At the webinar, experts discussed the development of the palliative care system in Kyrgyzstan.
Experts from various sectors—including government institutions, education, non-profit organisations, and clinical practice—shared the progress made, outlined the systemic challenges in palliative care in Kyrgyzstan, and discussed their future plans.
The speakers of the webinar are leading experts in the field of palliative care:
Taalaigul Sabyrbekova, co-chair of the Association of Palliative and Hospice Care of the Kyrgyz Republic
Milana Turgunalieva, PhD in Pharmaceutical Sciences, pharmacist, co-chair of the Association of Palliative and Hospice Care of the Kyrgyz Republic
Gulzhakhan Pirnazarova, head of the department of nursing in family medicine, Kyrgyz State Medical Institute of Postgraduate Education
Maral Turdumatova, palliative care physician, First Children's Hospice in Bishkek
Edilbek Turgunbaev, director of the Republican Rehabilitation Center of the Kyrgyz Republic
Azamat Kubataev, director of the public foundation "Fountain of Life"
You can watch the recording of the webinar in Russian or English on our Youtube channel.
Читать на Русском
Experts from various sectors—including government institutions, education, non-profit organisations, and clinical practice—shared the progress made, outlined the systemic challenges in palliative care in Kyrgyzstan, and discussed their future plans.
The speakers of the webinar are leading experts in the field of palliative care:
Taalaigul Sabyrbekova, co-chair of the Association of Palliative and Hospice Care of the Kyrgyz Republic
Milana Turgunalieva, PhD in Pharmaceutical Sciences, pharmacist, co-chair of the Association of Palliative and Hospice Care of the Kyrgyz Republic
Gulzhakhan Pirnazarova, head of the department of nursing in family medicine, Kyrgyz State Medical Institute of Postgraduate Education
Maral Turdumatova, palliative care physician, First Children's Hospice in Bishkek
Edilbek Turgunbaev, director of the Republican Rehabilitation Center of the Kyrgyz Republic
Azamat Kubataev, director of the public foundation "Fountain of Life"
You can watch the recording of the webinar in Russian or English on our Youtube channel.
Читать на Русском
National Context and Care Structure
Taalaigul Sabyrbekova, Co-Chair of the Association of Palliative and Hospice Care of Kyrgyzstan
Kyrgyzstan is a country with a population of approximately 7 million and a life expectancy of around 71 years. A significant portion of the population resides in rural areas. It is estimated that about 19,000 adults require palliative care each year (52% of them due to cardiovascular diseases), along with nearly 20,000 children (mainly due to congenital conditions).
Palliative care in Kyrgyzstan is structured across four levels:
1) Primary healthcare—family doctors, medical centres, and feldsher-midwife posts:
2) General hospitals—regional and district hospitals, centres for general medical care practice:
3) Specialised palliative care unit at the Republican Rehabilitation Centre:
4) National specialised institutions, primarily oncology centres:
In recent years, substantial progress has been achieved in legal and regulatory frameworks, including the incorporation of palliative care in national policy documents.
The current key priorities for the Association of Palliative and Hospice Care of Kyrgyzstan include:
Kyrgyzstan is a country with a population of approximately 7 million and a life expectancy of around 71 years. A significant portion of the population resides in rural areas. It is estimated that about 19,000 adults require palliative care each year (52% of them due to cardiovascular diseases), along with nearly 20,000 children (mainly due to congenital conditions).
Palliative care in Kyrgyzstan is structured across four levels:
1) Primary healthcare—family doctors, medical centres, and feldsher-midwife posts:
- Access to medical services near home;
- Prescription of medication;
- Pain management;
- Assignment of palliative status;
- Provision of primary palliative care.
2) General hospitals—regional and district hospitals, centres for general medical care practice:
- Short-term inpatient care for serious symptoms;
- Caregiving training.
- Psychological support.
3) Specialised palliative care unit at the Republican Rehabilitation Centre:
- Symptom management;
- Nursing care;
- Psychological support;
- Family training.
- Future plans involve transforming this unit into a methodological and educational centre to offer consultative support for general practitioners throughout the country.
4) National specialised institutions, primarily oncology centres:
- Chemotherapy;
- General management of symptoms;
- Surgery.
- Future plans involve establishing care centres for patients with cardiovascular conditions, as they account for a greater proportion of palliative patients than those with cancer.
In recent years, substantial progress has been achieved in legal and regulatory frameworks, including the incorporation of palliative care in national policy documents.
The current key priorities for the Association of Palliative and Hospice Care of Kyrgyzstan include:
- The further integration of palliative care into primary healthcare;
- Ensuring access to essential controlled medicines;
- Increasing the number of palliative care beds and units in general hospitals to serve more people;
- Establishing a second palliative care unit in Osh city.
Webinar PACED
Pain Relief: Key Barriers and Steps Forward
Milana Turgunalieva, PhD in Pharmacy, Pharmacist, Co-Chair of the Association of Palliative and Hospice Care
Milana presented the findings of an assessment regarding access to pain relief medications in Kyrgyzstan. The study revealed that only 14% of pharmacies licensed to dispense opioid analgesics actually provide the necessary medicines to patients, particularly morphine and its formulations suitable for children.
Identified key barriers include:
However, several significant advancements were made in 2023–2024:
Proposed next steps:
Milana presented the findings of an assessment regarding access to pain relief medications in Kyrgyzstan. The study revealed that only 14% of pharmacies licensed to dispense opioid analgesics actually provide the necessary medicines to patients, particularly morphine and its formulations suitable for children.
Identified key barriers include:
- Bureaucratic challenges in prescribing opioids;
- Lack of adequate training among physicians and ‘morphinophobia’;
- Pharmacies declining to stock unprofitable medicines (due to low demand);
- Medication shortages in remote areas.
However, several significant advancements were made in 2023–2024:
- Prescription validity has been extended to 14 days;
- Official state seals are no longer required on prescriptions;
- Patients can now obtain medications from any pharmacy, regardless of their registered address;
- Hospitals are now required to provide a 5-day supply of pain relief medication upon discharge.
Proposed next steps:
- Abolish the legal requirement for returning used ampoules;
- Expand the range of pain relief medications available;
- Improve logistics and storage systems;
- Implement centralised procurement;
- Enhance education and awareness initiatives for healthcare professionals.
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Education: Developing Capacity for Systemic Change
Gulzhakhan Pirnazarova, Head of the Department of Nursing in Family Medicine, Kyrgyz State Medical Institute of Postgraduate Training
Gulzhakhan highlighted that since 2012, Kyrgyzstan has engaged in systematic efforts to train doctors and nurses in the fundamentals of palliative care. International modules such as EPEC and ELNEC have been adopted, internships are being organised, and national training materials are currently under development. The curricula encompass topics such as pain management, ethics, communication, caregiving, and multidisciplinary teamwork.
Educators and palliative care specialists actively participate in international conferences and seminars and attend training programmes abroad. In addition, foreign experts have visited Kyrgyzstan as consultants.
One of the primary challenges continues to be the shortage of qualified trainers and the poor coordination between the healthcare and social sectors.
Proposed next steps:
Gulzhakhan highlighted that since 2012, Kyrgyzstan has engaged in systematic efforts to train doctors and nurses in the fundamentals of palliative care. International modules such as EPEC and ELNEC have been adopted, internships are being organised, and national training materials are currently under development. The curricula encompass topics such as pain management, ethics, communication, caregiving, and multidisciplinary teamwork.
Educators and palliative care specialists actively participate in international conferences and seminars and attend training programmes abroad. In addition, foreign experts have visited Kyrgyzstan as consultants.
One of the primary challenges continues to be the shortage of qualified trainers and the poor coordination between the healthcare and social sectors.
Proposed next steps:
- Launching a new programme on ‘The Multidisciplinary Approach to Palliative Care’ for teachers, doctors, nurses, feldshers, social workers, and volunteers;
- Reviewing educational curricula every three to five years in accordance with updated protocols and guidelines;
- Expanding interactive distance-learning programmes for healthcare providers on the fundamentals of palliative care.
Children’s Hospice: A Model of Dignity-Based Care
Maral Turdumatova, Palliative Care Physician, First Children’s Hospice of Kyrgyzstan, lecturer at the Higher School of Medicine
Maral spoke about the work of Kyrgyzstan’s first children’s hospice, which opened in 2015. Today, the hospice supports over 80 children with severe, incurable conditions, providing care for children and young adults aged 0 to 20.
Aside from direct palliative care, the hospice operates several support programmes:
Systemic challenges persist, including:
Maral spoke about the work of Kyrgyzstan’s first children’s hospice, which opened in 2015. Today, the hospice supports over 80 children with severe, incurable conditions, providing care for children and young adults aged 0 to 20.
Aside from direct palliative care, the hospice operates several support programmes:
- End-of-life care;
- Home-based care;
- Training parents to provide care at home;
- Respite care allows children to stay temporarily in the hospice, providing caregivers a much-needed break;
- ‘Second Wind’—a support programme for families with children discharged home on mechanical ventilation;
- The provision of food, feeding tubes, oxygen concentrators, and other equipment;
- A support group for parents of children receiving palliative care.
Systemic challenges persist, including:
- Insufficient legal and regulatory frameworks for paediatric palliative care;
- Lack of clinical guidelines and a national registry for children in need;
- Severely restricted access to essential medicines and medical supplies;
- Chronic understaffing.
Webinar PACED
New Inpatient Unit: A Model of Collaborative Success
Edilbek Turgunbaev, Director of the Republican Rehabilitation Centre
A palliative care unit was established at the Republican Rehabilitation Centre in January 2025. The Centre collaborates closely with oncology institutions, providing ongoing medical and rehabilitation care — and, as of this year, also accepting palliative patients.
Key challenges include a shortage of trained personnel and bureaucratic obstacles in obtaining a licence to dispense opioid medications. However, with the support of the Ministry of Health and the Palliative and Hospice Care Association of Kyrgyzstan, the team has already commenced providing care to patients.
A palliative care unit was established at the Republican Rehabilitation Centre in January 2025. The Centre collaborates closely with oncology institutions, providing ongoing medical and rehabilitation care — and, as of this year, also accepting palliative patients.
Key challenges include a shortage of trained personnel and bureaucratic obstacles in obtaining a licence to dispense opioid medications. However, with the support of the Ministry of Health and the Palliative and Hospice Care Association of Kyrgyzstan, the team has already commenced providing care to patients.
Palliative Care for Individuals Experiencing Homelessness
Azamat Kubataev, Director of the Public Foundation ‘Fountain of Life’
Azamat shared a unique experience of working with vulnerable groups. Since 2003, the organisation has been supporting people who are experiencing homelessness. In 2021, it opened its own hospice with a licence to provide palliative care and dispense opioid pain medications—because public hospitals were not accepting homeless oncology patients for stays longer than seven days.
The foundation supports the most vulnerable patients, often lacking documents, housing, or family. This serves as a powerful example of sustainable, justice-based practice extending into the field of palliative care.
Azamat shared a unique experience of working with vulnerable groups. Since 2003, the organisation has been supporting people who are experiencing homelessness. In 2021, it opened its own hospice with a licence to provide palliative care and dispense opioid pain medications—because public hospitals were not accepting homeless oncology patients for stays longer than seven days.
The foundation supports the most vulnerable patients, often lacking documents, housing, or family. This serves as a powerful example of sustainable, justice-based practice extending into the field of palliative care.
Conclusion
A foundation for a sustainable palliative care system is emerging in Kyrgyzstan. Despite facing complex challenges, effective care models are already in place, a professional community is developing, significant legal changes have been made, and clear priorities have been established.
The future lies in strengthening the legal framework, expanding paediatric palliative care, improving access to pain relief, training professionals, and building partnerships. Palliative care leaders in Kyrgyzstan depend on ongoing support from public institutions and international collaboration and knowledge exchange.
The future lies in strengthening the legal framework, expanding paediatric palliative care, improving access to pain relief, training professionals, and building partnerships. Palliative care leaders in Kyrgyzstan depend on ongoing support from public institutions and international collaboration and knowledge exchange.
Summary