Health in Kyrgyzstan

Last updated


Life expectancy at birth in Kyrgyzstan Life expectancy by WBG -Kyrgyzstan.png
Life expectancy at birth in Kyrgyzstan

Kyrgyzstan is a lower-middle income country in Central Asia with a population of 6,630,631 in 2022 and a projected increase of 42% by 2050. [1] The life expectancy at birth in 2021 was 71.2 years, an increase of 6.23 years from 66 years in 2000. [1] Healthy life expectancy has also increased, from 58.7 years in 200 to 63.4 years in 2021. [1] In the rest of Kyrgyzstan’s WHO region (Europe), the life expectancy at birth is 76.3 as of 2021, improved from 72.5 years in 2000, and the healthy life expectancy in 2021 is 66, improved from 63.7 years in 2000. [1]

Contents


Health System

Kyrgyzstan has a single mandatory health insurance system under the Mandatory Health Insurance Fund (MHIF), which covers a defined package of publicly covered services called the State-Guaranteed Benefits Programme (SGBP) [2] Only 69% of the population was covered by the MHIF in 2019, and many services require co-payments. [2] This is a decline in coverage since 2016, when 76% were covered. [2] Insured patients are fully covered for all primary care services, but the 31% of the population who are not covered, as well as patients who require services outside the SGBP, must pay entirely out-of-pocket. [2]

Decision-making around health policy is primarily within of the Ministry of Health, which is responsible for national health policies, health protection, and health insurance, though external development officers like the WHO have been supporting health system reform. [2] Under the current Healthy Person- Prosperous Country programme of health system reform (2019-2030) the national Public Health Coordinating Council is being revised, with the goal of strengthening the role of local authorities to improve coordination and intersectoral cooperation in implementing successful health programmes. [2]

Most primary, secondary, and tertiary health care providers are public, salaried employees administered by the Minister of Health at either regional, district, or city level. [2] Some organizations have mixed public-private ownership, like haemodialysis services. [2] Pharmaceuticals are entirely provided by private organizations, though some pharmacies have a contract with the MHIF. [2] The MHIF pools state budget funds, mandatory health insurance contributions, external donor funds and patient co-payments before allocating funds to providers. [2]

The village drug store in Tamchy, Issyk Kul Province E8287-Tamchy-drugstore.jpg
The village drug store in Tamchy, Issyk Kul Province

Private spending (mostly out-of-pocket payments) accounted for 46.3% of health expenditure in 2019. [2] Almost two thirds of this goes towards medical devices and pharmaceuticals which are either excluded from the SGBP pr require large co-payments. [2] The rest is due to co-payments for inpatient services and a smaller proportion to outpatients and dental services. [2] In terms of social security funding, collection of all funds by the tax authorities is being piloted in two districts, which would replace several smaller social security bodies like The Social Fund. [2]

External development assistance has been declining, from 15.7% in 2004 to 2.3% in 2019. [2] Voluntary health insurance is virtually non-existent.

Health Challenges

The biggest cause of death in Kyrgyzstan is cardiovascular disease (CVD). [3] Respiratory diseases and TB (including COVID-19) cause the next highest number of deaths, followed by neoplasms and chronic respiratory diseases. [4]

Causes of Death, 2021
CauseNumber of deaths per 100,000
Cardiovascular disease246.03
Respiratory infections and TB142.61
Neoplasms125.31
Chronic respiratory diseases55.94
Diabetes and kidney disease40.49

When it comes to the biggest burden of disease in Kyrgyzstan, a good measure is disability-adjusted life years (DALYs). Looking at DALYs instead of deaths, the impact of maternal and neonatal disorders and musculoskeletal disorders also become more important challenges to address. [4]

Highest Burden of Disease in DALYs, 2021
CauseDALYs per 100,000
Cardiovascular diseases5,427.81
Respiratory infections and TB4,431.18
Neoplasms3,209.97
Maternal and neonatal disorders2,517.69
Musculoskeletal disorders2,051.33


Evaluating risk factors is also important in determining the primary health challenges facing the country. In Kyrgyzstan, the factors that most influence the burden of disease in DALYs are malnutrition, air pollution, and high blood pressure. [4]

Action on Health

There have been four major health reforms since Kyrgyzstan's independence from the Soviet Union in 1991: Manas (1996-2005), Manas Taalimi (2006-2011), Den Sooluk (2012-2016, then extended to 2018), and now the current health reform programme is known as Healthy Person - Prosperous Country (2019-2030). [2]

In 2016, WHO reviewed heart attack and stroke services in Kyrgyzstan, and demonstrated that most patents were not diagnosed or treated on time due to fragmentation of clinical pathways and lack of clear implementation of guidelines recommendations, despite CVD being a priority of the health reform system at the time. [3] Based on this evaluation, Kyrgyzstan’s Ministry of Health established a working group in 2017 to design a service framework and roadmap for the development of CVD care systems under the coordination of the WHO Regional Office for Europe and the WHO Country Office in Kyrgyzstan. [3] Healthy Person - Prosperous Country is aiming for universal health coverage by 2030. [3] To address issues in fragmentation of clinical pathways and lack of effective guideline implementation, the programme incorporates vertical integration of health services and increased public health agency interaction to improve intersections with other sectors, like social services. [3] Various pilots to improve the integration of services are also in process, including for HIV/AIDS, tuberculosis, and mental health care. [2]

UN Sustainable Development Goal 3: Good Health and Well-being

To address health challenges in the country, several strategies are also working in tandem with the Healthy Person - Prosperous Country programme to adapt the global SDG targets related to health and wellbeing to the national context. [5] These include the National Development Strategy for the Kyrgyz Republic 2018-2040 and the Development Programme of the Kyrgyz Republic 2018-2022: Unity. Trust. Creation. [5] The Kyrgyz Government joined the International Health Partnership for UHC based on commitments in implementing the national SDG policy framework. [5] They also signed the United Nations Global Compact in 2018, a great demonstration of commitment to taking action towards universal health coverage. [6]

In 2019, Kyrgyzstan ranked 48 out of 162 countries in the Global SDG Index and Dashboards Report, which ranks countries by an aggregate SDG index of overall performance. In SDG 3, the goal targeting health and wellbeing, 71.6% of targets were achieved in Kyrgyzstan, considered “moderately good progress”. [5] Kyrgyzstan was selected as a pilot country for the Global Action Plan for Healthy Lives and Wellbeing for All (GAP) in the WHO European region, signing a joint statement of partnership to pledge commitment to supporting the national health priorities – in the case of Kyrgyzstan, these priorities are well-articulated in the Health 2030 policy programme. [5] The GAP coordination efforts focused on four priority accelerator areas: - Sustainable financing for health - Primary health care - Determinants of health - Data and digital health To support these priorities, the country-level Development Partner Coordination Council for Health (DPCC) meets on a quarterly basis and is coordinated by WHO. [5] The United National Development System Inter-agencry SDG Work Group also works to support by meeting on a monthly basis to coordinate efforts from United Nations bodies to advance the 2030 agenda and advocate with key stakeholders and government. [5]

Climate and Health

Kyrgyzstan is one of the most vulnerable countries to climate change in Central Asia. [7] Generally, this is due to its central position in a large continental landmass, the high contribution of weather and climate related activities due to its economy, its very high reliance on water resources for food and energy production, a rugged, steep, and often unproductive topography, and its limited ability to cope with climate change due to limited resource availability. [7]

Economic Impact

Kyrgyzstan heavily relies on its glacial meltwater for agriculture and energy, which is a seasonal process in which glaciers and snowfields amass snow and ice throughout the winter, then release it as water into streams, rivers, and lakes as it melts during spring and summer. [7] Hydroelectric power plants generate 90% of the country’s national electrical production. [7] Combined with agriculture, electricity production comprises 20-25% of the GDP, making the country highly dependent on glaciers for its economic health, as well as food and energy security. [7]

Over 60% of the Kyrgyz population lives rurally, with most dependent on natural resources via pastoralism and rainfed and irrigated agriculture. [7] All types of farming are extremely susceptible to climate change due to direct impact of rising temperatures, increases in rainfall variability, intensive agriculture and secondary impacts of higher temperatures on glacial meltwater availability. [7]

Climate change will likely reduce the national budget due to these impacts on Kyrgyzstan's agricultural and energy industries, and therefore also investments in services to protect its population from health impacts of climate change. Public services like schools, health centres, and social support services essential to children’s rights and wellbeing (and health) are already underfunded, especially in areas most at risk from climate threat. [7] The situation is likely to get worse as water/energy resources become scarce and competition for funding increases.

Impact on Children

Children are most vulnerable to climate impacts, which include a higher susceptibility to vector-borne diseases, undernutrition, respiratory infections caused by air pollution, physical danger associated with flooding and landslides and a higher risk of abuse, exploitation, trafficking, radicalisation and child labour as climate-related poverty increases. [7] Lifelong impacts of these threats on children include reduced physical and cognitive development and long-term mental and physical health complications and, as a result, lower lifetime earning potential, [8] as well as a greater reliance on functioning public services such as school and hospitals equipped with sufficient electricity for lighting and heating, and water for sanitation. [7]

Air Pollution

Air pollution is the biggest environmental risk factor for premature death and ill-health of children and adults in Kyrgyzstan. [9] A 2023 study on the health and social impacts of air pollution on women and children in Bishkek found that air pollution levels in Bishkek were far above those known to have major adverse health effects in urban populations. [9]

Exposure to air pollution prenatally can alter neurological responses and impair cognition throughout life. [10] Children’s lungs are also especially vulnerable to air pollution, and function of the lungs can be permanently altered during fetal or early post-natal life. [10] There is a large burden of disease resulting from exposure to air pollution in children because it leads to acute lower respiratory infections, as well as chronic conditions like asthma and chronic obstructive pulmonary disease. [10] Prenatal exposure to air pollution can also predispose people to cardiovascular disease later in life, [10] and high levels of air pollution could contribute to cardiovascular disease as the leading cause of death in Kyrgyzstan (see table in Health Challenges section).

Action on Climate and Health

There have been around US$200 million in investments to address climate change since Kyrgyzstan’s independence from the Soviet Union in 1991. [8] The money came from government, development banks, multilateral and bilateral sources, and primarily targeted agriculture, water management, and natural resource management. [8] However, children have not been targets of specific climate change investments despite being most vulnerable to impacts of climate change. [8]

UNICEF started the Healthy Environments for Healthy Children (HEHC) Global framework in 2021, which includes identifying air pollution as the leading environmental risk for mortality and burden of disease among children. [9] From this, an online course on children’s environmental health is being developed that could assist in training health workers on diseases related to air pollution. [9]

Historical health in Kyrgyzstan as of early 2010s

In the post-Soviet era, Kyrgyzstan's health system has suffered increasing shortages of health professionals and medicine. Kyrgyzstan must import nearly all its pharmaceuticals. [11] The increasing role of private health services has supplemented the deteriorating state-supported system. [11] In the early 2000s, public expenditures on health care decreased as a percentage of total expenditures, and the ratio of population to number of doctors increased substantially, from 296 per doctor in 1996 to 355 per doctor in 2001. [11] A national primary-care health system, the Manas Program, was adopted in 1996 to restructure the Soviet system that Kyrgyzstan inherited. [11] The number of people participating in this program has expanded gradually, and province-level family medicine training centers now retrain medical personnel. [11] A mandatory medical insurance fund was established in 1997. [11]

Largely because of drug shortages, in the late 1990s and early 2000s the incidence of infectious diseases, especially tuberculosis, has increased. [11] The major causes of death are cardiovascular and respiratory conditions. [11] Official estimates of the incidence of human immunodeficiency virus (HIV) have been very low (830 cases were officially reported as of February 2006, but the actual number was estimated at 10 times that many). The concentration of HIV cases in Kyrgyzstan’s drug injecting and prison populations makes an increase in HIV incidence likely. [11] More than half of the cases have been in Osh, which is on a major narcotics trafficking route. [11]

The maternal morality rate rose by more than 15% to 62 deaths per 1000,000 births from 2008 to 2009. According to non-governmental studies, things are worse than the official data indicate. [12]

The Human Rights Measurement Initiative [13] finds that Kyrgyzstan is fulfilling 81.2% of what it should be fulfilling for the right to health based on its level of income. [14] When looking at the right to health with respect to children, Kyrgyzstan achieves 98.4% of what is expected based on its current income. [15] In regards to the right to health amongst the adult population, the country achieves only 90.3% of what is expected based on the nation's level of income. [16] Kyrgyzstan falls into the "very bad" category when evaluating the right to reproductive health because the nation is fulfilling only 55.0% of what the nation is expected to achieve based on the resources (income) it has available. [17]


Related Research Articles

<span class="mw-page-title-main">Health in China</span> Overview of health in China

Health in China is a complex and multifaceted issue that encompasses a wide range of factors, including public health policy, healthcare infrastructure, environmental factors, lifestyle choices, and socioeconomic conditions.Although China has made significant progress in improving public health and life expectancy, many challenges remain, including air pollution, food safety concerns, a growing burden of non-communicable diseases such as diabetes and cardiovascular disease, and an aging population. In order to improve the situation, the Chinese Government has adopted a series of health policies and initiatives, such as the Healthy China 2030 program, investment in the development of primary health-care facilities and the implementation of public health campaigns.

<span class="mw-page-title-main">Health in Nigeria</span> Overview of health in Nigeria

In Nigeria, there has been a major progress in the improvement of health since 1950. Although lower respiratory infections, neonatal disorders and HIV/AIDS have ranked the topmost causes of deaths in Nigeria, in the case of other diseases such as monkeypox, polio, malaria and tuberculosis, progress has been achieved. Among other threats to health are malnutrition, pollution and road traffic accidents. In 2020, Nigeria had the highest number of cases of COVID-19 in Africa.

Health in Indonesia is affected by a number of factors. Indonesia has over 26,000 health care facilities; 2,000 hospitals, 9,000 community health centres and private clinics, 1,100 dentist clinics and 1,000 opticians. The country lacks doctors with only 0.4 doctors per 1,000 population. In 2018, Indonesia's healthcare spending was US$38.3 billion, 4.18% of their GDP, and is expected to rise to US$51 billion in 2020.

Health in Iraq refers to the country's public healthcare system and the overall health of the country's population. Iraq belongs to WHO health region Eastern Mediterranean and classified as upper middle according to World Bank income classification 2013. The state of health in Iraq has fluctuated during its turbulent recent history and specially during the last 4 decade. The country had one of the highest medical standards in the region during the period of 1980s and up until 1991, the annual total health budget was about $450 million in average. The 1991 Gulf War incurred Iraq's major infrastructures a huge damage. This includes health care system, sanitation, transport, water and electricity supplies. UN economic sanctions aggravated the process of deterioration. The annual total health budget for the country, a decade after the sanctions had fallen to $22 million which is barely 5% of what it was in 1980s. During its last decade, the regime of Saddam Hussein cut public health funding by 90 percent, contributing to a substantial deterioration in health care. During that period, maternal mortality increased nearly threefold, and the salaries of medical personnel decreased drastically. Medical facilities, which in 1980 were among the best in the Middle East, deteriorated. Conditions were especially serious in the south, where malnutrition and water-borne diseases became common in the 1990s. Health indicators deteriorated during the 1990s. In the late 1990s, Iraq's infant mortality rates more than doubled. Because treatment and diagnosis of cancer and diabetes decreased in the 1990s, complications and deaths resulting from those diseases increased drastically in the late 1990s and early 2000s.

<span class="mw-page-title-main">Healthcare in Kazakhstan</span>

The Healthcare in Kazakhstan is a post-Soviet healthcare system under reform. The World Health Organization (WHO), in 2000, ranked the Kazakhstan's healthcare system as the 64th in overall performance, and 135th by overall level of health.

<span class="mw-page-title-main">Health in Paraguay</span>

In terms of major health indicators, health in Paraguay ranks near the median among South American countries. In 2003 Paraguay had a child mortality rate of 29.5 deaths per 1,000 children, ranking it behind Argentina, Colombia, and Uruguay but ahead of Brazil and Bolivia. The health of Paraguayans living outside urban areas is generally worse than those residing in cities. Many preventable diseases, such as Chagas' disease, run rampant in rural regions. Parasitic and respiratory diseases, which could be controlled with proper medical treatment, drag down Paraguay's overall health. In general, malnutrition, lack of proper health care, and poor sanitation are the root of many health problems in Paraguay.

The current population of Myanmar is 54.05 million. It was 27.27 million in 1970. The general state of healthcare in Myanmar is poor. The military government of 1962-2011 spent anywhere from 0.5% to 3% of the country's GDP on healthcare. Healthcare in Myanmar is consistently ranked among the lowest in the world. In 2015, in congruence with a new democratic government, a series of healthcare reforms were enacted. In 2017, the reformed government spent 5.2% of GDP on healthcare expenditures. Health indicators have begun to improve as spending continues to increase. Patients continue to pay the majority of healthcare costs out of pocket. Although, out of pocket costs were reduced from 85% to 62% from 2014 to 2015. They continue to drop annually. The global average of healthcare costs paid out of pocket is 32%. Both public and private hospitals are understaffed due to a national shortage of doctors and nurses. Public hospitals lack many of the basic facilities and equipment. WHO consistently ranks Myanmar among the worst nations in healthcare.

Healthcare in Georgia is provided by a universal health care system under which the state funds medical treatment in a mainly privatized system of medical facilities. In 2013, the enactment of a universal health care program triggered universal coverage of government-sponsored medical care of the population and improving access to health care services. Responsibility for purchasing publicly financed health services lies with the Social Service Agency (SSA).

<span class="mw-page-title-main">Health in Cameroon</span>

The Human Rights Measurement Initiative finds that Cameroon is fulfilling 61.0% of what it should be fulfilling for the right to health based on its level of income. When looking at the right to health with respect to children, Cameroon achieves 81.7% of what is expected based on its current income. In regards to the right to health amongst the adult population, the country achieves only 70.5% of what is expected based on the nation's level of income. Cameroon falls into the "very bad" category when evaluating the right to reproductive health because the nation is fulfilling only 30.9% of what the nation is expected to achieve based on the resources (income) it has available.

<span class="mw-page-title-main">WASH</span> Water, sanitation and hygiene services

WASH is a sector focused on providing water, sanitation and hygiene services. It aims to achieve public health gains, uphold the human right to water and sanitation, reduce the burden of collecting drinking water and improve health and education outcomes. Access to WASH services is critical for sustainable development and is integral to achieving Sustainable Development Goal 6, which targets equitable access to water and sanitation for all. Services provided by WASH are useful for development in areas without proper sanitation services

<span class="mw-page-title-main">Health in Rwanda</span>

The quality of health in Rwanda has historically been very low, both before and immediately after the 1994 genocide. In 1998, more than one in five children died before their fifth birthday, often from malaria. But in recent years Rwanda has seen improvement on a number of key health indicators. Between 2005 and 2013, life expectancy increased from 55.2 to 64.0, under-5 mortality decreased from 106.4 to 52.0 per 1,000 live births, and incidence of tuberculosis has dropped from 101 to 69 per 100,000 people. The country's progress in healthcare has been cited by the international media and charities. The Atlantic devoted an article to "Rwanda's Historic Health Recovery". Partners In Health described the health gains "among the most dramatic the world has seen in the last 50 years".

The fertility rate was approximately 3.7 per woman in Honduras in 2009. The under-five mortality rate is at 40 per 1,000 live births. The health expenditure was US$197 per person in 2004. There are about 57 physicians per 100,000 people.

<span class="mw-page-title-main">Health in the Dominican Republic</span>

Health is the state of overall emotional and bodily wellbeing. Healthcare exists to provide healthiness to people and maintain their ideal conditions. In the Dominican Republic, health haphazardness has resulted in economic disgrace. It was because of the rising of infectious health disparities. Healthcare institutions work extensively toward understanding contagious diseases that influence the Dominican economy.

<span class="mw-page-title-main">Healthcare in Belize</span>

Healthcare in Belize is provided through both public and private healthcare systems. The Ministry of Health (MoH) is the government agency responsible for overseeing the entire health sector and is also the largest provider of public health services in Belize. The MoH offers affordable care to a majority of Belizeans with a strong focus on providing quality healthcare through a range of public programs and institutions.

Environmental health policy is governmental action intended to prevent exposure to environmental hazards or to "eliminate the effects of exposure to environmental hazards".

<span class="mw-page-title-main">Sustainable Development Goal 6</span> Global goal to achieve clean water and sanitation for all people by 2030

Sustainable Development Goal 6 declares the importance of achieving "clean water and sanitation for all". It is one of the 17 Sustainable Development Goals established by the United Nations General Assembly to succeed the former Millennium Development Goals (MDGs). According to the United Nations, the overall goal is to: "Ensure availability and sustainable management of water and sanitation for all." The goal has eight targets to be achieved by 2030 covering the main areas of water supply and sanitation and sustainable water resource management. Progress toward the targets will be measured by using eleven indicators.

<span class="mw-page-title-main">Water supply and sanitation in Laos</span>

Laos is a nation with plentiful surface water and broad rivers, but outside of cities, water sanitation and accessibility infrastructure is sparse. Few improvements have been made since the end of the Laotian Civil War in 1975, especially compared to peer nations such as Thailand. By 2015, 76% of Laotians nationwide were estimated to have access to “improved” water, while 71% were estimated to have access to “improved” sanitation.

<span class="mw-page-title-main">Climate change in Kyrgyzstan</span>

Climate change is evident in Kyrgyzstan. Among the countries in Eastern Europe and Central Asia, Kyrgyzstan is the third most vulnerable to the effects of climate change, such as changes in weather patterns that could lead to prolonged periods of precipitation and drought. Moreover, the frequent occurrence of extreme weather and climate events such as heatwaves, droughts, heavy rainfalls, and biotic/abiotic catastrophes during recent years are evidence of climate change. Kyrgyzstan is threatened with glacier melting and a lack of freshwater balance, which are accelerated by global warming. The average temperature has increased from 4.8 °C to 6 °C so far within the last 20 years. In 2013 the World Bank estimated a likely increase of 2 °C in average mean temperature by 2060 and of 4–5 °C by 2100, noting that the country's glaciers were significantly reduced and projected to decline further. A significant warming trend in Kyrgyztsan with a projected increase of 6°C under the Shared Socioeconomic Pathway (SSP) scenario SSP5-8.5 from 2076 to 2096. However the very slight increase in temperature is expected to positively affect climate-sensitive sectors such as agriculture, energy, and forestry as more land is within the optimum temperature band.

<span class="mw-page-title-main">Sustainable Development Goal 3</span> Good Health and Well-Being

Sustainable Development Goal 3, regarding "Good Health and Well-being", is one of the 17 Sustainable Development Goals established by the United Nations in 2015. The official wording is: "To ensure healthy lives and promote well-being for all at all ages." The targets of SDG 3 focus on various aspects of healthy life and healthy lifestyle. Progress towards the targets is measured using twenty-one indicators. SDG 3 aims to achieve universal health coverage and equitable access of healthcare services to all men and women. It proposes to end the preventable death of newborns, infants and children under five and end epidemics.

<span class="mw-page-title-main">Sustainable Development Goal 2</span> Global goal to end hunger by 2030

Sustainable Development Goal 2 aims to achieve "zero hunger". It is one of the 17 Sustainable Development Goals established by the United Nations in 2015. The official wording is: "End hunger, achieve food security and improved nutrition and promote sustainable agriculture". SDG 2 highlights the "complex inter-linkages between food security, nutrition, rural transformation and sustainable agriculture". According to the United Nations, there were up to 757 million people facing hunger in 2023 – one out of 11 people in the world, which accounts for slightly less than 10 percent of the world population. One in every nine people goes to bed hungry each night, including 20 million people currently at risk of famine in South Sudan, Somalia, Yemen and Nigeria.

References

  1. 1 2 3 4 "Health data overview for the Kyrgyz Republic". WHO Data. Retrieved 10 September 2024.
  2. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Moldoisaeva S, Kaliev M, Sydykova A, Muratalieva E, Ismailov M, Madureira Lima J, Rechel B, Zimmermann, J (2022), Kyrgyzstan: Health System Summary, 2022. WHO Regional Office for Europe on behalf of the European Observatory on Health Systems and Policies, Copenhagen
  3. 1 2 3 4 5 A service framework and roadmap for the development of care systems for heart attack and stroke in Kyrgyzstan. Copenhagen: WHO Regional Office for Europe, 2018
  4. 1 2 3 "VizHub". GBD Compare. IHME. Retrieved 10 September 2024.
  5. 1 2 3 4 5 6 7 Towards a healthier Kyrgyz Republic. Health and sustainable development progress report. Copenhagen: WHO Regional Office for Europe; 2020
  6. ↑ "Kyrgyzstan adopts new health strategy for 2019–2030". WHO Europe. 23 January 2019. Retrieved 10 September 2024.
  7. 1 2 3 4 5 6 7 8 9 10 UNICEF. "Climate Landscape Analysis for Children in Kyrgyzstan: UNICEF Working Paper, 2017" (PDF). UNICEF Kyrgyzstan.
  8. 1 2 3 4 UNICEF. "Climate Change & Resilience". UNICEF Kyrgyzstan. Retrieved 10 September 2024.
  9. 1 2 3 4 UNICEF. "Health and Social Impacts of Air Pollution on Women and Children in Bishkek, Kyrgyzstan" . Retrieved 10 September 2024.
  10. 1 2 3 4 UNICEF. "Exposure of children to PM2.5 air pollution in Bishkek" (PDF). Retrieved 10 September 2024.
  11. 1 2 3 4 5 6 7 8 9 10 Kyrgyzstan country profile. Library of Congress Federal Research Division (January 2007). This article incorporates text from this source, which is in the public domain.
  12. ↑ "D+C 2011/7-8 – Focus – Azimova/Abazbekova: Tough labour conditions for Central Asia's female health workers - Development and Cooperation - International Journal". Archived from the original on 2011-10-01. Retrieved 2011-09-06.
  13. ↑ "Human Rights Measurement Initiative – The first global initiative to track the human rights performance of countries". humanrightsmeasurement.org. Retrieved 2022-03-18.
  14. ↑ "Kyrgyzstan - HRMI Rights Tracker". rightstracker.org. Retrieved 2022-03-18.
  15. ↑ "Kyrgyzstan - HRMI Rights Tracker". rightstracker.org. Retrieved 2022-03-18.
  16. ↑ "Kyrgyzstan - HRMI Rights Tracker". rightstracker.org. Retrieved 2022-03-18.
  17. ↑ "Kyrgyzstan - HRMI Rights Tracker". rightstracker.org. Retrieved 2022-03-18.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.