Tag: health surveillance

New Report: Analysis of the capacity of the healthcare system of the Kyrgyz Republic to monitor lead concentrations

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To analyze the capacity of the healthcare system of the Kyrgyz Republic to monitor the concentrations of lead and other heavy metals in blood, urine and other media and existing regulatory legal acts as well as to provide recommendations for changes. The study was conducted in coordination with international project experts and using questionnaires developed by them.

Analysis of the capacity of the healthcare system of the Kyrgyz Republic to monitor lead concentrations (Desk review report) was prepared for the project Strengthening Health Systems to Reduce Lead Exposure. This report serves to justify the project and to inform decision-makers about the subsequent implementation of monitoring lead levels in children’s blood and determining priority actions to establish a sustainable monitoring, prevention, and treatment system for heavy metal poisoning, including lead.

Lead is a toxic element that even in small concentrations can have serious negative effects on human health, especially vulnerable groups such as children. Research indicates that exposure to lead can lead to developmental delays, reduced cognitive abilities, behavioral problems, and other adverse health outcomes (Lanphear et al., 2005; Canfield et al., 2003). However, despite the well-known risks associated with lead, many countries, including Kyrgyzstan, lack comprehensive monitoring and prevention programs for lead poisoning, particularly among children. This is due to insufficient data on the scale of the problem at the national level and a lack of awareness among the population and decision-makers about the importance and urgency of this issue.

Conducting this study will help fill the gaps in knowledge regarding current levels of lead in children’s blood in Kyrgyzstan and identify the main sources and pathways of lead exposure in children. The data obtained will serve as a basis for developing targeted public health programs aimed at reducing lead exposure and preventing its negative health consequences for children. This, in turn, will contribute to improving quality of life, reducing
healthcare costs, and enhancing public well-being.

To conduct monitoring of lead and other heavy metals concentrations in blood, urine, and other mediums, and to determine priority actions and effectively utilize existing resources, a situational analysis of the healthcare system’s potential in the Kyrgyz Republic was conducted.

Acknowledgements

We are grateful to the Ministry of Health, the Ministry of Natural Resources, Ecology, and Technical Supervision of the Kyrgyz Republic, as well as to the staff of centers and laboratories, including private ones, for their active support in conducting the assessment of the healthcare system’s potential in the Kyrgyz Republic for monitoring the concentration of lead and other heavy metals in blood.

The funder had no role in the capacity inventory design, data collection, analysis, and report preparation.

AUTHORS

  • Ainash Sharshenova, Doctor of Medical Sciences, Professor, International School of
  • Medicine, International University of Kyrgyzstan
  • Indira Zhakipova, Civil Society Association ECOIS-BISHKEK
  • Kubanych Almerekov, Civil Society Association ECOIS-BISHKEK
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Indonesia: Collaboration + Synergy = The Key

“The Strengthening Health System to Reduce Lead Exposure” Program in Indonesia

For non-profit organizations, collaboration is crucial in reaching organizational goals and creating a positive impact on the communities. In addition, synergy can make combined efforts accomplish more. Pure Earth has been partnering with governments, communities and industry leaders to identify and implement solutions in order to stop toxic exposures, protect health, and restore environments. The organization – collaborating with various global and local stakeholders – also specifically works to sustainably address the root causes of lead and mercury pollution.

In regards to health surveillance, conducting baseline Blood Lead Level (BLL) testing and analysis is crucial to understand prevalence, severity and sources of lead exposure. In 2023, with a grant from Takeda Pharmaceutical Limited (Takeda), Pure Earth launched “Strengthening Health Systems to Reduce Lead Exposure” program, a partnership between Pure Earth, Vital Strategies, and the Ministries of Health in Colombia, Indonesia, Kyrgyzstan, Maharashtra, India, and Peru to strengthen each country’s national healthcare system to better prevent, identify, and treat lead exposure.

Started in April 2024 until present, Yayasan Pure Earth Indonesia (PE Indonesia) and Vital Strategies (VS) have been in discussion with the Ministry of Health (MOH) of the Republic of Indonesia in designing and implementing the new national program to identify, monitor and reduce lead exposure. The working plan is still being developed together by the working team. Quite many inputs came up from the members of the working team, which consists of members from various institutions, including PE Indonesia, VS and directorates (Dit) under MOH, such as Environmental Health as the Coordinator, Public Health Governance (Takelkesmas), Center for Health Development Policy (BKPK), Data and Information Center (Pusdatin), as well as cross-sectoral government agencies, i.e. Central Bureau of Statistics (BPS) and many more. The last technical coordination meeting was just held on June 24, 2024, where small group meetings will be carried out to finalize and agree on the working plan.

Surveillance as one of the instruments in public health has a role in producing information from the data collected, hence stakeholders can determine effective and efficient policies (Groseclose, 2017). BLL Surveillance (SKTD) is expected to be a tool in monitoring children’s BLL nationally in Indonesia, so that policies in controlling lead exposure can be established effectively.

In the context of the implementation of the “Strengthening Health System to Reduce Lead Exposure” program, SKTD piloting activities will be carried out to obtain data on the prevalence of BLL in Indonesian children as reference material in efforts to strengthen the health system in Indonesia. The piloting activity will be carried out in two stages, the first phase of which is planned to be carried out in the second semester of 2024 with the aim of monitoring BLL in children in Indonesia and understanding the increasing prevalence of BLL in children, evaluating the capacity of existing resources, and testing the feasibility of implementing national BLL. Meanwhile, the second phase is planned to be implemented in 2026 with the aim of initiating the integration of SKTD into periodic active surveillance.

New Report: Childhood Lead Exposure Prevention: Assessment of Blood Lead Surveillance Capacity in Maharashtra, India

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As an essential step toward establishing such a system at the state level in Maharashtra, we conducted a capacity assessment to evaluate existing laboratory capacity and health system structure and provide recommendations for capacity strengthening and surveillance options best suited for Maharashtra. This capacity assessment report evaluated the policy landscape, public health infrastructure laboratory capacity to initiate and support a statewide childhood lead surveillance system, which will be fulfilled in close collaboration with the Public Health Department (PHD), Government of Maharashtra.

Preventing exposure to lead (Pb) is particularly important for health, because neurological and behavioral impacts caused by lead exposure among children are generally irreversible. Blood lead surveillance is a critical component of a comprehensive lead poisoning prevention program, as effective and comprehensive prevention begins with information obtained from surveillance. Unfortunately, at present, very few countries in Asia have established blood lead surveillance due to a lack of awareness and resources.

In India, a recent National Institution for Transforming India (NITI) Aayog—Council of Scientific and Industrial Research (CSIR) report has highlighted the importance of establishing blood lead surveillance that can generate high-quality local data to help understand lead exposure and health burden among Indian children. This may be implemented effectively at the state level, starting in states including Maharashtra, where there is demonstrated government commitment to addressing environmental health issues. Statewide childhood blood
lead surveillance typically involves monitoring blood lead levels (BLLs) among children and collecting other information that may indicate risks and sources of lead exposure.

Acknowledgements

Vital Strategies and Pure Earth gratefully acknowledge the support of the Public Health
Department of the Government of Maharashtra in this assessment. Commissioner of Health Services cum Mission Director National Health Mission gave his input and connected us with concerned senior health officials. We thank the officials from the State Family Welfare Bureau, State Health Systems Resource Centre, State Surveillance Unit, and State Public Health Laboratory for providing us with valuable insights who work under the leadership of the Director of Health Services. The assessment was made possible by the generous support received from Takeda Pharmaceuticals.

Contributors:

  • Yatin Pimplé, Vital Strategies
  • Yi Lu, Vital Strategies
  • Sumi Mehta, Vital Strategies
  • Dan Kass, Vital Strategies
  • Lavanya Nambiar, Pure Earth
  • Debanjana Choudhari, Pure Earth

The views expressed in this report are those of the contributors and do not necessarily reflect
those of the funders or the Public Health Department of the Government of Maharashtra.

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