ACCESS TO INCLUSIVE HEALTH SERVICES
Programme at a glance
The efforts of UNDP contribute to achieving the Sustainable Development Goal 3: Ensuring healthy lives and promoting well-being for all at all age and ensure gender equality. Together with other development partners UNDP supports Turkmenistan in the implementation of its national priorities aimed at ensuring a healthy lifestyle and well-being of the entire population of the country.
UNDP is the primary partner of the Global Fund to Fight AIDS, Tuberculosis and Malaria (GF) in Turkmenistan. We have established productive working relations with the Ministry of Health and Medical Industry of Turkmenistan to provide the most effective services for implementation of the national targets for control of tuberculosis. UNDP also partners with the local WHO office, National Red Crescent Society of Turkmenistan, as well with the global anti-TB initiatives, such as Stop TB Partnership.
Since the launch of the Global Fund’s TB grant in Turkmenistan in 2010, the country with the UNDP’s support has achieved significant results in TB control. To date, UNDP and the Government of Turkmenistan have jointly implemented grants totaling over $33 million. Over the past 12 years, in addition to the introduction of international standards for the diagnosis and treatment of tuberculosis, great efforts have been made for gradual transition to a full state funding of National TB program.
Together with the Government UNDP implements multi-vector projects covering a wide range of health services. UNDP purchases medicines and medical products necessary for the prevention and control of both communicable and non-communicable diseases (NCDs) to ensure a quality and free treatment of patients throughout the country.
As part of its efforts to respond to COVID19 pandemic UNDP closely cooperates with other UN Agencies. Together with WHO and UNICEF, UNDP implements a World Bank-funded national pandemic response project to strengthen the country's response and preparedness for current and future pandemics.
Rights-based and gender-sensitive approaches are essential to address inequalities and to build good health for all. Through its health programmes, UNDP Turkmenistan tackles gender-related inequalities in access to health services and focuses on improving women’s and girls’ health.
Gender norms may limit women's access to economic resources and services that require payment. The availability of health services and medicines purchased with UNDP support and distributed by the Ministry of Health and Medical Industry in the immediate vicinity reduces gender-related barriers to accessing, using and/or following preventive services for women and girls.
Attention is also paid to the purchase of medicines used to treat diseases and improve health of pregnant women and mothers of newborns to reduce maternal and neonatal mortality.
At the same time, identification of men as the target population for strategies and programme components to prevent the major risk factors and increase access to and sustainability of health services is crucial for reducing inequality between men and women.
We work to strengthen health and social protection system performance to deliver higher quality and more inclusive services, with a focus on control of tuberculosis and other infectious diseases, increasing prevention and response capacities for pandemics, improving treatment for noncommunicable diseases and expanding coverage of social protection.
CONTROLLING TB BY TIMELY DIAGNOSIS AND TREATMENT
TB is a major global health threat and the top infectious killer worldwide. Preventing new infections and ensuring timely and accurate diagnosis of TB is vital to ending the epidemic by 2030, as set by the 2030 Agenda for Sustainable Development.
The last 20 years have seen an increase in the spread of drug-resistant tuberculosis (DR-TB) in East Europe and Central Asia. This strain of TB cannot be cured by basic antibiotics. It needs to be treated with ‘second line’ drugs. It needs to be detected at an early stage through drug susceptibility testing (DST) by trained staff at specialized TB laboratories using sophisticated equipment in a highly controlled environment.
Since the launch of the TB grant in Turkmenistan, UNDP has supported the Ministry of Health and Medical Industry to conduct a major renovation and a comprehensive upgrade of the TB laboratories across the country.
As a result, there are 6 labs with rapid molecular detection of MDR-TB (Xpert technology), which ensured early start of the MDR-TB treatment.
The Global Fund grant has invested in TB control in Turkmenistan USD 23,8 million. In 2019-2020, UNDP received Government cost-sharing of USD 11,5 million to continue supporting the national efforts to control infectious diseases.
As a result of the Global Fund funded project, over 2550 patients were diagnosed with multidrug resistant TB during 2016-2019 and another 750 are expected to be diagnosed in 2020.
The grant helped raise capacity of 236 TB doctors and lab specialists, and also ensured empowerment of the local public association the National Red Crescent Society of Turkmenistan in grant management in health sector. Using the innovative lab tests and equipment – GenExpert - allowed conducting over 35 000 TB tests during 2016-2019.
NATIONAL REFERENCE LAB RECEIVES INTERNATIONAL RECOGNITION
Since 2010, Turkmenistan’s National Reference Laboratory has successfully passed the external quality assurance audits. The Laboratory has sent over 500 strains of TB mycobacterium, allowing to put more than 2,300 patients on treatment thanks to quality TB testing. The efficient running of the national TB laboratory is enabling doctors to choose precise medicines, provide quality treatment and effectively fight tuberculosis. The National Reference Laboratory of Turkmenistan has been annually awarded quality assurance certificates.
RAISING WOMEN’S AWARENESS HELPS IN EARLY DIAGNOSIS OF TB
The Government of Turkmenistan prioritizes public health and pays special attention to eliminating TB. Due to modern methods for diagnostics and treatment, TB rates (morbidity and mortality) have declined significantly over the past 10 years. However, to ensure sustainability of the results achieved, it is important to carry out preventive measures, which include public education, so that people are aware of the early symptoms of the disease and seek medical help, since in this case it is possible to diagnose the disease at an early stage and cure it.
In 2018, the National Red Crescent Society of Turkmenistan, the Women’s Union of Turkmenistan and the Ministry of Health and Medical Industry of Turkmenistan have signed a joint working plan to conduct an information campaign to raise awareness of the population on TB and other infectious diseases, promote healthy lifestyle and well-being through information sessions with special focus on women. The sessions are open for men also, who already exhibit interest in learning more about their health and well-being of their families.
These information sessions allow medical workers to talk to people about TB and its symptoms and ensure immediate access to the TB specialists who provide instant consultations, take notes of the raised questions and, where possible, take immediate action on the spot by putting potential patients in touch with the doctors.
As a result of the conducted information sessions starting from mid-2019, 114 people have been referred to seek for professional counseling on the issues of their overall health, and 60 people were referred to undergo lab tests for TB.
EMPOWERING CIVIL SOCIETY AND PUBLIC ASSOCIATIONS TO FIGHT TB
Starting from 2013, UNDP and the National Red Crescent Society of Turkmenistan (NRCS) provide support to Multidrug resistant-TB patients to complete the full course of medical treatment. The support includes home visits and phone consultations with patients to confirm that they follow the prescribed treatment. Nurses also inquire whether patients experience any problems that prevent them from adhering to the treatment in which case the NRCS helps in finding the solution.
Since 2011, NSRC as UNDP partner in grant implementation has built institutional capacities on financial, procurement, program implementation, monitoring and evaluation systems.
NRCS has launched “School of patient” where it brings together MDR-TB patients and their close ones to discuss TB treatment and ensure emotional support from the relatives and friends to the TB patients. NRCS’s “School of patient” has conducted 132 sessions around Turkmenistan and supported roughly 400 patients with their relatives and friends.