Public Health Systems Capacity Building in Central Asia

archived

The five counties of Central Asia (CA)--Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan—occupy a geographically large, strategically important position between Russia to the north, China to the east, Afghanistan to the south, and Iran to the west. Following the Russian Revolution, however, CA was brought under the hegemony of the Soviet Union, which created the modern boundaries of the five countries and installed Soviet educational, scientific and governmental systems. The near-exclusive use of the Russian language in national and regional scientific circles have created difficulties in accessing and using English-based (and, hence, Western-based) thinking in medicine. Varying projects have launched to begin to revise aspects of the existing health care systems while maintaining desirable aspects of the Soviet systems, e.g., entitlement of all citizens to health care. However, significant hurdles remain such as the following: insufficient use of evidence to guide creation of the prikaz, the Soviet-era “order” which hierarchically dictates practice at all levels of medicine in the health care sphere; medical research in CA is not currently up to the highest international standards ; there is little use of or interaction with English medical literature; an insufficient collection of and analysis and interpretation of appropriate data; a need for improved skills in the health care and laboratory setting; and a reliance on paper-based information systems.

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