Policy responses for Kyrgyzstan - HSRM


Policy responses for Kyrgyzstan

2.2 Workforce

Before the COVID-19 outbreak, the Ministry of Health planned to initiate a health workforce need analysis for the entire health system during the second quarter of 2020. Health workforce planning or projection related to the COVID-19 outbreak and response did not take place. Human resources for health were identified as a priority area for the current national health programme, with the main challenges including: a lack of health workforce in rural areas, migration, lack of effective intersectoral mechanisms to attract and retain staff in the regions, insufficient workplace resources (including physical and social infrastructure, access to mentoring and continuous professional development), and lack of planning and reliable sources of data on human resources.

Medical residents in the first and second year of education are involved with treatment measures. While all educational facilities have released their students from the educational process, this did not affect medical residents at the postgraduate level.

The Kyrgyz government announced that medical workers involved in the COVID-19 response will receive additional payments from the government account for the response to COVID-19 (https://rus.azattyk.org/a/30520105.html). Health workers who are part of mobile teams or other work related to COVID-19, will receive: doctors - 48,000 soms, paramedical staff - 35,000 som, junior medical staff - 29,000 som.  

Teams of volunteers organized by the Ministry of Health went to the south of the country on 30 March.

The work on capacity building of healthcare staff and other sectors able to support the health system response to COVID-19 is being taken forward by the Ministry of Health with WHO support. In early February 2020, 92 health care workers (doctors) from Bishkek and Chui oblast were trained in clinical case management of severe acute respiratory infection when COVID-19 is suspected. Regular online training organized by the Ministry of Health for specialists of all levels is provided by the Kyrgyz State Medical Institute of Retraining and Continuous Education. Training is developed based on national clinical guidelines on COVID-19 which are updated regularly (Order No. 173 to approve interim clinical guidelines on COVID-19 of 20 March 2020). The Ministry of Health is currently not considering placing medical and nursing students, nor to redeploy other specialists.

For the psychosocial and other occupational health support for health workers, the Republican Centre of Mental Health organized online consultations of children psychiatrists, psychiatrists, and clinical psychologists. The Ministry of Health has appointed a group of doctors to provide distance consultations and support to clinicians.

Order No. 253 on the provision of medical, psychological and psychotherapeutic assistance to the population of the Kyrgyz Republic during COVID-19 was signed on 24 April 2020. On 4 May 2020 Order No. 285 was approved, setting out a protocol and recommendations on psychological support.

Order No. 306 on the expenditure of funds for the payment of compensation payments during the period of epidemiological measures taken with regard to COVID-19 has been issued on May 12 to regulate compensation payment procedures for eligible facilities, application procedures for the need of financial resources, proper procurement and accounting of required resources for health facilities.  According to accepted payment procedures, physicians and management level personnel will be paid 23 times the value of the estimated indicators, which is about 47,100 KGS a month. Middle level personnel will be paid 20 times the value of the estimated indicator, which is about 42,600 KGS a month. Junior level personnel will be paid 18 times the value of the estimated indicator, which is about 39,600 KGS a month.

Order No. 320 has been issued on May 15 on the establishment of a coronavirus Scientific Advisory Council to provide advisory, scientific, analytical and methodological assistance in order to prevent the further spread of COVID-19 and to improve the quality of health care delivery.

Order No. 297 from May 8 has been issued on the approval of temporary standard operating procedures for health facilities of the republic during the COVID-19 epidemic. This order describes the compilation of standard operating procedures for the work of mobile teams, the use of personal protective equipment, and the work in facilities tasked with providing services on COVID-19.

On 29 June 2020, the President signed a document amending the Law "On the status of medical workers". The law had been adopted by the Jogorku Kenesh on May 21, 2020 with the aim of establishing guarantees and compensations for health workers in state and municipal health organizations, including in cases of emergency or a state of emergency. The law also provides regulations for the payment of compensations to healthcare workers at high risk of harm to their health during emergencies, and for payments for working in the quarantine zone involving work in harmful and dangerous conditions; it also regulates the event of the death of a medical worker as a result of an illness contracted while performing work under the above-mentioned conditions; obliges state and municipal health organizations to reimburse medical workers from their own funds for vaccination and treatment of occupational diseases in the amount determined by law, and to ensure periodic mandatory medical examinations.

On August 4 the Ministry of Health endorsed Order No. 584 on spending funds to pay compensation payments during the period of work of epidemiological measures for COVID-19. The order contains procedures for paying compensation to medical workers, a list of facilities involved in epidemiological measures, responsible staff and application forms for the need for financial payments according to needs and a report on the use of funds aimed at paying compensation to health workers.

At the media briefing on August 7, Aigul Boobekova, Head of the Human Resources and Organizational Work Department of the Ministry of Health, reported that currently, only 53% of all doctors work in Kyrgyzstan. At the beginning of 2020, the number of doctors in the country was 13,790. Out of 33,518 representatives of nursing staff (middle level personnel) 50% work currently, and out of 12,508 representatives of lower/junior level medical staff, 46% are currently in service. Furthermore, 10-14% of medical staff are in the risk group (age above 60), and about 10-12% are on sick leave or childcare leave. (https://rus.azattyk.org/a/30770881.html).

The number of budget places (paid from the state budget) for the 2020-2021 academic year’s medical training was increased as follows: pulmonology (35 places), emergency medical aid (12) and clinical laboratory diagnostics (20). Also, letters were sent to the Ministry of Finance and the Ministry of Education and Science with a request to allocate an additional 250 budget places for medical residents. (https://rus.azattyk.org/a/30770966.html). 

Technical support by WHO in tailoring and adopting COVID-19 surge planning tools for estimation and projection of country health workforce needs based on the number of mild, moderate, severe and critical patients for response is currently ongoing.  The Ministry of Health agreed to identify designated subdivisions and responsible focal points to ensure proper institutionalization and ownership of the tailored tool and its effective use for the COVID-19 pandemic response in the short term.

The Ministry of Health continues the mobilization and repurposing processes to supply regional health facilities with designated health workers. Medical doctors and residents were sent continuously to the Issyk-Kul, Osh and Chui regions (Orders № 210, 211, 216, 219 from November 17, 24, 30 and December 3, 2020).

The Kyrgyz State Medical Institute for Retraining and Continuing Education (KSMIRCE) informed the Ministry of Health that 12,209 medical workers were trained on distance learning courses, and 7,506 medical workers were trained on-site on infection control and correct use of PPE. 4,024 primary care specialists, 7,469 hospital specialists, 1,448 clinical residents and volunteers, and 532 specialists in laboratory issues were trained on the content of the 4th version of the national clinical protocol.

As of 15 December 2020, the total number of registered cases among medical workers was 4,041 and 3,781 of them had recovered.