Rural Kyrgyzstan Research Articles

Sustainability and long-term impact of community-managed water supply in rural Kyrgyzstan, Central Asia

How can Community Managed Water Supply (CMWS) become more sustainable? Recent studies in several countries indicate that the sustainability of many CMWS is poor. As a result, their long term impact on village lives is limited. This paper presents the findings of research on the sustainability and long-term impact of a group of CMWS created by the Rural Water Supply and Sanitation Project (RWSSP) in Kyrgyzstan, Central Asia. This project adopted a Community-Based Approach to maximize the sustainability and long-term impact of its CMWS. The research assessed the sustainability of these CMWS a decade after their completion. It used six measures to assess sustainability and examined four long-term impacts. The results are compared with studies from other countries. The influence of Community-Based Approach (CBA) on the results is discussed. Recommendations are made for changes in policies and strategies to improve the sustainability and long term impact of future CMWS in Central Asia and elsewhere.

Development Impacts of International Migration on “Sending” Communities: The Case of Rural Kyrgyzstan

This paper analyzes the impacts of international migration and remittances on different sources of income in rural Kyrgyzstan. Based on a household dataset from the Life in Kyrgyzstan panel survey of 1012 rural households, we estimate equations for crop income, livestock income, and nonagricultural income jointly in a system using the seemingly unrelated regressions (SUR) and general method of moments (GMM) three-stage least-squares (3SLS) estimators. Our results show that international migration had diverse effects on different sources of rural income in Kyrgyzstan. The effect of international migration in total was negative on crop income, but positive on livestock income and mixed for nonagricultural income. The positive effect of remittances on nonagricultural income implies that migration can promote diversification of rural households’ income sources. This in turn is associated with less income uncertainty and risk in the future and can provide a positive contribution to the economic development of a migrant-sending community.

Is it time to change? Portable echocardiography demonstrates high prevalence of abnormalities in self-presenting members of a rural community in Kyrgyzstan.

ObjectivesCardiovascular disease accounts for 42% of male and 51% of female mortality within Europe. Kyrgyzstan, population of almost 6 million, has amongst the highest rates within Europe, second only to Uzbekistan for female cardiovascular disease mortality (588 per 100,000). We attempted to identify established cardiovascular disease prevalence within a rural community in Kyrgyzstan using portable echocardiography.DesignFree open access echocardiography (VIVID-I, GE, USA) was offered to all adults in Batken district. Routine echocardiographic views were obtained and analysis performed using EchoPac Clinical Workstation (GE, USA). Mild valvular regurgitation, mild LV hypertrophy, patent foramen ovales and mild atrial enlargement were considered mild abnormalities; compensated ischaemic or valvular heart disease – moderate abnormalities, and decompensated congenital, ischaemic or valvular disease – severe abnormalities.ResultsOne hundred and twenty five adults (48 male, 77 female), mean age 53 ± 16 years, underwent echocardiography. Only 16% of participants had no significant abnormality, 46% had mild disease, 25% moderate, compensated disease and 13% had severe disease. Nine percent had congenital heart disease including one tetralogy of Fallot and one Ebstein’s anomaly. Average LV function was normal, however, 19 participants had EF < 50%. Forty percent of participants had a new diagnosis warranting formal follow-up, 12% a new diagnosis of heart failure.ConclusionUsing portable echocardiography, we identify a higher than reported prevalence of cardiovascular disease in rural Kyrgyzstan. Absence of portable tools and specialists for early diagnosis might lead to presentation in an advanced stage of disease when little can be done to improve mortality. Embracing remote access diagnostics is essential for disease identification within rural communities.

Forced Marriage and Birth Outcomes

We study the impact of bride kidnapping, a peculiar form of marriage practiced in Central Asia, on child birth weight. The search for a suitable mate in a kidnapped marriage is initiated by the groom, and there is typically non-coerced consent only by the male. We expect adverse consequences from such marriages, working through poor spousal matching quality and subsequent psychosocial stress. We analyze survey data from rural Kyrgyzstan. We apply several estimation models, including an IV estimation in which we instrument kidnapping among young women with the district-level prevalence of kidnapping among older women. Our findings indicate that children born to kidnapped mothers are of a substantially lower birth weight than children born to mothers who are not kidnapped. This has important implications for children’s long-term development; it also discredits the ritualized-kidnapping-as-elopement view.

The monetization of social celebrations in rural Kyrgyzstan: on the uses of hashish money

This article focuses on the embeddedness of hashish production in the local economy of Toolu, a village in Kyrgyzstan. It explores how transformations in social relationships and the monetization of gift giving put constant pressure on families to find cash in a semi-subsistence agricultural economy. Although not produced on an industrial scale in the community, hashish is used as a cash crop in times of deficit. Based on a mixed-methods study combining ethnographic fieldwork with survey data, I show how the hashish economy is intertwined with different forms of reciprocal relationships based on gift-giving practices and the monetization of social relationships. In doing so, I illustrate how the hashish economy is embedded in local livelihoods and shapes emerging forms of economic morality in Kyrgyz society.

PRACTICING HARMONY IDEOLOGY

Twenty-five years ago, drawing on her fieldwork among the Zapotec, the legal anthropologist Laura Nader proposed the term harmony ideology to characterize postcolonial systems of justice. She found outward social harmony to be the result of coercion, as people were denied access to legal means and were forced either into alternative dispute resolution or into autocoercion, in which marginalized people presented unity to outsiders to avoid state interference. This proposition constitutes a relevant advance in relation to previous approaches to conflict and harmony in the social sciences, but it falls short by failing to account for indigenous notions of and demands for harmony. Ethnographic data from rural Kyrgyzstan and the South Omo region of Ethiopia indicate that there are models of harmony active at various social levels and that harmony is a genuine concern of communities. Demands for harmony are performatively integrated into social practices. The authors argue that, rather than searching for a scale of sociality where harmony might be “organic,” it is necessary to critically assess proclamations of and demands for harmony as means of coercion even within small communities. A focus on social practice in such places reveals that the experience of community partly derives from acts of collectively condemning and sanctioning deviance.

Political Capital, Everyday Politics and Moral Obligations: Understanding the Political Strategies of Various Elites and the Poor in Kyrgyzstan

Using the Bourdieusian framework to analyse the nature of social stratification in rural Kyrgyzstan, this article examines how local politics is strategised by different groups in the social field. The article suggests two modifications to the Bourdieusian framework to reflect better the nature of local politics. First, despite lacking significant capital holdings, poor groups undertake everyday resistance and mediated politics. Second, intellectual and traditional elites engage in the politics of ‘doing the right thing’, motivated by a sense of moral obligation. The article provides a critical challenge to the concept of clan and elite-led politics which is often used to explain events in Central Asia.

Transfer behavior in migrant sending communities

We study how international migration changes the private transfers made between households in the migrant sending communities of developing countries. A priori, it is indeterminate whether migration and remittances strengthen or weaken the degree of private transfers in these communities. From a policy perspective, public income redistribution programs would have an important role to play if migration reduced the extent of private transfers. Using household survey data from rural Kyrgyzstan, we find that households with migrant members (as well as households receiving remittances) are more likely than households without migrants (without remittances) to provide monetary transfers to others and to receive non-monetary (i.e. unpaid labor) transfers from others. This suggests that migrant households, through their access to remittance income, insure their social networks against shocks or redistribute income to poorer households in the community and receive labor transfers in return. This implies that migration is unlikely to lead to a weakening of private transfers.

Ordering ideals: accomplishing well-being in a Kyrgyz cooperative of elders

In May 2005, after a tumultuous parliamentary election campaign had led to factionalism among the village population, village elders in northern Kyrgyzstan formed the cooperative Yiman Nuru (Light of Faith). The institution, which is headed by the local imam, was set up with the explicit aim to restore harmony and unity among all villagers. This article deals with how people in rural Kyrgyzstan try to achieve a state of well-being for themselves. Specifically, it analyses a chart the elders created upon forming the cooperative, in which they order their social and economic practices, their moral duties and responsibilities vis-à-vis other villagers, as well as their relationship with state actors, along the lines of three moral concepts: harmony, unity, and moral conduct. This chart provides a unique opportunity to probe into people's reflexivity and their own ways of reasoning about the meaning of well-being.

Homemaking, Homebuilding, and the Significance of Place and Kin in Rural Kyrgyzstan

ABSTRACTIn rural Kyrgyzstan, homes built by their owners house multigenerational families and are filled with objects that have been bought, made, acquired, and received. Many of them come as gifts cementing alliances with other families through marriage. This article discusses how kelin (daughters-in-law) and their families negotiate aspects of themselves and their relationships through interactions with these objects and places of domesticity. Many studies of Central Asia identify patrilineage and land as major factors in the constitution and experience of kinship and personhood. This article shows how the home provides an interesting alternative site for the examination of these. It is a perspective, moreover, that is vital when women's experience is relatively overlooked. Ethnographic fieldwork with households in Kyrgyzstan is drawn on to discuss the significance of domestic places and domestic objects for daughters-in-law. It highlights the negotiation of personhood outside the more discursively powerful locations such as lineage, place, and geographical region. It does so through focusing on ways of experiencing, envisioning and creating old and new homes, arguing that these are intimately connected to personhood. It is suggested that homebuilding can be understood as an explicit narration of self, while daily interaction with objects in the home is a more implicit form of self-expression and negotiation.

The Meanings of Pasture in Resource Degradation Negotiations: Evidence From Post-Socialist Rural Kyrgyzstan

Pasture use in the Kyrgyz Republic has changed significantly as a result of fundamental political, economic, and societal changes following the collapse of the Soviet Union and the subsequent changes in people's livelihoods. Government institutions criticize current land use patterns as unsustainable and the cause of degradation. But at the local level, pasture quality is rarely seen as a major problem. This article uses a qualitative approach to examine the tension between these views and addresses current land use practices and related narratives about pasture degradation in rural Kyrgyzstan. By focusing on meanings ascribed to pastures, it shows how people closely relate current practices to the experiences and value systems of the Soviet period and to changing identities emerging in the post-Soviet transformation process. It argues that proper understanding of resource degradation issues requires adequate consideration of the context of meaning constructed by local resource users when they make sense of their environment.

Making a Living in Uncertainty: Agro-Pastoral Livelihoods and Institutional Transformations in Post-Socialist Rural Kyrgyzstan

Making a Living in Uncertainty: Agro-Pastoral Livelihoods and Institutional Transformations in Post-Socialist Rural Kyrgyzstan

Coping with the energy crisis: Impact assessment and potentials of non-traditional renewable energy in rural Kyrgyzstan

The Kyrgyz energy sector is characterised by a dramatic energy crisis that has deprived a substantial part of the population from access to energy. Non-traditional renewable energy sources have emerged as a promising alternative in providing basic energy services to the rural poor. Based on qualitative interview data from local households and project planners, this study sets out to assess impacts, limitations and barriers of non-traditional renewable energy projects in rural areas in Kyrgyzstan. This study argues that recent renewable energy efforts from multilateral international agencies, the private sector, and nongovernmental organisations exhibit great potential in creating tangible benefits and improving basic energy services, but have so far been inefficient in establishing and replicating sustainable and long-term energy solutions. Existing practices need to be improved by attaching greater importance to the capacities and real needs of the rural poor. The guidance of integrated programmes and policies along with alternative financing schemes and awareness-raising are urgently needed to leverage local success stories and to facilitate a sustainable energy development in rural Kyrgyzstan.

Weapons of the wealthy: predatory regimes and elite-led protests in Central Asia

Introduction: Puzzles of People Power1. Institutional Uncertainty and Elite-Led Mobilization 2. The View from Below: Communities as Sites for Collective Action 3. The View from Above: State Influences on Elite Opportunities 4. Linkages across Classes: The Development of Subversive Clientelism 5. Mobilization in Rural Kyrgyzstan 6. Elite Networks and the Tulip Revolution 7. Assessing the Dynamics of Mobilization in Diverse ContextsConclusion: Political Economies, Hybrid Regimes, and Challenges to DemocratizationMethodological Appendix Index

Maternity care and birth preparedness in rural Kyrgyzstan and Tajikistan

Objective To assess a baseline level of maternity care knowledge of the population and of care providers in rural areas in Kyrgyzstan and Tajikistan (Central Asia). Methods Interviews with pregnant women and with men about their knowledge of key danger signs, serious health problems during pregnancy, labour and childbirth, and knowledge of basic infant care. Questionnaires about maternity care knowledge for providers, and checklists about providers’ communication and counselling skills and about facilities completed by observers. Results Level of knowledge among the population about possible complications during pregnancy and the postpartum period was low. Physicians in Kyrgyzstan scored an average of 55.2% correct answers on 52 knowledge questions about maternity care. Midwives and nurses in Kyrgyzstan, physicians and midwives in Tajikistan, scored on average less than 50% correct answers. In Kyrgyzstan, in seven out of 15 facilities (47%) staff was permanently available for treatment and referral of patients (24 h a day, 7 days a week). In Tajikistan this was the case in only 2 of 17 facilities (12%). Conclusion Kyrgyz and Tajik women and men have limited knowledge about possible complications during pregnancy, childbirth, and the period after childbirth. Service providers do not have an adequate professional level of knowledge of perinatal health issues and lack basic skills to monitor their work.

Migration and animal husbandry: Competing or complementary livelihood strategies. Evidence from Kyrgyzstan

Animal husbandry and labour migration are important livelihood strategies for a large proportion of the rural population in developing countries. Up to now, the two strategies have usually been studied by looking at either one or the other; their interlinkages have rarely been examined. Based on a case study in rural Kyrgyzstan, the aim of this paper is to explore the links between animal husbandry and labour migration. Results show that for most rural households, livestock is crucial yet not sufficient to make a living. Therefore, many people diversify their income sources by migrating to work elsewhere. This generates cash for daily expenses and the acquisition of new livestock, but also leads to an absence of workforce in households. Yet since remittances usually exceed the expenses for hiring additional workforce, most people consider migration profitable. From a socio-economic point of view, migration and animal husbandry can thus be considered important complementary livelihood strategies for the rural Kyrgyz population, at least for the time being. In the long term, however, the failure of young migrants to return to rural places and their settlement in urban areas might also cause remittance dependency and lead to an increasing lack of qualified labour. From an environmental point of view, the investment of remittances into animal husbandry poses challenges to sustainable pasture management. Increasing livestock numbers in rural areas raise pressure on pasture resources. Since most people consider animal husbandry their main future prospect while continuing to use pastures in a fairly unsustainable way, this may further exacerbate the over-utilization of pastures in future.

Balancing medicine prices and business sustainability: analyses of pharmacy costs, revenues and profit shed light on retail medicine mark-ups in rural Kyrgyzstan

BackgroundNumerous not-for-profit pharmacies have been created to improve access to medicines for the poor, but many have failed due to insufficient financial planning and management. These pharmacies are not well described in health services literature despite strong demand from policy makers, implementers, and researchers. Surveys reporting unaffordable medicine prices and high mark-ups have spurred efforts to reduce medicine prices, but price reduction goals are arbitrary in the absence of information on pharmacy costs, revenues, and profit structures. Health services research is needed to develop sustainable and "reasonable" medicine price goals and strategic initiatives to reach them.MethodsWe utilized cost accounting methods on inventory and financial information obtained from a not-for-profit rural pharmacy network in mountainous Kyrgyzstan to quantify costs, revenues, profits and medicine mark-ups during establishment and maintenance periods (October 2004-December 2007).ResultsTwelve pharmacies and one warehouse were established in remote Kyrgyzstan with < US $25,000 due to governmental resource-sharing. The network operated at break-even profit, leaving little room to lower medicine prices and mark-ups. Medicine mark-ups needed for sustainability were greater than originally envisioned by network administration. In 2005, 55%, 35%, and 10% of the network's top 50 products revealed mark-ups of < 50%, 50-99% and > 100%, respectively. Annual mark-ups increased dramatically each year to cover increasing recurrent costs, and by 2007, only 19% and 46% of products revealed mark-ups of < 50% and 50-99%, respectively; while 35% of products revealed mark-ups > 100%. 2007 medicine mark-ups varied substantially across these products, ranging from 32% to 244%. Mark-ups needed to sustain private pharmacies would be even higher in the absence of government subsidies.ConclusionPharmacy networks can be established in hard-to-reach regions with little funding using public-private partnership, resource-sharing models. Medicine prices and mark-ups must be interpreted with consideration for regional costs of business. Mark-ups vary dramatically across medicines. Some mark-ups appear "excessive" but are likely necessary for pharmacy viability. Pharmacy financial data is available in remote settings and can be used towards determination of "reasonable" medicine price goals. Health systems researchers must document the positive and negative financial experiences of pharmacy initiatives to inform future projects and advance access to medicines goals.

Flourishing retail in the post-soviet sphere? Potentials and constraints of small-scale retail activities in rural Kyrgyzstan

The demise of the USSR led to the collapse of its centrally organised retail system. With this collapse the supply of consumer goods dried up, especially in the remote parts of the former USSR. At the same time the advent of capitalism offered a new institutional framework for independent retail activities. In the Kyrgyz Republic, where the economic liberalisation followed strictly the Washington Consensus, a large number of small shops emerged in both urban and rural areas. This study analyses the reasons for this boom in retail start-ups as well as the constraints the mainly inexperienced merchants encounter. As will be shown, any success in retail activities depends greatly on the performance of other economic sectors. The main goal of starting a retail business is to minimize risks within the overall livelihood strategies of households in rural Kyrgyzstan.

Towards equitable access to medicines for the rural poor: analyses of insurance claims reveal rural pharmacy initiative triggers price competition in Kyrgyzstan

BackgroundA rural pharmacy initiative (RPI) designed to increase access to medicines in rural Kyrgyzstan created a network of 12 pharmacies using a revolving drug fund mechanism in 12 villages where no pharmacies previously existed. The objective of this study was to determine if the establishment of the RPI resulted in the unforeseen benefit of triggering medicine price competition in pre-existing (non-RPI) private pharmacies located in the region.MethodsWe conducted descriptive and multivariate analyses on medicine insurance claims data from Kyrgyzstan's Mandatory Health Insurance Fund for the Jumgal District of Naryn Province from October 2003 to December 2007. We compared average quarterly medicine prices in competitor pharmacies before and after the introduction of the rural pharmacy initiative in October 2004 to determine the RPI impact on price competition.ResultsDescriptive analyses suggest competitors reacted to RPI prices for 21 of 30 (70%) medicines. Competitor medicine prices from the quarter before RPI introduction to the end of the study period decreased for 17 of 30 (57%) medicines, increased for 4 of 30 (13%) medicines, and remained unchanged for 9 of 30 (30%) medicines. Among the 9 competitor medicines with unchanged prices, five initially decreased in price but later reverted back to baseline prices. Multivariate analyses on 19 medicines that met sample size criteria confirm these findings. Fourteen of these 19 (74%) competitor medicines changed significantly in price from the quarter before RPI introduction to the quarter after RPI introduction, with 9 of 19 (47%) decreasing in price and 5 of 19 (26%) increasing in price.ConclusionsThe RPI served as a market driver, spurring competition in medicine prices in competitor pharmacies, even when they were located in different villages. Initiatives designed to increase equitable access to medicines in rural regions of developing and transitional countries should consider the potential to leverage medicine price competition as a means of achieving their goal. Evaluations of interventions to increase rural access to medicines should include impact assessment on both formal and informal pharmaceutical markets.

Migration past and present: changing patterns in Kyrgyzstan

Internal and international labour migration is a main livelihood strategy for many people in rural areas of Kyrgyzstan. It is estimated that approximately one-third of the employable population of Kyrgyzstan is working abroad. However, current labour migration phenomena are not exceptional since Central Asia's history has always been characterized by the movement of people, including external and internal, forced and voluntary, legal and illegal, permanent and temporary, ethnically or economically motivated migration. This article gives an overview of the historical and present migration processes with a special focus on three village communities in rural Kyrgyzstan. It deals with the opportunities and difficulties with which labour migrants and their non-migrating family members are confronted today. The results are based on extensive field work in Kyrgyzstan.