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Palliative Care in Kyrgyzstan

Palliative Care in Kyrgyzstan. Kyrgyz Republic. Area 199.900 km 2 Population 5.4 million Almost 70% of territory are high mountainous and hard - to - reach regions Almost 70% - rural population, 80% of them are poor. General information. Birth rate : 26,8 on 1000

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Palliative Care in Kyrgyzstan

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  1. Palliative Care in Kyrgyzstan

  2. Kyrgyz Republic Area 199.900 km2 Population 5.4 million Almost 70% of territory are high mountainous and hard-to-reach regions Almost 70% - rural population, 80% of them are poor

  3. General information Birth rate: 26,8 on 1000 Average age : 24.7 years 65 years and older: 5, 8% Total mortality: 6,6 на 1000 нас. Life expectancy : 69.3 years male: 65.3 female: 73.64

  4. Age structure

  5. Mortality

  6. Mortality from cancer diseases UN total mortality rate in Kyrgyzstan in 2010-2015 - 7.1/1000 UN Mortality rate - 37,500 deaths Ministry of Health, total number of deaths in 2010- 36,152 people Ministry of Health,deaths from cancer in 2008 - 9.1% of all deaths in KG- 3,432 deaths WHO estimates in 2004 of cancer in Kyrgyzstan died 4000 people

  7. Main achievements of the health care system in KG Budget for health care increased from 10 % to 13 % Financial recourses were delivered from oblast to national level Further development of primary health care Reforming of public health sphere Development of village health committees MoH strengthened main departments Developed M&E system

  8. Lack of health care financing (GDP 3,7) Brain drain, lack of medical workers Weak material-technical base of health institutions There are areas of health, remaining outside of the reforms - oncology, psychiatry, TB Imperfection of the system of continuing education and training medical workers The high price of drugs(absence of the state regulation of prices ) Imperfect system of primary health care Main issues in health care system in KG

  9. Palliative care services and models 2 hospices for AIDS patients 2 PC departments in 2 Cancer centers State guarantee program (privileged injectable morphin) PC Department in National cancercenter serves arround 500 patients per year, 42.2% of of them die in the first year of the disease (one-year mortality rate

  10. Positive steps PC included to the new National strategy of reforming of health care system “Den - sooluk” PC included to the new National AIDS program PC included to the 4 laws on health care (Health care, Cancer, HIV/AIDS, TB) - need Parliament approval soon National strategy on PC developed

  11. Positive steps Working group on PC under the MoH Union for palliative care Mandatory health insurance found has budget for opioids by State guarantee program Political support – MoH, MHIF, Parliament members

  12. National PC Program: main characteristics and features Improve legislation base on PC Establish PC individual service providing on all levels Scale up public health role in development and realization of PC programs Include PC into post graduate education of physicians Define mechanisms and methods of PC financing Establish PC patients register M&E

  13. Problems At least 18 000 patients need PC annually No comprehensive educationalPC programs for physicians, medical students No PC standards, clinical protocols No oral morphine in the country No developed mechanisms of financing of PC activities No home care multidisciplinary PC models and hospices for all patients needed PC

  14. Next steps Implement EPEC Curriculum to Kyrgyz State Medical Academy, Kyrgyz State Medical Institute for Continuing Education, Medical colleges Develop clinical protocols, standards for PC Begin basic PC course in KSMI Involve Ministry of Social Protection on education on PC of existing social workers

  15. Next steps 2 pilot projects on home based palliative care, in Bishkek and Osh on the base of Cancer centers Provide technical support for existing 2 hospices for patients with AIDS centers in Bishkek and Osh To include PC in new National Cancer, TB programs and identify sources of funding Improve access to oral morphine and opioids

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