Over the last 20 years, the Kyrgyz Government has been reforming the health sector by reducing the overall hospital excess capacity, moving towards primary health care and by introducing mandatory health insurance based on solidarity principles. However, the medical education system has been functioning as in Soviet times by preparing narrow specialists only. This resulted in the current deficit of family doctors (1’640 family doctors instead required 3’000, which is 2.7 per 10’000 population) in particular in rural areas. Moreover, the family medicine is not attractive for the graduates due to work overload and low salaries. This situation put on hold the overall reforms of the sector to strengthen the primary care system. Against this background, the medical education reforms were started by the Ministry of Health in 2009 with support of SDC. The reforms of the medical education system, oriented towards international standards, are requiring time, resources and international expertise to ensure continuity and sustainability. This phase of the project will concentrate on finalization of the medical education reforms implementation at all levels of medical and nursing education to meet the needs of the population and the primary health care system in Kyrgyzstan, and reduce the deficit of family doctors in particular in rural areas.

The population basic health needs, in particular in rural areas, are met by well qualified and competent health professionals in line with the Health Sector Reforms

The project’s beneficiaries are graduates at 3 levels of medical and nursing education:

a) admitted students at pre-graduate level: 3’504 students (876 per year);
b) 80% of those students 3’000 that will continue postgraduate education (750 per year) and
c) Family Doctors are being trained at CME 1’500 per year;
d) 13’880 nurses at pre-graduate level (3’470 per year).
Another target group of the project are faculty members of the academic institutions and tutors at health facilities 1’590.

Outcome 1: Policy- and decision-makers at national level and relevant stakeholders develop and implement relevant policies 

Outcome 2: Doctors and nurses provide improved health services

Expected results:  

• Policy Dialogue and Governance mechanisms are in place to ensure quality of medical education
• Strategic alignment of the Human Resources policy with the health sector priorities is ensured
• Clinical practice is increasingly applied in the course of Pregraduate Medical Education
• Strong focus is placed on General practitioners/Family doctors in the Postgraduate Education
• The competence of practicing health workers increased through continuous medical education
• Nurses’ competencies is upgraded and well integrated in the primary health care

Results from previous phases:  

During Phase I the pregraduate medical education system was reformed towards preparing the general practitioners based on new international standard curriculum introduced in 2012, first graduates are expected in 2018. Students appreciate this curricula, their satisfaction rate with the learning process is increasing (2013 from 61% to 87% in 2016);

• The Kyrgyz State Medical Academy has improved its internal management and adapted teaching processes to the new curriculum;
• In 2016 the Osh State University Medical Faculty has launched this new curriculum with permanent support of their peers from Kyrgyz State Medical Academy;
• The Ministry of Health decided to revise the postgraduate education with focus on preparing the family doctors for the primary care system and approved the postgraduate and continuous medical education reform strategy in 2015;
• The decentralized postgraduate trainings was piloted and tested in Naryn oblast. As a result of this pilot the regulation on postgraduate medical education was revised and submitted to the government for approval;
• The continuous medical education system is reforming with focus on decentralization of the teaching processes through e-learning and peer-review groups in the regions.

Hôpitaux Universitaires de Genève in partnership with the Public Foundation “Initiatives in medical education”

Medical education is one of the core components of the Den Sooluk strategy (2012-2018) and is reviewed and coordinated annually at the Joint Annual Review. Synergies with other Swiss funded projects: Health Budget support through SWAp in Kyrgyzstan; Health Facilities Autonomy, Health Care Waste Management, Strengthening Governance of the Primary Health Care System, Strong and Inclusive Parliament Democracy and Medical Education project in Tajikistan.

Phase 2 01.05.2017 - 31.08.2021   (Completed)