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Health Partnerships Program in Central Asia: 1998-2006

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Health Partnerships Program in Central Asia: 1998-2006 American International Health Alliance Health Partnership Program Central Asia Republics 1998 – 2006 Final Performance Report Health Partnership Program: Central Asian Republics (1998-2006) Final Performance Report ii Funding from the United States Agency for International Development (USAID) was received through cooperative agreement EE-A-00-98-00010-00 The American International Health Alliance, Inc. (AIHA) is a 501(c)(3) not-for- profit corporation created by USAID and leading representatives of the US healthcare sector in 1992 to serve as the primary vehicle for mobilizing the volunteer spirit of US healthcare professionals to make significant contributions to the reform of healthcare overseas through partnerships. Health Partnership Program: Central Asian Republics (1998-2006) Final Performance Report iii Health Partnership Program: Central Asian Republics (1998-2006) Final Performance Report iv PREFACE This final performance report is a comprehensive overview of AIHA programs in the Central Asian Republics (CAR) between 1998 and 2006. The report describes AIHA’s unique partnership twinning model, the development and evolution of the program in the region, and the main program components funded during this period. The report presents summary results by country, including details of each partnership and project, together with profiles of selected US and CAR partners, as well as more in-depth success stories. Also included are overviews of results from the perspective of key regional and cross-cutting areas of impact. The conclusions section reflects on the overall legacy and lessons learned. The views expressed in this final report do not necessarily reflect those of USAID. IHA’s mission is to advance global health through volunteer-driven partnerships that mobilize communities to better address healthcare A priorities while improving productivity and quality of care. Founded in 1992 by a consortium of American associations of healthcare providers and of health professions education, AIHA is a nonprofit organization that facilitates and manages twinning partnerships between institutions in the United States and their counterparts overseas. It has supported to date 116 partnerships linking American volunteers with communities, institutions, and colleagues in 22 countries in a concerted effort to improve healthcare services. Operating with funding from the United States Agency for International Development (USAID), the Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services, the Library of Congress, the Susan G. Komen Breast Cancer Foundation and other organizations, AIHA’s programs represent one of the US health sector’s most coordinated responses to global health concerns. Health Partnership Program: Central Asian Republics (1998-2006) Final Performance Report v Health Partnership Program: Central Asian Republics (1998-2006) Final Performance Report vi ACKNOWLEDGEMENTS The American International Health Alliance (AIHA) wishes to express its sincerest gratitude to the countless professionals in Central Asia and the United States who gave so generously of themselves to the partnership program in Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan. The program was successful because these individuals demonstrated the courage and commitment to change; the patience, dedication, and hard work to gain new knowledge and skills; and a generous spirit of trust and collaboration. Together they made significant contributions to improving healthcare services and delivery for thousands of people throughout the region. AIHA also thanks the United States Agency for International Development (USAID) for the opportunity and privilege of working in the CAR region and for its steadfast support of the partnership program. Finally, AIHA gratefully acknowledges the contributions of dedicated staff in its Washington, DC, and regional offices in managing and implementing the program and in preparing this final performance report. Health Partnership Program: Central Asian Republics (1998-2006) Final Performance Report vii Health Partnership Program: Central Asian Republics (1998-2006) Final Performance Report viii TABLE OF CONTENTS PREFACE ..........................................................................................................................................................v ACKNOWLEDGEMENTS.........................................................................................................................vii TABLE OF CONTENTS ..............................................................................................................................ix ACRONYMS AND ABBREVIATIONS ....................................................................................................xi EXECUTIVE SUMMARY...........................................................................................................................xiii I. PROGRAM OVERVIEW........................................................................................................................1 A. Introduction ................................................................................................................................1 B. The AIHA Partnership Model..................................................................................................3 C. Program Design And Implementation....................................................................................3 D. The Central Asia Program In Numbers ...............................................................................11 II. COUNTRY SUMMARIES .....................................................................................................................12 A. Kazakhstan (1999-2006)..........................................................................................................13 B. Kyrgyzstan (1999-2006)...........................................................................................................22 C. Tajikistan (1999-2006)..............................................................................................................27 D. Turkmenistan (1999-2006)......................................................................................................30 E. Uzbekistan (1999-2006)...........................................................................................................35 III. MAJOR AREAS OF IMPACT..............................................................................................................43 A. Health Professions Education................................................................................................43 1. Medical Education...............................................................................................................44 2. Nursing..................................................................................................................................54 3. Health Management Education.........................................................................................65 4. Skills-Based Training...........................................................................................................73 B. Primary Healthcare...................................................................................................................83 1. Community-Oriented Primary Care (COPC)..................................................................84 2. Women’s Wellness Centers................................................................................................93 C. Access to Health Information and Communications....................................................... 101 D. Emergency Medical Services ............................................................................................... 110 E. HIV/AIDS ............................................................................................................................. 117 IV. BEST PRACTICES AND LESSONS LEARNED......................................................................... 130 APPENDICES ............................................................................................................................................. 138 Appendix A: List of Key Health Partnership Program Events in CAR (1999-2006)........... 138 Appendix B: List of CAR Health Partnership Program Products........................................... 147 Health Partnership Program: Central Asian Republics (1998-2006) Final Performance Report ix Health Partnership Program: Central Asian Republics (1998-2006) Final Performance Report x ACRONYMS AND ABBREVIATIONS AAMC Association of American Medical Colleges AIHA American International Health Alliance ARV Antiretroviral AUPHA Association of University Programs in Health Administration CA Cooperative Agreement CAR Central Asian Republics COPC Community-oriented Primary Care CPG Clinical Practice Guidelines EBP Evidence-based Practice ECFMG Educational Commission for Foreign Medical Graduates EMS Emergency Medical Services EMSTC Emergency Medical Services Training Center FAIMER Foundation for Advancement of International Medical Education and Research FGP Family Group Practice FMC Family Medicine Center FMTC Family Medicine Training Center F-RCEM Ferghana Affiliate of the Republican Center for Emergency Medicine HIV/AIDS Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome HME Health Management Education HMTC Health Management Training Center ICT Information and Communications Technology ICTC Infection
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