Description
Introduction: The current high burden of both communicable and noncommunicable diseases,and concomitant crisis of COVID-19 pandemic,the climate crisis and conflict and political instability in the WHO European Region,continues to expose the existing vulnerabilities in the health systems and widened gaps in health and well-being among Central Asian countries (CACs) population of the Republic of Kazakhstan,the Kyrgyz Republic,the Republic of Tajikistan,Turkmenistan and the Republic of Uzbekistan.
Closing the gaps requires adequate numbers of competent health workers with optimal skills mix and who are equitably distributed,adequately supported and enjoy decent work.In 2022,based on WHA resolution 74.15 and the evidence supporting the role of Government Chief Nursing Officers (GCNOs) in improving regulation of working conditions and education,the WHO Regional Office for Europe launched regular discussions with the GCNOs in four Central Asian Countries (CACs).
Nurses and midwives are the majority of health workers in CACs,accounting for 70% of practicing health professionals.This is over the regional average of 61.2% where 89% of nurses and 98% of midwives are women.They interact with population from birth to death accounting for 90% of the contacts between patients and health professionals,and are crucial in improving access to quality health care,especially in rural,hard-to-reach and underserved areas.
Objectives: To present an analysis on nursing capacity in Central Asia and highlight the achievements and priorities for improving health outcomes through nursing and midwifery in Central Asia and launch the 2024-2030 Action Plan for Strengthening Nursing and Midwifery in Central Asia.
Methodology: A desk review of National Health Workforce Accounts data were consolidated with data available to GCNOs and used in a series of workshops,study visits and discussions taking place in all four countries over the course of 2 years.Based on the analysis and further interviews with key stakeholders a set of challenges and opportunities were identified and framed according to the Global Strategic Directions for Nursing and Midwifery: Jobs, Education, Service Delivery and Leadership.
Discussions: Clearly the four countries in question are at very different stages of development with each of the countries having seen achievements in different areas than the others.Kazakhstan has excelled in areas of Education policies,while Kyrgyzstan excels in areas of leadership,Tajikistan in its recent developments in workforce planning and Uzbekistan in introducing a range of new service delivery models.The countries proximity in terms of culture, geography and political development allows for important collaborations and learnings that should be understood to strategically and efficiently advance health developments in this region.
Conclusions: CACs have introduced a broad set of reform initiatives aiming at strengthening the health system to move towards universal health coverage that includes nurses and midwives as essential team members.The health sector is a major source of employment,particularly for women.The current educational reforms and curricular development,combined with innovations in leadership, clinical practice and health workforce challenges such as the lack of primary health care physicians make even more urgent the need to invest and act to develop nursing and midwifery full potential in CACs.
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