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Report on implementation of strategic plan of the state authority Ministry of healthcare and social development of the RK for 2014-2018

Report on implementation of strategic plan of the state authority

Ministry of healthcare and social development of the Republic of Kazakhstan

(name of the state authority - developer)

for ___2014-2018__,

(planned period)

Approved  by the order of the Ministry of healthcare and social development of the Republic of Kazakhstan

(name of the legal or statutory legal act

Based on which the strategic plan of state authority has been approved)

 

From "_5__" of   _December _ 2014_ # __299__

Period of report: 2014

 

1. Achievement of goals, objectives, target indicators,

Measures and result indicators

 

Strategic orientation 1. Strengthening of the citizens' health and decrease in the mortality level

Goal 1.1. Effective system of prevention, treatment and rehabilitation of diseases

Codes of budgetary programs aimed at achievement of this goal цели 001, 009, 010, 011, 012, 014, 015, 016, 017, 023, 104

Target indicator

Source of information

Unit of measurement

Reporting period

Reasons for failure to achieve

planned

actual

 

1

2

3

4

5

6

1. Life expectancy

Statistical data

years

71

-

 

No data (formed by the Committee of statistics in May of the current year)

2. Decrease in total mortality

Statistical data

per 1000 of population

7,62

7,65

(preliminary data)

Forecasted to be achieved (formed by the Committee of statistics in May of the current year)

3. State quality inspection (SQI) position on life expectancy

WEF data

position

100

99

Achieved

4. SQI position on infant mortality

WEF data

position

96

81

Achieved

5. SQI position on prevalence rate of tuberculosis

WEF data

position

104

102

Achieved

6. SQI position on medium length impact on the tuberculosis business

WEF data

position

110

111

Not achieved

7. SQI position on HIV prevalence rate

WEF data

Position

44

1

Achieved

8. SQI position on medium length impact on the HIV/AIDS  business

WEF data

position

74

81

Not achieved

9. SQI position on transparency of decisions made by the state authorities

WEF data

position

28

40

Not achieved

10. SQI position on favoritism in making decisions by state officials

WEF data

position

76

76

Achieved

11. SQI position on public confidence in politicians

WEF data

WEF data

34

34

Achieved

Objective 1.1.1. Improvement of approaches to prevention of diseases and formation of healthy lifestyle

Indicators of direct results

Source of information

Unit of measurement

Reporting period

Reasons for failure to achieve

planned

actual

1

2

3

4

5

6

1. Prevalence rate of tobacco smoking among population

MHSD

%

18,2

-

No data. Opinion poll will be conducted once in three years.

2. Prevalence rate of alcohol drinking among population

MHSD

%

14,0

-

No data. Opinion poll will be conducted once in three years.

3. Population coverage by screening examinations

MHSD

% of target population

70

70

Achieved

4. Annual number of socially significant projects implemented jointly with NGOs

MHSD

unit

9

9

Achieved

5. Share of the youth covered by activities of the youth health centers in proportion to total number of youth

MHSD

%

6,0

6,8

Achieved

Measures aimed at achievement of direct result indicators

Performance

1

2

1.                  Improvement and monitoring of the National screening program

Within the framework of State program of health care development "Salamatty Kazakhstan" (hereinafter – State program), for the purpose of ensuring efficiency and quality of screenings the National screening program was improved. In 2014 screenings for breast cancer, cervical cancer, colorectal cancer, prostate cancer, esophageal and gastric cancer, hepatocellular cancer was started in 5 regions (Aktobe, Atyrau, Karaganda, Kostanai and North Kazakhstan oblasts) in addition to 6 regions where these screenings are carried out since 2013. Since 2015 these screenings will be introduced throughout the republic.

Besides, currently additions are made now to the order MH RK dated November 10, 2009, #685 in part of the age categories of 18-25-30-35 excluding since 2015 from screenings for circulatory system diseases (hereinafter – CSD), and also introduction of SCORE system for CSD risk assessment to increase the concern of primary health care service.

 Besides, new screening is added to be conducted for early detection of behavioral risk factors associated with psychoactive agents' use among the 17 years and older pupils of secondary general education schools, specialized secondary and higher education institutions.

The List of the republican health care organizations responsible for the methodical management and analysis of screenings conducted for target groups of population is expanded, and also functional obligations for introduction of occupational health examination of target groups of population are identified.

Monitoring is conducted by the National center for problems of healthy lifestyle formation. Based on the monitoring results, in 2014, 7,6 million screening researches were conducted, 2,4 million people were covered, 243,4 thousand people with diseases (10,0%) were detected, efficiency of screening researches constituted 10%, for the purpose of health improvement and further care more than 230 thousand people were registered for regular medical check-up.

2.                  Strengthening of material-and-technical base of primary medical and sanitary care facilities

To implement this measure in 2014 for municipal and district clinics of 6 regions the radiological equipment (X-ray devices, photofluorography devices, stationary and mobile) were procured at the amount of KZT206,9 million.

 

3.                  Development of the social  workers' institute at the level of primary medical and sanitary care

Within the framework of State program to increase efficiency of primary health care, the services of social psychological assistance which consist of 2188 social workers and 731 psychologists are functioning since 2011,   if compared with 2013 their number increased by 3%.

4.                  Implementation of the disease management program

In 2014, according to the order MH RK dated 01.04.2013, # 211 "On implementation of the program for management of chronic noninfectious diseases (DMP) at 7 policlinics of 2 pilot regions - the North Kazakhstan and Pavlodar oblasts  DMP implementation is under way on 3 nosologies - arterial hypertension, diabetis and chronic heart failure. DMPs are based on partnership between doctor and patient the purpose of which is to create patient-oriented model with distribution of responsibility for health between the medical workers and the patient, at that the expected results are prevention of complications of chronic noninfectious diseases, decrease in expenses, increase in efficiency of medicine use.

With all DMP participants the agreements on participation in DMP are concluded, and the control sheet of the DMP participant and the patient diary are executed. Coordination Councils are created.

Coordination councils on DMP are created, in December, 2014 the first meeting where organizational issues were discussed took place. For effective implementation of measures together with the national coordinator the center work plan for 2015 is developed.

For informing the population on DMP implementation the article titled "Disease management" (of 26.11.2014 #231 (27852) was published in the Kazakhstanskaya Pravda newspaper. Work is under way.

5.                  Development and improvement of protocols of diagnostics and treatment of patients at the outpatient level

Development and revision of clinical protocols (hereinafter - CP) were conducted taking into account the main priority directions in healthcare sector, as well as the frequency of the found diseases. Orders of the MH RK approved the structures of working groups and the list of CP subjects for development and revision in 1 and 2 half-year  of 2014 (orders of the Responsible secretary of the MH RK of 09.04.2014, #177 and the order MH RK of 13.10.2014, #139).

 In 2014 within the framework of CP base improvement of the KP base 255 CPs were revised and developed.

6.   Development of mechanisms for increase in the citizens' joint responsibility for their health

To establish legislative framework for joint responsibility of citizens for their health the following norms aimed at increase of joint responsibility for health preservation of not only citizens, but also employers were  included into the draft Law of the RK "On amendments and additions to the Code of RK "On Health of Nation and Healthcare System":

1) in article 155 – no work permission for the persons having not passed through obligatory medical examinations, preventive examinations within the limits of guaranteed volume of free medical care;

2) approval of procedure for formation of joint responsibility of employers for creating conditions required to pass preventive medical examinations by persons;

3) conclusion of the contract for rendering the outpatient and polyclinic care and provision with medicines within the framework of  guaranteed volume of free medical care  between the patient and the health care facility.

Currently the draft Law is in the Senate of Parliament of the RK.

7.                  Dissemination of information-and-educational materials in the youth health centers (YHC) on aspects of healthy lifestyle and prevention of diseases

By 2014 number of the Youth health centers (hereinafter – YHC) reached 87, more than 487,0 thousand information and education materials on aspects of healthy lifestyle and prevention of diseases were disseminated among them. In total more than 298,8 thousand people applied to YHC.

Objective 1.1.2. Improvement of diagnostics, treatment and rehabilitation of the main socially important diseases and injuries

Indicators of direct results

Source of information

Unit of measurement

Reporting period

Reasons for failure to achieve

planned

actual

1

2

3

4

5

6

1. Decrease in mortality from diseases of blood circulation system

statist. data

per 100 thousand of population

205,9

168,41 (prelim. data)

Achieved, as the negative dynamics is a positive result (final data will be formed in May of the current year)

2. Decrease in mortality from cancer diseases

statist. data

per 100 thousand of population

95,8

91,79 (prelim. data)

Achieved, as the negative dynamics is a positive result (final data will be formed in May of the current year)

3. Decrease in mortality from injuries, accidents and intoxications

statist. data

per 100 thousand of population

92,1

87,86

(prelim. data)

Achieved, as the negative dynamics is a positive result (final data will be formed in May of the current year)

4. Decrease in mortality from tuberculosis

statist. data

per 100 thousand of population

5,5

4,7

(prelim. data)
 

Achieved, as the negative dynamics is a positive result (final data will be formed in May of the current year)

5. Decrease in morbidity by tuberculosis

 MHSD data

per 100 thousand of population

71,4

66,4 (prelim. data)
 

Achieved, as the negative dynamics is a positive result (final data will be formed in May of the current year)

6. Retention of HIV-infection communication in age group of 15-49 years at not more than 0,6 level

 MHSD data

%

0,6

0,168 (prelim. data)
 

Achieved, as the negative dynamics is a positive result (final data will be formed in May of the current year)

7. Increase in specific weight of malignant neoplasms detected at І-II stages

 MHSD data

%

55,1

55,4 (prelim. data)

Achieved (final data will be formed in May of the current year)

8. Increase in specific weight of 5-year survivability of the patients with malignant neoplasms

 MHSD data

%

50,6

50,2 (prelim. data)

Achievement for 99,2% (final data will be formed in May of the current year)

 

9. Decrease in suicide committing among children of 15-17 years

statist. data

100 thousand of population

17,5

16,1 (10 months, prelim. data)

Achieved, as the negative dynamics is a positive result (final data will be formed in May of the current year)

10.Lowering of indicators of primary morbidity by mental disorders and behavioral disorder

MHSD data

100 thousand of population

90,0

59,0 (prelim. data)

Achieved, as the negative dynamics is a positive result (final data will be formed in May of the current year)

11. Increase in specific weight of hospital-replacing technologies in aggregate volume of inpatient and hospital-replacing care

MHSD data

%

30

31,4

Achieved

12.Quantity of innovation medical technologies implemented into the healthcare system of the Republic of Kazakhstan

MHSD data

units

14

14

Achieved

13.Number of specialists of oncologic service who had training and retraining

In country

MHSD data

146

146

Achieved

Abroad

MHSD data

97

107

Achieved

Measures aimed at achievement of direct results  indicators

Performance

1.                  Improvement and implementation of standards for diagnostics and treatment of socially important diseases

Within the framework of improving the  diagnostics and treatment standards for socially importantt diseases, the 759 standard for organization of rendering the medical rehabilitation to population of the RK including that for socially important diseases is developed and approved by the order of the MH RK dated December 29, 2013, #759 (registered in the MJ on 29.01.2014 under #9108), iimplementation is started since 2014. The standard regulates procedure for rendering medical rehabilitation as the medical services set aimed at preservation, partial or full recovery of disordered and (or) lost functions of organisms of the patients and persons with disabilities.

Besides, the Instruction on arrangement and implementation of preventive measures for tuberculosis, schemes and modes for treatment of patients with multiple and wide medicinal resistance to tuberculosis is approved by the order MHSD dated August 22, 2014, #19 (hereinafter - M/WMR to TB).

2.                  Implementation of new standards for laboratory diagnostics

To implement new standards of laboratory diagnostics, within the framework of the World Bank project the international consultants are involved. Within this work the assessment of laboratory service state was carried out. Based on the assessment results development of the national strategic development plan of laboratory service of the RK and the guide on quality management system was started. Within the framework of this work, it is planned to create the National clinical reference-laboratory and 4 expert laboratories. In 2015 the work is continued.

3.                  Construction of the National cancer center in Astana

The term of the measure does not come yet.

 

4.                  Creation of 5 regional high-technology centers of radiation oncology with modern equipment

To equip the high-technology centers for radiation oncology in Astana, Almaty, Aktobe and Semei the modern radiological equipment (linear accelerators, computer tomographs) were procured at the amount of KZT10,4 milliard.

Currently the installation of procured equipment is carried out. Launch of these centers is planned for 1 half-year of 2015.

5.                  Creation of  simulation center and 2 centers for nuclear medicine

On the basis of scientific research institute of oncology and radiology the creation of simulation center for training of oncologic service specialists in methods of modern low-invasive surgical treatment is planned. For these purposes it was planned to procure the surgical robotized system, the areas for installation of the robotized surgical system have been prepared.

On the basis of the Semei Regional oncologic dispensary the construction of nuclear medicine corpse (PET-center of Semei) is under completion. Implementation of this project is provided by financial funds and is carried out within the framework of republican budget. Akimat of EKO in the person of Construction Department of EKO performs as the customer. Completion of the facility is planned for 2015.

On the investment offer on development and examination of the feasibility report of PET- center on the basis of KazNIIOiR in 2015 and on its construction in 2016-2017 there is a positive economic conclusion of MNE RK.

6.                  Implementation of new technology in oncology

Implementation of modern technologies proceeds. On the basis of  NIIOiR operations on breast endoprosthetic repair, voice artificial limbs and joints are performed.

One of the important directions of oncologic service development is conducting the immune-cyst-chemical research which make it possible to carry out effective medicinal therapy. In 3 created reference-centers and the pathomorphologic laboratories of oncology dispensaries for 2014 (according to preliminary data) more than 12,0 thousand researches are conducted. Within the framework of State program implementation all oncology dispensaries, since 2014, are equipped with the equipment for tele-pathology which allows to hold remote consultations with NIIOiR and the reference-centers for verification of diagnoses and definition of treatment tactics.

7.                  Training and advanced training of specialists for oncologic service in the country and abroad

Within 005 budgetary program for development of the advanced international medical technologies in 2014 on bases of the leading clinics of the foreign and neighboring countries 107 oncologic service specialists were trained in topical issues of hematology and transplantation of marrow, surgery of a backbone, low-invasive surgery at tumors of head and neck, etc. (The Czech Republic, on the basis of university hospital Motol; base of G.Russi Institute, France; Riga eastern clinical university hospital; Center for oncology and medical radiology named after N. N. Alexandrov. Minsk, Belarus, etc.); 

On the basis of "Ruđer Medikol Ciklotron d.o.o." institute (Zagreb, Croatia) 4 engineers of the Semey ROD were trained in issues concerning special ventilation maintenance and organizing the production of radiopharmaceuticals. 5 engineers of the Semey ROD were trained in the BIONT company, (Slovakia) in organizing the production of radiopharmaceuticals and maintenance of cyclotron.

 Concerning children's oncohematology the specialists were trained on the bases of university clinic "Sharite", Berlin, Germany and in Federal scientific clinical center of children's hematology, oncology and immunology, Moscow.

8.                  Implementation of modern methods of diagnostics and treatment of children suffered from cancer diseases in conformity to international standards

For the purpose of implementing the  diagnostics and treatment methods for children with oncologic diseases according to international standards, the treatment of children with oncologic pathology is carried out in 2 republican centers - RSE "Scientific center for pediatrics and children's surgery" in Almaty and JSC National Scientific Center for Motherhood and Childhood.

Jointly with the German experts 14 clinical protocols for diagnostics and treatment of oncologic diseases at children adapted for Kazakhstan are developed and approved, more than 70 medico-economic tariffs for financing of these protocols are approved.

New diagnostics methods and innovative methods of therapy, such as allogene and autologic transplantation of marrow are implemented.

Rehabilitation care of children after intensive course of chemotherapy and the supporting therapy is carried out in the Republican children's rehabilitation center "Burabai" and Republican children's sanatorium of "Ala Tau" in Almaty.

To arrange the early diagnostics of oncologic and hematologic diseases at children in 2014 more than 1,5 thousand pediatricians and general practitioners from the remote regions of the republic were trained.

 

9.                  Development of the measures aimed at social support of the patients suffered from tuberculosis

In all regions the measures aimed at social support of patients with tuberculosis are implemented. Thus, in dynamics the increase in rendering social support to patients with tuberculosis is noted. So, in 2014, in the republic for the above purposes  KZT553,6 thousand were allocated (in 2013 - 403,2), the specific weight of the budget for the social support in total financing of measures against tuberculosis increased from 1,1% in 2013 up to 1,6% in 2014.

10.              Submission of proposals on development of statutory legal acts regulating mechanisms of search and continuation of treatment for the persons released from the places of imprisonment suffered from tuberculosis with non-completed treatment

Together with the Ministry of Internal Affairs of RK the mechanism of interdepartmental interaction at release of patients with tuberculosis from correction system facilities (hereinafter – CSF) is improved. Rules for organizing the anti-tuberculosis care in correction system facilities are approved by the order of the Ministry of Internal Affairs of the RK dated August 19, 2014, #530 according to which the health service of correction system facilities beforehand (in 1 month) at release upon termination of the term of punishment and in 15 calendar days at conditionally early release informs the anti-tuberculosis organizations on the released persons. The persons released from confinement  institutions are subject to registration for regular medical check-up within 5 calendar days from the date of release.

Also, according to article 173 of the Criminal and executive code of the RK the patients released from establishment with an infectious form of tuberculosis who are constituting danger to people around and didn't complete a full course of treatment during punishment serving after release by a court decision are subject to forced treatment in the specialized anti-tuberculosis organizations at place of release.

The above statutory legal acts entered into effect since January 1, 2015.

11.              Provision of the RC reference-laboratories with  the AIDS test-systems for determining viral load at HIV-infected

In 2014 for definition of viral loading at HIV-positive people for reference-laboratories of  RC AIDS  19 sets were purchased within the State program and 73 sets through Global fund were purchased. 3707 researches were conducted.

12.              Improvement of material-and-technical base of emergency medical stations and inpatient hospitals

In 2013 within the framework of 022 budgetary program "Target current transfers to budgets of oblasts, Astana and Almaty for material-and-technical equipment of healthcare organizations at the local level" program for timely rendering medical care to population, including of the remote settlements, for emergency medical service 140 units of the sanitary motor transport were procured.

13.              Coordination and monitoring of the activities conducted by sanitary aviation services

Coordination and monitoring of sanitary aviation activities is executed by the Republican center of sanitary aviation, totally for 2014 there were 1875 departures, 1736 transportations, 140 operations on a place, 491 advisory services performed.

In total 2393 medical services are rendered to 2367 patients, including 429 women with obstetric and gynecologic pathology, to 390 children with pathology of newborns, to 538 children with pathology of children's age, to 496 patients with injuries (including to 183 victims of road accident), to 342 patients with CSD and to 171 patients with other diseases.

Changed on 20 February, 2015 - 23:57
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