Health Care Waste Management in Kyrgyz Hospitals

Kyrgyzstan has been reforming the health sector since 1995 to improve the quality of care. During the last years of the health sector reforms, there were some efforts to improve the infection prevention control system; yet substantial problems such as the transmission of hospital acquired infections to patients and the bw quality of care remain, which complicate patients‘ treatment and recovery process. Hospital acquired infections were not registered and effective prevention measures often neglected by the health system due to lack of knowledge. The Republican Center for lnfection Control was established in early 2000 as one of Ministry of Health‘s agencies to provide strategic directions and methodological guidance to the infection prevention control system. Professionals at the Republican Center for lnfection Control are weil educated and up-to date with international standards and evidence regarding the subject of infection prevention control. However, the center has no umbrella structure with administrative functions and lacks sufficient human resources that allow bringing infection prevention control standards to the level of health care facilities (i.e. through training). Thus, an appropriate hospital acquired infections control system needs to be deveioped and institutionaiised with donor support to enhance the quality and safety of care in Kyrgyz hospitals and to increase population‘s trust towards public health services.

lncrease patient and staff safety in healthcare facilities by sustaining the infection control system.

The main beneficiaries are patients of hospitals, in particular women after delivery, newborns, patients that went under surgery and intensive care, as they are the most affected by hospital acquired infections. At the health system level, the primary target group are the health care professionals. The secondary target group is the Ministry of Health, as the project clearly supports it to implement infection prevention control.

• Standardized hospital acquired infections control System is functioning at national level
• Patients (women after delivery, newborns and patients undergoing surgery and intensive care) are safe during hospitalisation

Results from previous phases:  

One of the main results of the previous phases was the introduction of the infection prevention control system in the maternities, which contributed to the reduction of maternal mortaiity (39.2% in 2013 and in 38.5% in 2015) and infant mortality (15.8% in 2013; 15.2% in 2015). This experience was replicated in other health facilities during Phase III.

The main results from the Phase III are:

• lmproved adherence to infection prevention control guidelines deveboped by the Ministry of Health at the national level and in health facilities
• lmproved registration of hospital acquired infections due to extensive trainings and capacity building of infection control specialists, hospital managers and multi-disciplinary health staff
• lncreased budget albocation to infection prevention control in the hospitals
• 38 hospitals‘ laundry departments modernised
• lmproved infection prevention control measures applied by trained health staff in particular due to the behavioural change of hospitals‘ managers

Despite progress, sustainability is not yet ensured. The following elements were identified jointly by the Ministry of Health and implementing partners to enhance sustainability:

• Standardisation of hospital acquired infections control measures at national level will ensure the implementation of infection prevention control in all health facilities to reduce risks for patients to get hospital acquired infections
• Constructive cooperation between the managers of health facilities and the responsible authorities (Sanitary Epidemiological Services, Republican Center for lnfection Control, and Ministry of Health) will support the elimination of hospital acquired infections in health facilities
• Integration of infection prevention control modules into Continuous Medical Education will ensure the sustainability of infection prevention control training component

The project will be implemented in synergy with other Swiss supported projects (Medical Education Reform, Health Facilities Autonomy, Investment Climate), as it contributes to a general reform of the health System in Kyrgyzstan with many similarities in approach and policy dialogue. The project is aligned with Den Soluuk Strategy 2012-2018 and the joint annual review platform is well used for policy dialogue.

Phase 4 01.04.2017 - 31.05.2019   (Completed)