequate
care because medical personnel are not well trained; pharmaceuticals,
medical supplies, and equipment are insufficient; and facilities are
generally inadequate and unsanitary.
In 1991 Kyrgyzstan had 15,354 doctors, or 34.2 per 10,000 people.
Paramedical workers totaled 42,448, or 94.6 per 10,000 people. Some 588
outpatient clinics were in operation, averaging 139 hours of patient
visits per eight-hour shift. In addition, 246 general and twenty
specialized hospitals were in operation; nearly one-third of all hospitals
were located in Osh Province (which also had about one-third of the
country's total population). By contrast, the capital city, Bishkek, had
the fewest hospital facilities per capita of all regions, providing 1.55
general hospitals per 100,000 population. Like other Central Asian
countries, Kyrgyzstan has continued the Soviet practice of state
enterprises having their own clinics and sanatoriums. With the dissolution
of the Soviet Union, Kyrgyzstan's residents lost the right to free
treatment in the hospitals of other former republics, making unavailable
many types of specialized treatment that the Soviet system had apportioned
among adjacent republics.
Very few truly private health facilities have developed in the early
post-Soviet period, and those that exist face very high licensing fees.
Although it is illegal for state employees in the health field to
diversify their activity into private practice, by 1993 many health
workers were accepting unreported payments for providing additional
treatment. In 1992 the maximum salary of a medical specialist such as a
surgeon was only about 18 percent higher than the maximum salary of a
technician or laboratory worker. Under such conditions, the rising cost of
living in 1992 and 1993 forced many doctors to leave medicine for higher
salaries in other professions.
Kyrgyzstan produces no vaccines of its own and almost no medicines or
other pharmaceuticals. Drug availability is substantially higher at
regional facilities than at smaller ones, but items such as
antihistamines, insulin, antiseptics, vaccines, and some narcotics are
either extremely scarce or extremely expensive. The other former Soviet
republics now demand payment in United States dollars, which Kyrgyzstan
does not have, for medical supplies. Because of the scarcity of vaccines,
there is a greatly increased likelihood of epidemics of diseases such as
diphtheria and measles. An outbreak of measles in Bishkek in early 1993
was said to be just below epidemic level. It has become common practice in
hospitals and clinics to require patients to provide their own medicines
for operations and other medical procedures. Because virtually the only
available medicines are those for sale in the public bazaars, quality is
questionable, and accidental poisonings caused by misuse and spoilage have
been reported.
Kyrgyzstan's post-Soviet financial crisis has reduced government support
of the Soviet-era health system, forcing government planners to formulate
an ambitious health care delivery reform program. The center of the
program is a transformation of the national health system into a system of
public health insurance, in which compulsory employer fees and a health
insurance tax on employees would support care for employees, and state
contributions would support care for unemployed citizens. All employed
citizens would be required to carry health insurance. All care providers
would switch from the salary basis of the old system to a fee-for-service
payment system. Because the banking, record-keeping, and tax systems of
the country are not ready to support such a nationwide program, however,
installation has lagged far behind the original timetable, which called
for a pilot program in Bishkek in 1993.
Data as of March 1996
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