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Interview with the Vice-Minister of Health and Social Development of the Republic of Kazakhstan S.R.Musinova for “Liter” from 20.09.2014

Announcements: 

Improvement of the Kazakhstan’s health care proceeds

Health care is an area which is paid a special attention in Kazakhstan. There are good reasons for that alongside with the experience of developed countries where the health is cultivated in society, and is revered as the overriding benefit. Healthy people is base for a welfare state; national health care has gone through a lot of reforms adhering to this principle in the last decade, whose main purpose is the affordable and qualitative healthcare for every citizen of the Republic of Kazakhstan. Moreover, the health of Kazakhs has become a part of public policy long ago. The Vice-Minister of Health and Social Development of the Republic of Kazakhstan Serikbol Musinov have told the “Liter” newspaper about the appearance of medical cluster today, changes that have occurred over the past year and what changes are expected in medicine in the near future. 

- In the Address of the President to the People of Kazakhstan “Kazakhstan's way-2050: Common aim, common interests, common future” the main emphasis is on the development of primary health care. Serikbol Rahimkanovich how much progress has already been achieved in this direction?

- The development of primary health care (PHC) is put as a priority development of the entire health care system in our country. It cannot be differently because Kazakhstan is home to the Almaty Declaration of the World Health Organization (WHO) in primary health and sanitary care. Therefore, the main goal of the second phase of the “Salamatty Kazakhstan” state program is the consolidation and strengthening of primary health care, the creation of the medical and social models of primary health care aimed at the final result

 What have we done? Currently, almost every physician of a primary health care is responsible for the two nurses. The positions of a social worker and a psychologist are introduced. Non-governmental organizations operate social orders on health care. Family health centers with prevention offices and psycho-social support, youth centers, clubs for elderly people, profile schools health have been established. Work on establishing an information support system is being held. PHC doctor becomes the protagonist that directs and coordinates the activities of all services on an outpatient basis. The standards of organizations registry that provide ambulatory and polyclinic care have been developed. This system is receiving calls and pre-registration of patients to medical appointments through telephone and websites of PHC organizations, etc. All this is being successfully implemented in the clinics of the country. 

– How the National screening program is being implemented in Kazakhstan?

- One of the main factors of disease detection on its early phase is screenings. In 2009 the first three screening on early diagnosis of hypertension, breast cancer and cervical cancer was introduced in Kazakhstan. Today, as you said yourself, it is the national screening program. It includes 11 screening programs. More than half, that is the six of them are aimed at early diagnosis of cancer.

I want to emphasize the importance and cost-effectiveness of early diagnosis of diseases on the example of cancer only. For example, treatment of one patient  with breast cancer in the first and second stages cost for the state for 4300 dollars, the same treatment of the 4th is the 146 thousand dollars, i.e. 34 times greater. And if we reduce the number of identified patients with breast cancer at 4th stage from fifteen to five percent, it would save nearly 49.5 million dollars for the treatment of breast cancer only.

– It’s no secret that untimely provision of drugs for outpatients appears to be a cause of dissatisfaction among patients. What positive results have been reached in this sensitive issue?

– More than two million patients are provided with free outpatient treatment medicines for 48 diseases each year. This is very important as the adequate supply of drugs on an outpatient level enables to reduce the risks of complications of chronic diseases, and, consequently, reduce hospitalization costs in expensive hospitals. Starting this year, we have upgraded the free outpatient medicines provision system. Differentiated approach providing the therapy for a number of chronic diseases was introduced (basic therapy and therapy for more socially vulnerable segments of the population).

Outpatient drug coverage will be improved in the future. All the necessary medicines and basic complementary therapies will be provided free of charge to those who have shown the commitment to the care and interest in maintaining their own health.  

– Medical assistance should primarily focus on the patient. What efforts are being made in this regard by the Ministry of Health?

- A lot of things are being done at the primary health care level, but the needs of the population are growing and we must be ready for new challenges. It is necessary to radically change the principle of primary health care physician’s work and create patient oriented model with an emphasis on prevention the risk factors and diseases.

The patient should have unrestricted access to primary health care.

This requires appropriate conditions both at the system level and at the level of health care providers, as well as their willingness to take responsibility for the health of the population. Today it is necessary to consider multi-disciplinary and multi-level approach in the development of primary health care which involves the central and local executive bodies, medical schools, professional associations and research institutes. Involving citizens and patients, as well as other organizations in the development of primary health care is a natural process as the patient must always be at its center.

Specialized services responsible for cardiovascular diseases, oncology, tuberculosis, HIV / AIDS, drug addiction, psychiatry, child and maternity, advocacy and promotion of healthy lifestyles should be fully integrated with the primary health care. Integration of specialized services will improve the availability and quality of services to the population of the republic.

Relevant research institutes, NC and universities should teach the issues of oncology alertness, tuberculosis alertness, and compliance of early diagnosis algorithms and treatment of circulatory system diseases, advice on disease prevention, maintenance of healthy lifestyles, family planning, reducing deaths from controllable causes to the physician of a primary health care.

All of these plans will be implemented gradually. The result of all reforms should promote the development of preventative technologies in primary health care organizations, expanding the range and quality of services, ensuring effective use of resources, increasing the motivation of health workers and the development of competition in providing primary care.

World experience shows that all successful health systems have achieved good performance and good health level of the population mainly due to the development of primary medical and sanitary care as the key element of health.

–It was announced last year that the first geographically remote office of the World Health Organization on primary health care will be opened in Almaty. Tell us on what stage this project is and what our country will benefit from?

– I want to note that it is a great honor for our country to open the first geographically remote office of WHO on primary health care in Almaty. The first major UN office in the European region and Central Asia will coordinate the 53 states that are members of the WHO. This will allow Kazakhstan to form a credible policy on the development of primary health care in the world in accordance with the Declaration of the WHO / UNICEF PHC adopted in 1978 in Alma-Ata.

From a practical point of view, the geographically remote office will enable the expansion of bilateral projects in the field of health care, in the scientific and practical research, advanced trainings for health professionals, not only for the European region, but for the world in long term perspective. It will also enable both economic and software development of the health sector and the country as a whole.

New challenges confront us with the new tasks in the field of public health. This is the development of shared responsibility principles, ensuring equitable access to the health care, more efficient use of available resources and the use of modern approaches to the informatization of the health care system.

Health is the only area that accompanies man from his birth to the very old age; therefore, it plays an important role in the development of human capital and increases the level of human potential. Of course, there is still much to do for a decent future of generations to come. By the joint efforts of government, employers, citizens and society as a whole we can provide high living standards which are based on the health of the nation. It is paramount in our work. 

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