![]() ![]() Testing exists, but quality is uncertain. Poor people do not have even this poor option. ![]() It is common in the CARs, for example, for people in cities with financial means to “laboratory shop” by visiting multiple laboratories, comparing conflicting results in an attempt to decipher what might be correct results. It is often thought that ex-Soviet health care systems are near-equivalents of Western systems…they are not. Valid laboratory results are also necessary for rapid detection and control of outbreaks of infectious diseases and other public health threats at their source and therefore essential for global health security but valid test results can be elusive. The appropriate diagnosis and then management of illness requires valid test results. Based on these trends, quality management of clinical laboratories – including the management of equipment – will require attention at the local level, which is the model used for laboratories in developed countries and one espoused for health care systems by the World Health Organization European Office as it assists countries in the former Soviet Union. The delivery of laboratory services to neglected rural populations requires additional decentralization. In these dynamic societies, diagnostic services for patients will increasingly need to occur in local, non-specialized laboratories based in hospitals or clinics. Health care systems are changing but the traditional laboratory structures have operated from a centralized, national level, with oversight of service quality generally conducted by national ministries of health. ![]() Although overall population density is low, many men have left - to work in Russia or elsewhere, leaving villages without men poverty by national standards is widespread in all countries, particularly in rural areas health care systems are poor and a growing percentage of the population is moving to cities to escape poverty and adopting Western lifestyles and diets, creating new health challenges. Challenges involve governance - as authority has transitioned from highly standardized Soviet bureaucracies to more independent political structures at regional, national, provincial and local levels – and demographic. These countries – Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan – have faced enormous challenges in establishing and stabilizing their institutions since attaining independence in 1991, following the dissolution of the Soviet Union. At the crossroads between Europe and Asia, the Central Asia Republics (CARs) have received increased (but insufficient) attention from the international community due to the political and economic significance of the region. ![]()
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