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T. Duisenova reported to the public about the work of the MHSD of RK

Tamara Duisenova

Today in "Kazmedia center" held a meeting of the Minister of Healthcare and Social Development of RK Tamara Duisenova with the population.

During the event, the head of the MHSD of RK told to the citizens about the work of the Ministry, to improve the quality and accessibility of healthcare, social well-being of Kazakhstan people and employment.
The event was attended by representatives of the presidential Administration, the office of the Prime Minister of RK, deputies of the Mazhilis and the Senate of the Parliament, the ministries of interior, finance, justice, energy, defense, education and science, public service, agriculture, information and communications. At the reporting meeting of Tamara Duissenova with population also came the members of the Public Council of MHSD of RK, representatives of NWF "Samruk-Kazyna", NCE "Atameken" National chamber of healthcare, professional associations, Trade union of medical workers, NGO, subordinate organizations and veterans of the MHSD of RK. In the mode of video-conference was attended heads of the departments of healthcare, coordination of employment and social programs, territorial departments of committees of the MHSD of RK, deputies of regional maslikhats, NGO and etc.
At the beginning of his speech, the Minister noted, that in the framework of implementation of National Plan - "100 concrete steps" on the implementation of five institutional reforms declared by the President of the country, provides for the implementation of new model of healthcare system based on shared responsibility of state, employers, workers or citizens themselves.

In this year the MHSD of RK started to implement a new state Program of healthcare development "Densaulyk" for 2016-2019 years. It is a logical continuation of previous programs and aimed at further deepening of reforms in the healthcare sector.
One of the important directions of the new State program is the prevention of diseases. In this regard, based on the experience of OECD countries and recommendations of experts from the World Bank and World Health Organization will be created in Kazakhstan public Healthcare Service through the integration of sanitary-epidemiological service, services of healthy lifestyle and proper feeding. Its main functions are: surveillance and monitoring of communicable and major non-communicable diseases; preventive measures; raising awareness of the population and etc.
For the prevention of diseases among children of school medicine will be transferred from education to the healthcare system. Already prepared the relevant draft of Law. Since the beginning of the year in a pilot mode implements a Calendar of Wellness events for students throughout the year.

It provides: the conduct of prophylactic examinations of children directly in schools, involving mobile teams of specialists; organization of wellness events during the school season and during the holidays; the introduction in schools of healthcare technologies, such as the prevention of violations of posture and vision, additional vitaminization, physiotherapy, use of products with "functional" food (dairy products), oxygen cocktails and herbal remedies and etc.
For the period since January to March examination covered 2.6 million students or 97.9% of the total amount. On dispensary registration in connection with newly identified diseases put 305,8 thousand students (11.4 %).
The program is designed "Bala-aman". This web-resource, which provides: demonstration of various types of exercise to reduce fatigue and stress among children in the lower grades; the formation of the correct posture with specific examples; and skills in nutrition; training of children to first medical aid.
This program is since September till December 2016 in pilot mode will be implemented in schools in Astana and Almaty since January 1, 2017 in all schools of the country.
Special attention will be paid to improving the detection of diseases at early stage. Together with WHO experts carried out analysis of the effectiveness of National screening program, resulting in decision on the need to revise the target groups by age and frequency of screening tests.

In addition, training of medical workers on early detection of diseases and information system of tracking and monitoring of persons undergoing screening tests.
Along with this will be simplified procedure of passing professional examinations in the adult population. With the passage of mandatory preliminary medical examinations (for employment or admission to study and etc.) citizens will contact the Department of State corporation for citizens, where they can obtain a medical certificate about state of health, provided that the expiration date has not expired.

And, if necessary, further assessment by the relevant experts, citizens will be able to CSC, choose a clinic and time of service.

In addition, simplification of procedure of granting of preferential medicines dispensary patients. Doctors will write a prescription for subsidized medicines for people with chronic diseases once a quarter, for patients with severe illnesses receive expensive drugs every month. The pharmacy will maintain records and issuance of appropriate medicines to patients based on prescriptions issued to them. The harmonization of the prescriptions will be carried out in  automated manner through information system "factory setting".

Testing will begin since July of this year in Astana.
The Minister noted that one of the main directions of the State Program "Densaulyk" is the implementation of Disease Management Program (DMP) in primary medical-sanitary care.
In Kazakhstan, the implementation of DMP began in 2013 in a pilot mode 7 clinics in North Kazakhstan and Pavlodar oblasts on three diseases: hypertension, chronic heart failure and diabetes. Program participants were more than 1.2 thousand people.
In the result of the implementation of the pilot project in 75% of patients stabilized level of blood pressure, formed the skills of control and regularity of intake of antihypertensive drugs. The number of hospitalizations patients with chronic heart failure is reduced in 2 times.
Given the positive experience of implementation of DMP in the pilot regions, in this year its implementation started in clinics of Astana, Almaty, West Kazakhstan, Karaganda and Kostanay oblasts. Since 2018 DMP will be implemented in all regions of the country.
Tamara Duisenova also said that MHSD of RK developed a Road map for the implementation of the integrated model of medical care in 5 main socially significant, non-communicable diseases and diseases that significantly affect the demographics of the population: acute myocardial infarction, acute violation of cerebral circulation (stroke), malignant neoplasm, injuries, pregnancy and childhood.

In each direction will be the whole cycle of services: prevention, curative measures, including rehabilitation, clinical supervision, medical and social services. The services demanding difficult process units and specialists with high qualifications, will be centralized at the district, regional and republican levels. And services that do not require complex processing plants would be in the medical organizations at the place of residence.
Created 5 coordinating councils to implement activities in the framework of the implementation of the roadmap and identified the responsible national organization of healthcare. Developed specific measures to improve the quality of medical care: organized courses of improvement of qualification of medical workers at all levels of medical care; work has begun on the revision of standards of care, to improve clinical protocols and algorithms, processes and routes of patients and etc.
It is planned to create integrated two-level model of emergency care. On the ground - the local level will create a single ambulance service and medical flights. It will include the aviation region, ambulance service district, city and rural districts. The second is the national level service will include the aviation, single dispatching service ambulance with automated GPS system and telemedicine.

With the aim of improving the quality of training in domestic Medical Universities are working to attract strategic partners included in the top 500 best global universities. These medical schools of USA, UK, Germany, South Korea, Finland and other countries. In addition, since September of this year in 6 medical colleges introduced the Finnish model of nursing education.

To ensure the further development of healthcare infrastructure created the project team and approved Road map for the development of infrastructure and PPP for 2016-2018 years. Jointly with local Executive bodies are formed medical map of the regions. They will determine the number of medical facilities, which is necessary to ensure the availability of medical services, regardless of their place of residence. A list of objects will include the construction, reconstruction, private sector involvement and transfer of individual objects in trust management with the use of PPP mechanisms.

Conducted a complete inventory of all used  medical equipment, determination of the level of wear. Prepared proposals for changing the order of purchase of medical equipment: institutions will be able to buy medical equipment costing up to 5 million tenge, from 5 to 100 million tenge – lease, and with the cost exceeding 100 million tenge is purchased at the expense of Republican and local budgets.

With the aim of improving drug provision of the MHSD of RK drafted regulatory legal acts on simplification of registration of medicines that meet international quality standards. Together with foreign experts developed and implemented the national drug formulary. It includes all registered drugs in the Republic with proven clinical efficacy and limit price of each trade name. Updated list of medicines purchased in the framework of the guaranteed volume of free medical aid, provided the first stage of the implementation of reference pricing. There is conducting work on the transition to the standards of good pharmaceutical practices (GXP).
To ensure the financial sustainability of the healthcare system, pursuant to the instructions of the President, carries out preparatory work on introduction of system of mandatory social medical insurance (further - MSMI) providing the joint and several liability for the health of the citizens of the state, employers and employees. After launch of MSMI in Kazakhstan, more than 9.8 million people belonging to socially vulnerable segments of the population (12 residents), will receive medical services by paying premiums for them by the state.
Speaking about the socio-labor sphere, Tamara Duisenova said that to ensure the employment of MHSD of RK has been implementing the program "Road map of employment 2020" (further – "RME 2020"). In 2015 in all areas of the Road map have been employed more than 167 thousand persons, including direct employment for open positions. Of these, 85% were employed in permanent jobs (142 million people). More than 6 thousand people received microcredit to set up and expand their businesses, which have created more than 6.1 thousand additional jobs. 14 thousand people were offered free training, 24, 5 thousand people were employed by government-subsidized jobs, 1.2 thousand people moved to the new place of residence with the provision of housing and employment assistance.

On behalf of the Head of state, this program was updated. It has provided new tools to preserve jobs. It is subsidizing the lost wages of skilled workers, the provision of grants to employers for training (retraining and improvement of professional skill) of their employees, the organization of vocational training of young workers, with the obligatory condition of keeping their jobs. In 2016, from 100,8 billion tenge allocated for the implementation of "RME-2020", 63 billion tenge will be directed on realization of new initiatives.
The Minister also stressed that despite the current situation in the economy of the social commitments undertaken by the Government to the people, are executed on time and in full.
In 2016, the cumulative pension was increased by 9%, all benefits – 7%, and state social benefits for disability and survivor benefits by 25%.

In the framework of the National Plan - "100 concrete steps" since January 1, 2018 three types of social assistance paid to currently low-income citizens, will be transformed into targeted social assistance (further - TSA) in a new format. It will be provided only with the active participation of able-bodied family members in programs of assistance of employment and social adaptation.

In this regard, the phased implementation of new approaches in the framework of "Orleu" project, which in 2014 was launched in a pilot mode in three regions and from the second half of 2015 in all regions of the country (38 districts and cities).

Average per capita income for participants of "Orleu" project has increased more than 2 times; the number of recipients of TSA decreased by 31.8%, of state allowances for children on 2.1%; in measures to promote employment involved 90% of the working participants of the project.

Gradually implement an action Plan to ensure rights and improve the quality of life of persons with disabilities for 2012 – 2018 years. Systematically is working to create an accessible environment for persons with disabilities through the certification and adaptation of objects of social and transport infrastructure; provision of technical auxiliary (compensatory) means of rehabilitation, conducting oral-aural adaptation of children with disabilities after cochlear implantation with configuration and replacement of speech processors.

According to the centers of employment, annually employed 75% of applied to them are invalids.
For man's exit from difficult situations are special social services in hospitals, day centers, home care, temporary stay. Today social services include invalids, the elderly, victims of trafficking, prisoners, persons consisting on the account of the probation services. Since last year launched a pilot project on introduction of the integrated model of special social services on the basis of the East Kazakhstan oblast. By the end of this year will be implemented Road map for building a mechanism of interaction between interested services, training of professionals systems of education, healthcare, social protection and probation services.
After his speech Tamara Duisenova answered to various questions of the citizens. 

Changed on 29 June, 2016 - 17:03
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