Gaining health : analysis of policy development in European ...

Chapter 4
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In the case of Kyrgyzstan, description of the basic policy
umbrella document is necessarily limited to the infrastructure
of implementation. There are no sub-policies to be
analysed in classical terms, such as tobacco or nutrition
policy. In most countries, the key question is the integration
of different sub-policies. In Kyrgyzstan, the challenge is just
the opposite: how will starting with a broad umbrella policy
document ensure appropriate differentiation in the activities
of NCD policy?
The main dilemma in assessing the present situation is to
foresee the future of implementation in a country with
economic hardship, striking social inequities and political
uncertainty. Experience from some other central Asian
countries indicates that progress from rhetoric and cliché to
real action is far from guaranteed. In such a highly uncertain
situation, even a medium-term forecast is rather risky.
2.2. Manas Taalimi, the broad health policy strategy
The Kyrgyz National Health Care Programme, Manas Taalimi
2006–2120, was approved in February 2006 by means of
Government Decree No. 100. This is in fact a broad health
policy strategy, including a strong public health component
and with emphasis also on health promotion and some
key issues of NCD prevention. The situation analysis of the
strategy draws some important conclusions related to the
further policy development to tackle NCD.
According to Manas Taalimi, community involvement in
health protection and promotion is one of the key elements
in the success of the public health approach (2). In
the context of reforming the mechanism of governance,
certain functions or responsibility for health promotion
can be delegated to NGO. The capacity and resources of
NGOs, which are able to make decisions more flexibly and
more quickly, are gaining importance in supplementing the
activities of public health organizations. This is certainly a
new and important change in health policy as compared to
Soviet times. There are already examples of good practice
for community involvement at regional and local levels.
Some new approaches are emphasized in the strategy,
such as a shift to more active, intersectoral cooperation
by various stakeholders in order to identify clear priorities
and common ground. As important stakeholders, a
number of NGOs are working in close collaboration with
the health sector. Donor organizations provide training to
new members on self-help and mutual help and on disease
prevention and control. According to the strategy document
(2), these are in fact the most promising resources
for the future implementation process. Good examples
are community-based patient organizations such as those
concerned with hypertension, asthma, diabetes and other
NGOs in the field of social protection.
The major goal of the strategy is “to improve the health
status of the population through the creation of a responsive,
efficient, comprehensive and integrated system of individual
and public health service delivery; increased responsibility
of every citizen, family and public authority; and health
administration for each person and society in general” (2).
Compared to other national documents, this goal is rather
unusual. Despite The text expresses a clear commitment
of the Kyrgyz Government to NCD prevention and a high
level of openness to new ways of thinking in this respect.
1. From the NCD policy perspective, two general objectives
are explicitly expressed in the document Improvement
of mechanisms enabling and promoting the
involvement of the population in physical and mental
health promotion and disease prevention.
2. Involvement of the mass media in working more
actively with the public in relation to health protection
and health promotion, thus increasing public awareness
of the health reform process.
Case studies: policy development in countries for tackling noncommunicable diseases