However, many challenges still remain. The rate of child mortality in rural areas is 1.6 times higher than in cities. The system of provision health services is underdeveloped. Neonatal, infant and under-five mortality in the poorest quintile are higher than in richest quintile.
While transmission of HIV to newborns was reduced, the proportion of women among people affected by HIV also increased between 2011 and 2013, from 30 per cent to 42 per cent.
51 per cent of new HIV cases registered in 2014 were among women of reproductive age.
Several bottlenecks affect health outcomes and hamper further progress: health-care services and life-saving interventions for mothers, children and adolescents often provided based on outdated methods, which are not patient-centred. There are significant gaps in the continuum of care provided to adolescent, pregnant and women in the delivery, newborn and children due to overall weak integration within the health system.
‘We had big problems here before we started working with UNICEF. We didn’t have modern equipment, doctors were not trained to resuscitate children,’
says Dr. Ainura Uzakbaeva, deputy director of the Republican Infections Hospital in Bishkek.
Health managers and service providers lack sufficient competencies and skills to provide quality health services to sick children, children with developmental delays, and to inform caregivers in timely seeking support from health providers. Outflow of health workers due to low financial motivation, limited quality of infrastructure, absence of essentially needed equipment, high out of pocket payments and high price of medicines are another reasons for an access barriers to health services.