Rights and responsibilities: Women leadership for health in Kyrgyzstan.

The World Health Organization (WHO) is committed to empowering countries by implementing a gender, equity, and human rights approach in the health sector. The objective of this gender and inclusion analysis is to assess potential gender disparities of health sector management in the Kyrgyz Republic. The employed mixed-method approach takes advantage of data triangulation. Besides information from the literature and policy documents available at the international and national levels, the analysis includes interviews and data from the self-assessment of health services managers in the Kyrgyz Republic. A convenience sample of 75 health managers was taken and after up to three reminders a commendable response rate of 80% was achieved which resulted the final sample size of N = 60. A factor analysis using quartimax orthogonal rotation was applied to investigate the correlation between Teaching Qualification, Digitalization, Training Usefulness, Computer Workplace, and Gender Equality. In 2021, the Kyrgyz Republic adopted a new Constitution, which provides a sound legal framework to support gender equality and promote women's empowerment. However, according to a survey, only 42.9% of the respondents felt that equal rights and opportunities were integrated into their job descriptions. Similarly, only 40.7% believed that their institutions' written documents reflected a commitment to equal rights and opportunities for both genders. Two factors were identified as influencing gender equality: (1) personal and (2) technical aspects. Regarding personal aspects, gender equality, teaching qualification, and training usefulness were found to be significant. Regarding technical aspects, the computer workplace was related. In recent years, the Kyrgyz Republic has been developing a culture of gender equality. Political will is essential to promote and make organizational change possible. It is important to create a written mid-term policy that affirms a commitment to gender equality in organizational behavior, structures, staff, and management board compositions. Healthcare institutions need to prepare strategic and operational plans that incorporate gender equality principles.

Armenia: health system review

The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. Since independence, the health system in Armenia has undergone numerous changes that have effectively transformed a centrally run state system into a fragmented one that is largely financed from out-of-pocket payments. The population, especially those in need, meet with limited access to health services, and those services which are available are often of questionable quality, as health care standards and quality assessment systems are absent. Drugs on the essential drugs list are generally not affordable to those in need. Many health facilities, especially in rural areas, lack modern medical technology and what is available is not distributed efficiently. The commitment to free health care thus remains more declarative than factual, as informal payments are still expected in many cases. Despite significant investments in primary care, a disproportionate share of resources has been invested in secondary and tertiary care. Nevertheless, Armenia is increasingly engaged in reforming the system from one that emphasizes the treatment of diseases and response to epidemics towards a system that emphasizes prevention, family care and community participation. The shift towards a primary care orientation is noticeable, with gradually increased roles for health workers to influence the determinants of health.