Today the Minister of healthcare and social development of the RK Tamara Duisenova has presented to deputies of the Senate of Parliament of the RK new State program of healthcare development of the RK "Densaulyk" for 2016-2019.
At the beginning of her speech she informed on results of implementing the State program "Salamatty Kazakhstan", designed for 2011-2015. Thanks to systematic work, for the specified period it was succeeded to reach the following indicators:
- increase in the life expectancy till 71,62 years (2010 – 68,41 years);
- decrease in the total population mortality by 15,3% (2010 – 8,94 per 1000 population, 2014 –7,57);
- increase in birth rate by 2,6% (2010 – 22,54 per 1000 population, 2014 – 23,13);
- decrease in maternal mortality in 1,9 times (2010 – 22,7 per 100 thousand born 2014 – 11,7);
- decrease in infantile mortality in 1,7 times (2010 – 16,58 per 1000 born live, 2014 – 9,72);
- decrease in tuberculosis morbidity among population by 30,3% (2010 – 95,3 per 100 thousand population, 2014 – 66,4) and mortality more than twice (2010 – 10,6 per 1000 population, 2014 – 4,9).
- retention of distribution of HIV/AIDS at the concentrated stage (2014 – 0,2%).
Tamara Duisenova emphasized that in nearest 4 years the strategic goal in the sphere of healthcare are: increase in life expectancy till 73 years by 2020, improvement of availability and quality of medical services, enhancement of financing and management system in the healthcare.
Minister reported that in Kazakhstan the new service will be created on the basis of integration of epidemiological service and service of formation of healthy lifestyle and nutrition rationalization.
The service functions will include: increase of the population awareness and its involvement in actions aimed at prevention and decrease in harmful effects of various factors of environment, unhealthy food and behavioral risks ensuring epidemiological monitoring of infectious and main noninfectious diseases, including mental health disorders and traumatism; providing, coordination and expansion of the intersectoral interaction aimed at protection and strengthening of the country population health; ensuring control of compliance with the law and other legal norms in the field of health protection and epidemiological safety; introduction of the international systems of long-term modeling and forecasting of diseases development at the regional and national levels.
The central core in arrangement of medical care will become the primary medical and sanitary care (hereinafter - PMSC) within which the stage-by-stage increase in the list of medicines for free out-patient treatment is planned. Universality of PMSC will be provided by further transition to the family principle of service (hereinafter - FPS) providing supervision over health of the person during all his life taking into account features of the organism in each age period with emphasis on prevention. FPS will be carried out by general practitioners or multi-disciplinary teams from among currently working district doctors (therapists, pediatricians, gynecologists), depending on personnel completeness of the concrete region). With increase in number of general practitioners and growth of their competency they will replace the multi-disciplinary teams.
Further development of transport medicine, including sanitary aviation, emergency medical care and telemedicine, network of mobile pharmaceutical units is also provided.
Specialized medical care will be integrated with all healthcare services. At that development and implementation of the special plans of action on the main socially important, noninfectious diseases and diseases significantly influencing the country population demography is provided: acute myocardial infarction, acute cerebral vascular incident (insult), malignant neoplasms, injuries, pregnancy and obstetric aid. In each direction there will be rendered all cycle of services: prevention, medical measures, including rehabilitation, dispensary observation, medical and social services.
Along with that, development of highly qualified special medical care with involvement of the best world practices will proceed.
As institutional basis of the national system for control of quality of medical care there will be established the Joint commission on quality to which the following functions will be imposed: approval of clinical protocols, standards in healthcare; improvement of system for accreditation of the medical organizations; assistance in implementation of National policy of medicines' provision; making decisions on inclusion and an exclusion of medicines, medical products and other medical technologies in structure of the tariffs compensated at the expense of GVFMC and OSMS; assistance in effective management of human resources in healthcare.
In order to solve issues concerning quality, safety and availability of the medicines provided to the population the Kazakhstan national drug formulary will be developed (hereinafter - KNDF) until the end of 2015. The British national drug formulary which is considered in the world as "the gold standard" is taken as the basis of KNDF.
KNDF will include all list of the medicines registered in Kazakhstan, information on their proved clinical efficiency, on possible bad effects and the limit price for each preparation. Thus, it will become the big reference book, both for doctors, and for citizens of the country.
To ensure financial sustainability of healthcare system the mandatory social medical insurance will be introduced in Kazakhstan since 2017. The state will execute payments for 15 categories of citizens (social and vulnerable segments of the population). Employers will pay for hired workers. The workers and self-employed citizens registered in tax authorities will pay for themselves.
To accumulate contributions and purchase of medical services on the basis of Committee of medical service payment of MHSD RK the Fund of social medical insurance in an organizational and legal form of noncommercial joint-stock company will be established. The Government of the RK will act as the founder and the sole shareholder.
Rates of contributions will raise stage-by-stage: for the state from 4% in 2017 up to 7% in 2024, for the employer from 2% in 2017 up to 5% in 2020, for the worker from 1% in 2019 up to 2% in 2020, for self-employed citizens (individual entrepreneurs, private notaries, private judicial performers, lawyers, professional mediators, natural persons gaining income under contracts of civil character) from 2% in 2017 up to 7% in 2020. Contributions for employers will be attributed to deductions at calculation of corporate income tax, for workers and self-employed citizens - at calculation of individual income tax.
Further development of medical and nurse education will provide for trinity of clinical practice, medical education and scientific activity. For this purpose it is planned to develop the concept for development of the integrated academic medical centers (university clinics) on the basis of functional (consortia) and organizational (holdings) association of the scientific organizations, medical schools, inpatient and out-patient organizations on the principle of complete cycle of medical services and training. Creation of new clinical bases and university clinics will be carried out in partnership with the leading international universities and medical organizations. Practice of involving the leading foreign experts, scientists and teachers in the academic processes will gain broad development.
For appraisal of level of theoretical knowledge and practical skills of graduates the system of independent assessment of competence based on professional standards and the best international practice will be introduced.
Implementation of new State program of healthcare development "Densaulyk" will promote strengthening health of citizens and societies in whole, increase in life expectancy; increase of availability, completeness and quality of medical care; expansion of free out-patient provision of medicines; decrease in level of informal payments on healthcare; will provide access to modern and safe medical technologies and medicines