Abstract
Objective/Background: This study assessed Kyrgyzstan's progress with developing its rural primary care workforce and prioritized next steps to build on its current momentum. Kyrgyzstan has improved rural health care since 1997 through the implementation of family medicine, retraining of rural doctors and nurses, and other efforts. Attrition, emigration, urbanization, and population growth are threatening these hard-won advances. In response, Kyrgyzstan is now educating family medicine residents at rural sites and improving salaries. This study explores other steps to strengthen its rural health care, especially its rural generalists.Methods: This was an observational study using a two-phase survey process. To access the current status of Kyrgyzstan's rural health care system, we surveyed key stakeholders within that system using a draft version of the new World Health Organization Rural Pathways Checklist. To prioritize next steps, we asked rural FM residents to rank the relative importance of 31 possible future actions to support Kyrgyzstan's rural primary care workers.Results: Doctors and nurses involved in teaching rural health workers identified that Kyrgyzstan has made good progress with rural professional support and upskilling of existing health workers through education. They saw the least progress with selection of health workers and monitoring. The rural family medicine residents' top ten suggestions for rural recruitment and retention all involved improving working conditions (providing housing, internet, basic medical equipment, protected time off, better salaries, and more respect) and improving clinic efficiency (switching clinic scheduling from walk-in based to appointment based, optimizing the roles of clinical team members, and decreasing low-value clinic visits).Conclusions: The WHO Rural Pathways Checklist helped to evaluate Kyrgyzstan's current efforts to promote rural primary care. The priorities listed above from the next generation of potential rural family doctors could help guide future steps to promote rural health in Kyrgyzstan and the Former Soviet Union.
Highlights
History of Family Medicine (FM) in KyrgyzstanAfter independence from the former Soviet Union in 1992, Kyrgyzstan adapted its health care system to meet some daunting challenges
Not surprisingly the FM teachers consider professional support and upskilling of existing rural health workers as the most fully implemented aspect of the country’s plan to support rural health, since they have accomplished a lot in this area
The FM residents identified the importance of creating a rural faculty development program and providing regular educational opportunities, including educational teleconferencing for peers
Summary
History of Family Medicine (FM) in Kyrgyzstan After independence from the former Soviet Union in 1992, Kyrgyzstan adapted its health care system to meet some daunting challenges. A similar parallel KSMIRCE program trained nurse trainers, who retrained 85% [3,890] of the county’s outpatient nurses to become FM nurses using a two-month curriculum. This retraining process is still active for doctors and nurses, and to date 6,212 nurses have been retrained as FM nurses In the 1990s, the infant mortality rate became lower in the rural areas than in the urban areas with a growing separation between the two rates at least through 2010 [6]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
