Kyrgyzstan : final country report

Specific objectives were to establish the capacity for providing quality RH/FP services in no less than 375 FGPs and to enhance the role of the FGP Association (FGPA) as a technical and professional resource for FGPs. SEATS exceeded project expectations by improving services through RH training, client and provider education materials, and equipment provision at 434 FGPs. These FGPs now have the capability to provide high-quality RH/FP services to clients. SEATS also demonstrated the feasibility of integrating quality RH services into the regular service delivery of internists and pediatricians. A replicable model for effective, large-scale training for the integration of these new services into FGPs was established. Full training capability is in place at the Republican Center for Continuing Education via its subdivision, the Family Medicine Excellence Center. The FGPA was strengthened as a professional resource and technical clearinghouse for FGPs through the distribution of large quantities of RH materials and equipment. SEATS activity resulted in improved FGP provider competence, increasing by 40% the level of knowledge of contraceptive technology. The FGP physicians" recognition of a woman"s right to choose her method of contraception nearly doubled, from 45% to 88%. The number of clients who reported receiving information on various contraceptive methods from their FGP provider increased dramatically from 67% to 90%. In a mere 18 months, the SEATS Project achieved remarkable success through intense activity and was recognized by the Minister of Health as having made a significant contribution to health care reform and the development of family medicine in Kyrgyzstan. The importance of building strong relationships with and among counterparts and related institutions, regionally and nationally, is the most important lesson learned from the SEATS Project in Kyrgyzstan. Without the bonds and linkages between Kyrgyz institutes that developed during SEATS, the project would probably not have been as successful. The nature of the health care reform effort in Kyrgyzstan required that traditional RH institutions join together with non-reproductive health institutions. Moreover, linkages were formed between different RH entities that in the past rarely collaborated. For example, the Human Reproduction Center, the Marriage and Family Center, and the Venereal and Dermatological Dispensary all work in RH, but seldom worked together in the past. All the institutions were excited by the intense collaboration that took place while working with the SEATS Project and look forward to continued collaboration and the development of the RH capacity of the FGPs. These linkages will continue to enhance all aspects of RH services in the future and lend strength to long-term sustainability. Finally, without an extremely flexible approach, SEATS would likely not have been able to meet the needs of its Kyrgyz partners or the requirements of the USAID/CAR scope of work. The wide variations among regions, cultures, level of knowledge, logistical difficulties, harsh weather, and poor infrastructure required SEATS and its Kyrgyz partners to be exceptionally flexible in order to complete the task at hand.