The relationship between a comprehensive index of prosperity and suicide rates in former Soviet countries, including a comparison with European and Asian countries: Discussion from a new perspective.

Investigations of suicide in countries of the former Soviet Union, which broke into 15 different countries in the early 1990s, require examinations of a combination of economic, social, and health factors. It is important to address these factors individually and to examine the various composite indicators for each. Moreover, it would be worthwhile to explore the potential applicability of a comprehensive worldwide index. We analyzed data from nine of the former Soviet countries for which both the annual suicide rate and the Global Competitiveness Index (GCI) were available for the years 2006-2017. We determined the precise relationships between the suicide rate and the GCI during this period in these nine countries as well as in nine countries with high suicide rates in Europe and Asia. The results indicated the following: (i) In six of the nine former Soviet countries with complete data, the suicide rate showed a relationship with the GCI. Notably, this relationship was inverse in all but one country. (ii) Among the nine European and Asian countries with high suicide rates, three exhibited a correlation between the suicide rate and the GCI. Measures to prevent suicide should be devised especially in countries of the former Soviet Union through collaboration among multiple fields and organizations, as necessary, with particular attention paid to countries with worse or worsening GCI values.

Energy poverty in the Energy Community region: Interrogating policy formulation and coverage.

The capacity of the state to develop and implement policy at the complex nexus of energy infrastructure, social inequality and housing is indicative of the political priorities of governing structures and, by extension, the nature of statecraft more generally. We compare and contrast the energy poverty amelioration policies of two former Yugoslav and two post-Soviet states located outside the European Union, but seeking to join its regulatory sphere - Serbia, Montenegro, Ukraine and Georgia - against the background of deep and persistent patterns of domestic energy hardship. We are particularly interested in uncovering the time horizons, socio-technical systems and target constituencies of different policy measures, as well as energy sector-specific responses to the COVID-19 pandemic. We find that most states in the region have done little to address some of the more substantive challenges around improving housing quality, energy efficiency and gender inequality. However, energy poverty is present in the policy lexicon of all case study countries, and Ukraine, in particular, has advanced a number of more sophisticated approaches and programmes.

Origin and evolution of subtype B variants in the former Soviet Union countries.

Contrary to the global trend, between 2010 and 2020, an increase of 43% new HIV infections was recorded in Eastern Europe and Central Asia. Analyses of phylogenetic relationship, and routes and modes of transmission of the HIV-1 subtype B across the former Soviet Union (FSU) region are currently lacking. The objective of this analysis was to investigate the origin and transmission routes of HIV subtype B in FSU countries. We performed phylogenetic and phylodynamic analyses using 21,007 publicly available subtype B sequences from Europe and Asia, including thirteen FSU countries. Our study suggests that BFSU strain evolved more recently in FSU countries (Russia, Kyrgyzstan, Uzbekistan, Tajikistan, Belarus, Ukraine, Lithuania, Latvia, Georgia, Armenia, Azerbaijan) compared to the Western B variant in Western Europe (Austria, Belgium, Germany, Luxembourg, Netherlands, Switzerland). The primary high-risk group responsible for the transmission of subtype B was found to be MSM/homosexual. Intermixing of phylogenetic clusters among high-risk groups and bridging with the general population indicated that the HIV epidemic is no longer confined to distinct key populations - emphasizing an urgent need to improve the HIV harm-reduction efforts among high risk as well as general populations.

Cultural competence in multi-family psychoeducation groups: The experiences of Russian-speaking immigrant mothers of adults with severe mental illness.

The successful integration of cultural competence with evidence-based practices in mental health services is still limited for particular cultural populations. The current study explored culturally adapted family psychoeducation intervention for immigrants from the former Soviet Union (FSU) in Israel who care for a family member with severe mental illness (SMI). Semi-structured in-depth interviews were conducted with 18 immigrant mothers about their experience of taking part in Russian-speaking multi-family psychoeducation groups (MFPGs). Qualitative content analysis revealed five salient processes and changes that participants attributed to their engagement in the intervention: 1) from a language barrier to utilization of and satisfaction with services; 2) from a lack of information to acquiring new mental health knowledge; 3) from harboring a family secret to exposure and sharing; 4) from social isolation to cultural belonging and support; 5) from families blurring boundaries to physical and emotional separation. The results showed that these changes-linguistic, cognitive, emotional, socio-cultural and relational-improved family coping and recovery. Implications for cultural adaptation of family psychoeducation for Russian-speaking immigrants are discussed.

Exposure to Terror Attacks and Traumatization Among Immigrants From the Former Soviet Union to Israel: The Positive Effects of Bicultural Identity and Bicultural Social Support.

THE STUDY GOALS: The study examines the connection between exposure to terror attacks from the Gaza Strip, post-traumatic stress disorder (PTSD) symptoms, cultural identities, and social support among immigrants from the Former Soviet Union (FSU) to Israel. SUBJECTS: The study was conducted using a community sample of immigrants from the FSU to Israel living within a radius of 60 kilometers from the Gaza Strip (n = 601). METHOD: The study was cross-sectional and used anonymous questionnaires. The following scales were applied: the Measure of Exposure to Terrorism (Pat-Horenczyk, R., Abramovitz, R., Peled, O., Brom, D., Daie, A., & Chemtob, C. M. (2007). Adolescent exposure to recurrent terrorism in Israel: Post-traumatic distress and functional impairment. Journal of Orthopsychiatry, 77 (1), 76-85), the PTSD Checklist - Civilian Version (Weathers, F., Litz, B., Herman, D., Huska, J., & Keane, T. (1993). The PTSD checklist (PCL): Reliability, validity, and diagnostic utility. Paper presented at the ninth annual meeting of the international society for traumatic stress studies), the Social Network Interview (Mueller, D. P. (1980). Social networks: a promising direction for research on the relationship of the social environment to psychiatric disorder. Social Science &Medicine-Medical Psychology & Medical Sociology, 14A (2), 147-161), the Scale of Identification with Cultural Groups (Roccas, S. (1997). Factors affecting identification with groups: Personality, group characteristics, and interaction between them. The Hebrew University), and the Scale of Adherence to Group Cultural Practices (Birman, D., & Tyler, F. B. (1994). Acculturation and alienation of Soviet Jewish refugees in the United States. Genetic, Social, and General Psychology Monographs, 120 (1), 101-115). FINDINGS: The study results demonstrated that social support received from both the immigrant group and the larger society buffered the effect of exposure to terror attacks on PTSD symptoms among immigrants. Both components of cultural identity, identification with the group and adherence to the group's cultural practices, predicted social support received from the group. The effects were demonstrated for the support received from the immigrant group and the larger society. MAJOR IMPLICATIONS: The study results indicate that the immigrant group and the larger society may provide social support to immigrants in a stressful situation. The bicultural identity enables immigrants to receive social support from both cultural groups. Thus, the present study advances our understanding of the connection between the immigrants' bicultural identity and psychological well-being/distress. On the theoretical level, the present study advances our understanding of the immigrants' coping with the potentially traumatizing situations combining ideas of the conservation of resources (Hobfoll, S. E. (2011). Conservation of resources theory: Its implication for stress, health, and resilience. In S. Folkman (Ed.) The Oxford handbook of stress, health, and coping. Oxford University Press) and acculturation theories (Berry, J. W. (2005). Acculturation: Living successfully in two cultures. International Journal of Intercultural Relations, 29 (6), 697-712). From the practical point of view, the study results indicate that for immigrants to cope successfully with life-threatening situations, helping services must ensure the immigrants' access to the resources of both the immigrant group and the larger society and strengthen the immigrants' bicultural identity.

Immigrant generation, acculturation, and mental health literacy among former Soviet Union immigrants in Israel.

BACKGROUND: Research on Mental Health Literacy (MHL) has been growing in different geographical and cultural contexts. However, little is known about the relationship between immigrant generations, acculturation, stigma, and MHL among immigrant populations. AIMS: This study aims to examine differences in MHL among immigrant generations (first, 1.5, and second) from the former Soviet Union (FSU) in Israel and to assess whether differences are accounted for by immigration generation or acculturation. METHOD: MHL was assessed among 420 participants using a cross-sectional survey adapted from the Australian National Survey. Associations of immigrant generation, socio-demographic characteristics, and acculturation with MHL indices were examined using bivariate and multivariable analyses. RESULTS: First generation immigrants reported poorer identification of mental disorders and higher personal stigma than both 1.5- and second-generation immigrants. Acculturation was positively associated with identification of mental disorders and negatively associated with personal stigma across all immigrants' generations. When all variables were entered into a multivariate model predicting MHL indices, acculturation and gender were associated with personal stigma and only acculturation was associated with better identification of mental disorders. CONCLUSION: Differences in MHL among FSU immigrants in Israel are mainly explained by acculturation rather than by immigrant generation. Implications for policy makers and mental health professionals working with FSU immigrants are discussed.

Self-efficacy and knowledge in pediatrics among family medicine physicians in Armenia: A survey study.

Background: Armenia has trained physicians to practice family medicine (FM) for over 20 years. The pediatric population comprises a significant proportion of patients seen by FM practices, yet to date, there have been no studies assessing the knowledge and self-efficacy of FM physicians regarding pediatric care. As the first step is needs assessment to improve the quality of care, this study aims to assess the self-efficacy and knowledge of FM physicians regarding the care of pediatric patients. Materials and Methods: We distributed a survey to attendees at an FM conference in Lori Province, Armenia. The survey instrument assessed demographics and experience, self-efficacy in providing pediatric care, and pediatric knowledge via questions adapted from the American Board of Family Medicine (ABFM). Results: Eighty-seven percent of participants were female. Roughly half (45%) had trained through an FM residency program, while the remainder had retrained to become FM physicians following a residency in another field. Almost all (97%) practiced outside of the capital city, Yerevan. About half believed that their didactic (51%) and clinical education (48%) prepared them either "extremely" or "very" well. Overall, there was no clear relationship between participants' reported self-efficacy in a given area of pediatrics and their score in that area on the knowledge portion of the survey. Conclusions: Our findings reveal opportunities for improvement in knowledge related to pediatric care in FM physicians in Armenia, as well as a lack of relationship between reported self-efficacy and knowledge. Thus, future programs should not rely solely on self-reported gaps to identify or prioritize areas of focus. Further study is recommended in other specialties in Armenia and internationally to improve future programs.

Differences in health literacy domains among migrants and their descendants in Germany.

Background: Health literacy (HL) is considered to be an important precondition for health. HL research often identifies migrants as vulnerable for low HL. However, in-depth data on HL among migrants especially in its domains of health care, disease prevention and health promotion and its determinants are still scarce. Objective: The aim of this study was therefore to analyse the current status of HL among migrants and their descendants from Turkey and from the former Soviet Union (FSU) in Germany and factors associated with it. This has not been studied using large-scale data and bilingual interviews. We differentiate between dimensions of HL, namely the domains of health care, disease prevention and health promotion which goes beyond many previous studies. In addition, we explore new mechanisms by testing the explanatory power of self-efficacy and interethnic contacts for migrants' HL. Methods: The study includes 825 first- and second-generation adult migrants from two of the largest immigration groups in Germany, from Turkey and FSU, who were interviewed face-to-face in German, Turkish or Russian in late summer 2020. HL was measured using the HLS19-Q47 instrument. Age, gender, educational level, social status and financial deprivation, chronic illness, health-related literacy skills, self-efficacy, interethnic contacts, migration generation, duration of stay and region of origin were considered as possible determinants. Ordinary least square regressions were estimated. Results: The average general HL score was 65.5. HL in health promotion and disease prevention was lower than in health care. Low financial deprivation, health-related literacy skills, and self-efficacy were positively correlated with each HL domain. Educational level, social status, age, gender, duration of stay and interethnic contacts were positively correlated with HL in some domains. Region of origin was only correlated with the domain of disease prevention until interethnic contact was accounted for. Conclusion: Our study contributes to the existing knowledge by analyzing different domains of HL and testing its correlations with self-efficacy and interethnic contact among migrants. We reveal that migrants cannot generally be considered as vulnerable for low HL, as oftentimes outlined. There is a need for interventions e.g. to enhance the understanding of health information among subgroups with lower HL.

Native and immigrant social workers working with immigrants: Appraisal of the immigrant group, acculturation orientations and burnout.

The present study investigates the effects of group appraisal and acculturation orientations on burnout of social workers working with immigrants. The study is based on the Threat-Benefit and the Acculturation Theories. The proposed theoretical model was tested in a sample of social workers working with immigrants from the Former Soviet Union (FSU) in Israel (n = 313). Amongst the study participants, 254 were Israeli born, and 59 were immigrants from the FSU. The results demonstrated that social workers' acculturation orientations mediate the connection between the appraisal of the immigrant group and the social workers' burnout when working with immigrants from this group. Specifically, appraisal of immigrants as beneficial for the receiving society was associated with a stronger orientation towards preserving the immigrant culture (ß = 0.22). On the other hand, appraisal of immigrants as threatening the receiving society was associated with a weaker orientation towards preserving the immigrant culture (ß = -0.21) and with a stronger orientation towards acquiring the majority culture by immigrants (ß = 0.12). A stronger acculturation orientation related to preserving the immigrant culture was associated with a lower level of burnout (ß = -0.13) and a higher sense of personal accomplishments of social workers working with immigrants (ß = 0.20). Immigrant social workers, compared to their native colleagues, reported a higher level of personal accomplishment (M[SD]IM  = 5.08[1.24] vs. M[SD]IS  = 4.21[1.39]) but also a higher level of burnout working with immigrant clients (M[SD]IM  = 1.88[0.83] vs. M[SD]IS  = 1.60[0.63]). The main conclusion following the present study relates to the importance of developing a positive appraisal of immigrants and accepting the immigrant culture for successful work with immigrants.

Health literacy in former Soviet Union immigrants in the US: A mixed methods study.

BACKGROUND: People with limited health literacy may have trouble finding, understanding, and using health-related information and services and navigating the healthcare system. PURPOSE: The purpose of this study was to assess the health literacy of immigrants from the former Soviet Union (FSU) using the Health Literacy Survey (HLS19-Q12 in Russian) and explore associated socio-demographic factors. METHOD: This mixed methods study recruited adult immigrants through social networks and social media and included data from online survey and follow-up interviews. Variance in health literacy was explained using multiple linear regression. Qualitative data were analyzed through modified Grounded Theory approach. FINDINGS: Survey respondents (n = 318) were primarily female college-educated FSU immigrants aged 20-74 from 14 of the 15 FSU countries and distributed across 33 US states. Forty percent scored at or below predefined cut-offs for inadequate or problematic health literacy levels. Social status, social support, and English proficiency were significant variables in explaining variance in health literacy scores while controlling for age, gender, and education. Interviews (n = 24) identified eight themes: English proficiency, social support, health insurance, experience with health care, complexity of the US healthcare system, relevant health information, health beliefs/practices, and trust. DISCUSSION: There is a need to distribute health-related information in the native language (e.g., Russian), potentially through social media and immigrants' social networks. Health providers should be aware of the prevalence of inadequate and problematic health literacy among FSU immigrants and consider associated social factors.

In the Shadows of Others: Unheard Voices of Older Russian Immigrant Women in the United States.

Older post-Soviet immigrants in the U.S. have been largely overlooked by research despite their unique experience of having lived in a totalitarian regime until middle age, only to find their lives profoundly altered after its fall. Our qualitative study examined the experiences and caregiving expectations of 16 older post-Soviet immigrant women (mean age = 74.5 years, SD =5.8) through in-depth, face-to-face interviews. Data analysis revealed four themes: broken family ties, happiness in the little things that money can buy, intergenerational comparison, and a nursing home is not an option. Overall, our findings emphasize immigration as an important life course event, with profound implications to one's social position, familial ties, employment opportunities contributes to a deeper understanding of how historical context shapes the aging experiences and intergenerational relationships.

Real Exchange Rate Misalignments and Currency Crises in the Former Soviet Union Countries.

The paper explores the utility of real exchange rate misalignments from their equilibrium for identification of currency crises in the former Soviet Union countries. We estimate equilibrium exchange rates for 10 former Soviet Republics employing behavioural equilibrium exchange rate (BEER) and natural real exchange rate (NATREX) concepts and pooled mean group estimator. Subsequently, we compare the estimated misalignments before, during and after the currency crisis episodes and regress the misalignments on crisis-related variables. The results indicate that the misalignments tended to increase before the crises and visibly reduced after, thus serving as potentially viable predictors of such events.

Barriers to Colorectal Cancer Screening Among Russian-speaking Immigrants: The Importance of Culture and Home Country Experiences.

There is potential to improve low colorectal cancer screening rates, reduce mortality, and narrow health disparities, if the distinctive screening barriers among Russian-speaking immigrants were better understood. However, there is little relevant research about the topic. To address this gap, this study aimed to identify barriers to timely colorectal cancer screening, especially colonoscopies, among Russian-speakers in New York City. Thirteen key informant interviews were performed with providers, community leaders, and academics. Eight focus groups were then conducted with 81 Russian-speaking individuals, age 50-75, who had not had a timely colonoscopy. Results were translated, transcribed, coded and analyzed. Barriers identified included individual, communal, and structural issues. Distinctive barriers, such as those related to culture and to the experiences of living under the Soviet system, were uncovered. Barriers identified can potentially be reduced through interventions suggested by the research, including more education and more effective provider recommendations.

Immigrant Caregivers: The Double Burden Experience of Immigrants Caring for a Family Member With Severe Mental Illness.

The aim of this study is to examine the factors that shape the burden experience among immigrants caring for a family member with severe mental illness. In-depth semi-structured interviews were conducted with 32 immigrant caregivers from the former Soviet Union in Israel. The interviews were analyzed using qualitative content analysis. The participants described their burden as an accumulation of economic, linguistic, social, emotional, and health-related adversities that negatively affect their coping and adaptation on the personal and familial level. The results showed that the objective and subjective burdens they experience include dimensions pertaining to their role as family caregivers, dimensions pertaining to their immigrant status, and the circular interaction between these two, which intensifies the overall experience of burden. The study proposes a new term-the "double adaptation burden"-that can help promote the design of research, interventions, and policies suited to the multiple challenges of immigrant caregivers.

[Beginning of foreign exchange of acupuncture-moxibustion in New China: the whole story of the experts from the former Soviet Union studying acupuncture-moxibustion in China in 1956].

Through checking the archives from China Academy of Chinese Medical Sciences (CACMS), the event that the experts from the former Soviet Union visiting China and learning acupuncture-moxibustion in 1956 was sorted out. In 1956, under the framework of Sino-Sovien Agreement on Scientific and Technology Cooperation, 3 medical experts assigned by the former Soviet Union came to China for the investigation and study of acupuncture-moxibustion. Institute of Acupuncture and Moxibustion, CACMS was in charge of this activity at that time. The Institute had developed a detailed plan, in which, the teaching schedule was designed on the base of New Acupuncture and Moxibustion written by ZHU Lian and ZHU Lian herself gave the lecture. After 3-month study, the experts had mastered the basic theory and clinical techniques of acupuncture-moxibustion and had launched the relevant clinical and scientific work of acupuncture-moxibustion successfully after returning to their country. This event opens up the foreign exchange of acupuncture-moxibustion in New China and provides the foundation for international training and higher education of acupuncture-moxibustion thereafter.

Projecting the global impact of fossil fuel production from the Former Soviet Union.

Detailed projections of the Former Soviet Union (FSU) fossil fuel production has been created. Russian production has been modelled at the region (oblast) level where possible. The projections were made using the Geologic Resource Supply-Demand Model (GeRS-DeMo). Low, Best Guess and High scenarios were created. FSU fossil fuels are projected to peak between 2027 and 2087 with the range due to spread of Ultimately Recoverable Resources (URR) values used. The Best Guess (BG) scenario anticipates FSU will peak in 2087 with production over 170 EJ per year. The FSU projections were combined with rest of the world projections (Mohr et al. 2015b), the emissions from the High scenario for the world are similar to the IPCC A1 AIM scenario. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40789-021-00449-x.

Colorectal Cancer among Resettlers from the Former Soviet Union and in the General German Population: Clinical and Pathological Characteristics and Trends.

This study examined time trends and clinical and pathological characteristics of colorectal cancer (CRC) among ethnic German migrants from the Former Soviet Union (resettlers) and the general German population. Incidence data from two population-based cancer registries were used to analyze CRC as age-standardized rates (ASRs) over time. The respective general populations and resettler cohorts were used to calculate standardized incidence ratios (SIRs) by time-period (before and after the introduction of screening colonoscopy in 2002), tumor location, histologic type, grade, and stage at diagnosis. Additionally, SIRs were modeled with Poisson regression to depict time trends. During the study period from 1990 to 2013, the general populations showed a yearly increase of ASR, but for age above 55, truncated ASR started to decline after 2002. Among resettlers, 229 CRC cases were observed, resulting in a lowered incidence for all clinical and pathological characteristics compared to the general population (overall SIR: 0.78, 95% CI 0.68-0.89). Regression analysis revealed an increasing SIR trend after 2002. Population-wide CRC incidence decreases after the introduction of screening colonoscopy. In contrast the lowered CRC incidence among resettlers is attenuating to the general population after 2002, suggesting that resettlers do not benefit equally from screening colonoscopy.

Alcohol control policies in Former Soviet Union countries: A narrative review of three decades of policy changes and their apparent effects.

ISSUES: The last Soviet anti-alcohol campaign of 1985 resulted in considerably reduced alcohol consumption and saved thousands of lives. But once the campaign's policies were abandoned and the Soviet alcohol monopoly broken up, a steep rise in mortality was observed in many of the newly formed successor countries, although some kept their monopolies. Almost 30 years after the campaign's end, the region faces diverse challenges in relation to alcohol. APPROACH: The present narrative review sheds light on recent drinking trends and alcohol policy developments in the 15 Former Soviet Union (FSU) countries, highlighting the most important setbacks, achievements and best practices. Vignettes of alcohol control policies in Belarus, Estonia, Kazakhstan, Lithuania and Uzbekistan are presented to illustrate the recent developments. KEY FINDINGS: Over the past decade, drinking levels have declined in almost all FSU countries, paralleled by the introduction of various alcohol-control measures. The so-called three 'best buys' put forward by the World Health Organization to reduce alcohol-attributable burden (taxation and other measures to increase price, restrictions on alcohol availability and marketing) are relatively well implemented across the countries. IMPLICATIONS: In recent years, evidence-based alcohol policies have been actively implemented as a response to the enormous alcohol-attributable burden in many of the countries, although there is big variance across and within different jurisdictions. CONCLUSION: Strong declines in alcohol consumption were observed in the 15 FSU countries, which have introduced various alcohol control measures in recent years, resulting in a reduction of alcohol consumption in the World Health Organization European region overall.

The Incidence of Intestinal Gastric Cancer among Resettlers in Germany-Do Resettlers Remain at an Elevated Risk in Comparison to the General Population?

OBJECTIVE: Previous studies have shown that the incidence of gastric cancer (GC), and particularly intestinal GC, is higher among resettlers from the former Soviet Union (FSU) than in the general German population. Our aim was to investigate if the higher risk remains over time. METHODS: GC cases between 1994 and 2013, in a cohort of 32,972 resettlers, were identified by the respective federal cancer registry. Age-standardized rates (ASRs) and standardized incidence ratios (SIRs) were analyzed in comparison to the general population for GC subtypes according to the Laurén classification. Additionally, the cohort was pooled with data from a second resettler cohort from Saarland to investigate time trends using negative binomial regression. RESULTS: The incidence of intestinal GC was elevated among resettlers in comparison to the general population (SIR (men) 1.64, 95% CI: 1.09-2.37; SIR (women) 1.91, 95% CI: 1.15-2.98). The analysis with the pooled data confirmed an elevated SIR, which was stable over time. CONCLUSION: Resettlers' higher risk of developing intestinal GC does not attenuate towards the incidence in the general German population. Dietary and lifestyle patterns might amplify the risk of GC, and we believe that further investigation of risk behaviors is needed to better understand the development of disease pattern among migrants.

Keys to Expanding the Rural Healthcare Workforce in Kyrgyzstan.

Objective/Background: This study assessed Kyrgyzstan's progress with developing its rural primary care workforce and prioritized next steps to build on its current momentum. Kyrgyzstan has improved rural health care since 1997 through the implementation of family medicine, retraining of rural doctors and nurses, and other efforts. Attrition, emigration, urbanization, and population growth are threatening these hard-won advances. In response, Kyrgyzstan is now educating family medicine residents at rural sites and improving salaries. This study explores other steps to strengthen its rural health care, especially its rural generalists. Methods: This was an observational study using a two-phase survey process. To access the current status of Kyrgyzstan's rural health care system, we surveyed key stakeholders within that system using a draft version of the new World Health Organization Rural Pathways Checklist. To prioritize next steps, we asked rural FM residents to rank the relative importance of 31 possible future actions to support Kyrgyzstan's rural primary care workers. Results: Doctors and nurses involved in teaching rural health workers identified that Kyrgyzstan has made good progress with rural professional support and upskilling of existing health workers through education. They saw the least progress with selection of health workers and monitoring. The rural family medicine residents' top ten suggestions for rural recruitment and retention all involved improving working conditions (providing housing, internet, basic medical equipment, protected time off, better salaries, and more respect) and improving clinic efficiency (switching clinic scheduling from walk-in based to appointment based, optimizing the roles of clinical team members, and decreasing low-value clinic visits). Conclusions: The WHO Rural Pathways Checklist helped to evaluate Kyrgyzstan's current efforts to promote rural primary care. The priorities listed above from the next generation of potential rural family doctors could help guide future steps to promote rural health in Kyrgyzstan and the Former Soviet Union.