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Speech by Vice-Minister of health and social development of Kazakhstan, Tsoi A.V. on the briefing on "the Best traditions of national health – the result of successful work of health care workers" on 16 June 2016 in CCS

Dear participants of the briefing!

All the reforms of the sector the last years are inextricably linked with the initiatives of the Leader of the nation. Health is one of the most sensitive indicators of economic development of the country, and expenditure on health care is, first of all, investments that bring economic returns.

The Message to the people of Kazakhstan in 2014 "Strategy "Kazakhstan-2050": new political course of the established state" the Head of state put before the healthcare industry's ambitious goals is:

- increase the duration of life in Kazakhstan to 80 years and above;

- Kazakhstan should become one of the leading Eurasian centers of medical tourism.

The President's instructions were reflected in the policy documents of the industry. In 2015 completed implementation of the State program of healthcare development of the Republic of Kazakhstan "Salamatty Kazakhstan" for 2011-2015.

Its main achievements were the increase in life expectancy of the Kazakhstanis to 3.6 years compared with 2010 and by the end of 2015 amounted to 72 years (2010 – 68,41).

Improved the basic health indicators of the population. Was almost 2.0 times (1.8) to reduce maternal and infant mortality is 16.2% of the total mortality. Mortality from malignant neoplasms decreased by 15.4%, from tuberculosis – by 2.8 times.

I want to emphasize that these results were possible thanks to the joint efforts of state bodies, business structures and the public.

The activities of state bodies for the protection of health coordinates the national coordination Council under the Government. Since 2011 it is headed by the supervising Deputy Prime Minister, on the ground created similar councils if Deputy Akims of regions.

To ensure a healthy diet together with the Ministries of agriculture, education and science, culture and sports and local Executive bodies in the schools implemented a project to provide children with food, food products, enriched with vitamin mineral complex.

With the aim of reducing road traffic injuries in collaboration with the Ministry of internal Affairs (emergency Committee) established in the office of transport medicine is air ambulances, medical and rescue points.

40 EN-route medical and rescue points created on the most dangerous sites of roads of Republican significance, for 5 years, done about 4 thousand visits to traffic accidents, provided medical assistance to more than 12 thousand victims, including more than 800 children.

The air ambulance service for 5 years implemented more than 6,7 thousand flights in regions with heavy patients. Transported about 6 thousand patients for health reasons, conducted more than 500 operations on site. At the same time, from 8.5 thousand saved patients more than 1.6 million women, including pregnant and new mothers, and more than 3 thousand children.

The result of the measures taken during the implementation of the state Program the death rate from accidents and traumas declined by 18.9 %.

Stable sanitary-epidemiological situation. In 2014, the world health organization recognized the country free of polio and malaria.

Jointly with local Executive bodies created by service of a healthy lifestyle. On the basis of primary health care organizations created more than 3.5 thousand specialized health schools, 101 anti-Smoking centre, 87 youth centers of health.

For development of preventive medicine implemented a national screening program, which aims to identify diseases, primarily cancer (breast cancer, cervical cancer, colorectal cancer, cancer of the esophagus and stomach, liver cancer, prostate cancer, glaucoma, hepatitis b and C, BSC,). This year the program covered about 2 million people.

Established socio-psychological assistance, including more than 2.1 thousand social workers and more than 800 psychologists.

To reduce queues to regional practitioners, and strengthening the preventive work in primary health care organizations introduced the additional posts of nurses. The General practitioner on the plot are 3 nurses at the local therapist and pediatrician – 2 (total in the country in primary health care organizations work 6900 2-d and 3 nurses). Delegated some powers of local doctors to average workers (the writing of free recipes, inspection of dispensary patients, etc.)

Since 2010 in the framework of the Unified national health system (hereinafter ), implemented the principle of "free choice of hospital", develops healthy competition among suppliers of SBP, which positively affects the quality of medical services. The share of private suppliers SBP at the end of 2015 amounted to about 30%, up to 2010 they were one.

Stable funding and new payment methods become the starting mechanism of development of the country has a high and unique technologies, implemented at the international level.

Every year the country hosts over 75 thousand cardiac surgeries. Opened 40 stroke centers, which provide skilled care to patients with acute violation of cerebral circulation, one of the serious complications leading to mortality and disability. The introduction of advanced technologies have significantly reduced the level of morbidity and mortality from cardiovascular disease. As a result, the mortality from circulatory diseases over the last 5 years has decreased to 2.0 times.

Actively developing transplantation of organs and tissues. Over the past 5 years conducted more than 700 organ transplants (heart, lung, liver, pancreas).

Kazakhstan is among 22 countries that carry out unique, high-tech surgery to implant the device mechanical circulatory support (LVAD – Left Ventricular Assist Device), the National research cardiac surgery center. Here is a heart transplant. Over the past 4 years (2012-2015) held on 28 transplants the donor heart.

For each of these operations saved the lives of the young, able-bodied people, improving their quality of life.

Research centers and national clinics pass on their experience to the regions. Today, of the 130 clinics that provide high-tech help, the 80 is a regional hospital. Because of this, citizens living in remote regions, receive the assistance in the field, not leaving in the Republican hospital.

We have focused our efforts on the fight against cancer. Along with the introduction of screenings for the early detection of cancer, allocated significant funds for the provision of chemotherapy in accordance with the needs. Strengthened material-technical base of oncological hospitals, purchased expensive equipment. Created 5 high-tech centers of radiation Oncology.

Much remains to be done in this direction. Here we involve foreign partners. Together with them the planned creation of a National scientific cancer centre in Astana, meeting the modern requirements, where cancer patients can receive free professional help. It is no secret that today our citizens are suffering from cancer, and in some cases go for treatment in foreign clinics.

In 2014, measures were taken to reduce the inequality in financing of outpatient care between regions. This ensured equal access of population to outpatient care.

Today the payment for rendered medical services is made by the final result – it stimulates efficient use of resources.

Implemented a differentiated remuneration, a stimulating component for physicians and nurses in primary care. Today a doctor receives a monthly addition to salary, on average 54 thousand tenge, nurses – 30 thousand tenge.

Quality health care means, primarily, high professionalism of medical staff.

Improving the system of continuous professional development of medical workers. The training programs are translated into flexible formats (modular, remote, workplaces). Doctors given free choice of educational programmes and institutions. The introduced funded system, taking into account the participation in conferences, retreats, workshops, etc.

In 2015, funds from the Republican budget-trained more than 14 thousand professionals, 90 of them abroad.

The basis of quality assurance is to standardize medical care. Continually improving standards with the aim of bringing them to international. This work is conducted jointly with professional associations.

Accreditation as one of the mechanisms of quality management today takes precedence when receiving the state of the order to a guaranteed aid. The national accreditation standards close to international ones.

I also want to note that for several of the clinics of the medical Holding received a certificate of international accreditation. This will begin the development of medical tourism, to attract foreign citizens for treatment in our advanced clinics.

Ensured availability of medicines – from 2012 some categories of patients are provided medicines free of charge for the more than 400 names on 48 diseases.

Strengthening the material-technical base. During the period of implementation of the state Program developed and implemented leasing of equipment and use of medical equipment. Healthcare organizations provided the possibility of independent purchase of medical equipment to 5 million tenge in the framework of the tariff for treated case.

In the framework of the Project "Construction of 100 schools and 100 hospitals" built 99 health care facilities, was allocated 287 billion. In the framework of the Project "Construction of 350 outpatient clinics, feldsher-midwife stations and polyclinics" for 5 years, built 310 health facilities. In 2016 it is planned the construction of 40 facilities today, 5 have been completed.

Thanks to the development of e-health, full-fledged users of health information systems have become patients themselves. Now everyone can independently, through the Internet to attach to the clinic of their choice, to track the progress of the queue for planned hospitalization.

By 2020, every citizen will have an electronic health passport, which will include key medical information and history of diseases.

Established a national telemedicine network – today it includes 197 telemedicine centers, it allows to eliminate the gap between urban and rural areas in availability of secondary and tertiary care. For 2015 held about 25 thousand consultations.

Medicine, like other industries, is in a state of permanent movement. And, along with achievements in the national healthcare remain a number of pressing problems.

In comparison with the countries of the Organization for economic cooperation and development (OECD) in Kazakhstan maintains a high level of mortality from cardiovascular diseases, traffic accidents and cancer of working age.

Along with all of the countries faces the global challenges of increasing life expectancy of the population, chronic non-communicable diseases. This will inevitably lead to further growth of consumption of medical services, and thus increase the financial burden on the health sector.

In addition, the responsibility towards the state and the person should be clearly delineated. According to the world Health Organization: health is 50% dependent on lifestyle of the person, and only 10% from the health system.

To solve the above problems and to achieve the level of health of the 30 most developed countries of the world, it is necessary to ensure the financial sustainability of the health system. Quality of care should meet the needs of the population and to meet international standards.

Taking into account the identified problems, we with the assistance of international experts, has developed a State healthcare development program "Densaulyk" for the years 2016-2019.

It aims to consolidate and develop the results achieved and will be the basis for the systematic development of the national health system until 2050.

In addition, as you know, the Plan of the nation's "100 steps" on the implementation of five institutional reforms declared by the President, envisages a number of activities in the health sector.

This year we will have specific performance measures arising from the Plan of the nation. This development of private medicine, introduction of corporate management, mandatory social health insurance, the establishment of a joint Commission for quality of medical services.

Given the above, the following priorities of the state Program:

Further development of interagency cooperation.

Based on the experience of OECD countries, we create a public health service. It will bring together the sanitary and epidemiological service, services, healthy lifestyle and proper feeding.

Will continue giving priority to PHC, the strengthening of its preventive orientation.

Medical assistance level of care will be carried out according to the principle of regionalization is an integrated model of medical care. Here we focus on 5 diseases and conditions that impact most on the demographic situation of the country (BSK, Oncology, trauma, maternal and infant mortality).

Health services that do not require sophisticated equipment, will be decentralized and be in health organizations closer to the community. And health care services that require complex technological interventions and highly skilled professionals, will be centralized at the district, regional, provincial and national levels.

An important component of the program is staffing. To improve the quality of training in Russian medical Universities attract strategic partners included in the top 500 best universities of the world. This medical school USA, UK, Germany, South Korea, Finland and other countries – they signed memorandums on mutual cooperation.

In addition, since September of last year, 6-year colleges introduced the Finnish model of nursing education.

For the further development of health infrastructure will be actively developed public-private partnerships.

Together with the administrations of the regions formed maps of development regions. They will determine the number of objects that will provide access to health services, regardless of their place of residence. The list will include the objects of construction, reconstruction, private sector, and the objects transferred in trust management with the use of PPP mechanisms.

To date, 5 health organizations transferred to the trust management, privatized about 10 health facilities of local importance.

14 PPP projects, of which 2 Republican, are in various stages of implementation.

Will improve the provision of medicines. Together with the British experts, Kazakhstan introduced a national drug formulary (CNF). It will include only those drugs which have proven clinical efficacy.

Is working on the transition of the domestic production of medicines to the standards of good pharmaceutical practice, in 2018 they will be required.

To ensure the financial sustainability of the system as instructed by the Head of state, will introduce a system of mandatory social health insurance, which should ensure the creation of balanced and sustainable system of providing guarantees and obligations of medical care.

November 16, 2015 the Law "On compulsory social health insurance".

We have begun awareness-raising work among the population on the main provisions of mandatory social health insurance.

At the end of his speech, may I say that surely our citizens deserve the best health care system in the present difficult economic conditions, when as never before the important social support of the population of the state, we are fully aware of the responsibility that rests on us to accomplish the tasks set before us by the President.

Thank you for your attention.


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