Health Targets in the Former Soviet Countries: Responding to the NCD Challenge?

Abstract

This article examines health target-setting in 12 former Soviet countries: Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, Tajikistan, Turkmenistan, Ukraine, and Uzbekistan. We explored which health targets were set out in national health strategies and within the context of the United Nations initiative on the Millennium Development Goals (MDGs). We found that few former Soviet countries embraced health targets in national health strategies that were quantitative and time-bound. In contrast, measurable and time-bound targets were adopted by almost all countries in the region within the MDG initiative. As the MDG initiative failed to reflect the considerable burden of non-communicable disease in the region, and focussed entirely on communicable disease and mother and child health, this meant that health targets were missing for one of the most severe health challenges in the former Soviet countries. The quality of health data that could guide national health policies is another major challenge for the control of both communicable and non-communicable disease, as well as improvements in mother and child health.

Leading causes of death of women of reproductive age in the Republic of Georgia: findings from the National Reproductive Age Mortality Survey (2014)

“… 16 The excessive use of ill-defined and “other” unspecified codes particularly for external causes, cancers, and CVDs, in addition to systematic undercounting of maternal causes in the routine registration system, was also documented in earlier studies conducted in other former Soviet Republics and was largely attributed to artifacts in cause-of-death certification and coding practices. 8 , 15 , 16 , 32 – 34 Our study, therefore, signifies the need for continued trainings for physicians and coders in these important procedures, 32 as well as periodic assessments of the quality of routine mortality statistics, using VA as the best and reliable approach to improve national and regional cause-of-death data, particularly for deaths occurring without medical attention, in order to inform public health priorities. 8 – 11 , 35 – 37 …”

“…As with other former Soviet bloc countries, Georgia continues to face the critical challenges of data quality, 8 , 15 , 16 notwithstanding recent meaningful reforms to improve its CRVS system. 17 This has been reflected in substantial inconsistencies between official statistics and the various survey findings supported by international agencies.…”

“…17 This has been reflected in substantial inconsistencies between official statistics and the various survey findings supported by international agencies. 15 , 18 The first national RAMOS, conducted in Georgia in 2008 (RAMOS08) through the technical support of the US Centers for Disease Control and Prevention (CDC), revealed considerable discrepancies between these two sources in overall and cause-specific mortality patterns for women of reproductive age in 2006, highlighting the important gaps in both death registration coverage and cause-of-death ascertainment in the CRVS system. 19…”