In Naryn region, one of Kyrgyzstan’s most remote areas, up to 50 percent of women newly diagnosed with breast cancer in 2021-2022 did not survive beyond their first year, according to analysis by the Republican Centre for Health Promotion.

By contrast, the World Health Organization’s Global Breast Cancer Initiative notes that five-year survival exceeds 90 percent in high-income countries, where screening and timely treatment are widely available. In lower-income settings, survival is often far lower, reflecting late detection and limited access to care.

“Many women delay getting checked,” says Aida Sultangazieva, an epidemiologist and Head of the Non-Communicable Disease Prevention Department at the Republican Centre for Health Promotion. “When information is limited and services feel far away, they often put things off, even when they feel something is wrong.”

“Primary health care is usually the first place they turn to,” she adds, “but in remote areas, getting referred on can take time, and that delays diagnosis.”

Launched in 2020, the six-year Foundations for Health and Empowerment (F4HE) programme, funded by the Aga Khan Foundation and implemented by Aga Khan Health Services in the Kyrgyz Republic, has worked with national institutions to support community outreach, screening, telemedicine consultations and psychological support in selected districts of the Naryn, Jalal-Abad and Osh regions.

“What matters most is timing,” says Aida. “When women come earlier, we can explain what’s happening and help them move to the next step.”

Early detection begins with awareness

In 2024, community information sessions in the At-Bashy and Ak-Tal districts of Naryn region helped women recognise early signs of breast cancer and pathways to care.

Primary healthcare workers and volunteers from village health committees were trained to support women through the screening process, while district administrations helped organise screening days during working hours so that women could attend without losing income or family support.

Women who took part received personal examination cards, providing a clear record of results and recommended follow-up. For health workers, the cards made it easier to track cases over time; for women, they offered clarity about next steps.

Weekly telemedicine consultations linked rural primary-care facilities with oncologists at the National Centre of Oncology in Bishkek. During these sessions, local doctors presented suspected cases, reviewed symptoms and examination findings, and agreed on whether a woman needed referral to a specialist centre or could continue observation and treatment closer to home.

By the end of 2024, more than 6,000 women had been screened across the two districts, leading to referrals for further diagnostic assessment, including confirmed cases of breast cancer.

Expanding reach and addressing stigma

The approach first tested in Naryn was extended to the Aksy and Ala-Buka districts of Jalal-Abad region, while outreach continued in Osh region, including Alai, Chon-Alai and Kara-Kulja districts. As the work expanded to additional districts, screening coverage increased. By the end of 2025, more than 40,000 women had been screened across the three regions, with those requiring further examination referred to regional and national oncology centres.

Health teams also began reaching out to men, as women often needed their support to attend screening. In many families, decisions about time, travel and household responsibilities shape whether women are able to seek care.

Yet awareness alone was not always enough to overcome deeply rooted fears and beliefs. Some women avoided hospitals altogether, while others believed that prayer or traditional remedies alone would heal them.

“For many women, cancer is still perceived as a death sentence,” explains Elmira Ibraeva, Head of Psychological Support at the Dem Psychological Support Centre. “There is shock, denial and fear of treatment.”

“Some older women say, ‘I have lived my life,’ and refuse chemotherapy,” she says.

Hesitation did not always mean refusal. Some women initially delayed follow-up, returning weeks or months later with questions, while others came back accompanied by family members after discussing their concerns at home.

Women facing a suspected or confirmed cancer diagnosis were offered counselling, including one-on-one and group sessions, providing space to ask questions, share concerns and talk through treatment options. Family members also received counselling to help them understand the diagnosis and learn how best to support women through treatment and recovery.