“All health issues currently raised by the public are reflected in the draft changes proposed to the Densaulyq State Program for 2016–2019, which we ask today to review and approve for implementation,” the minister said, noting that the Ministry of Healthcare analyzed official addresses, discussions and publications in the media and social networks. In addition, the most acute public health issues were considered at meetings of the Public Council. Recommendations from various NGOs were also taken into account.
Thus, Birtanov notes that all key issues of the health care system were divided into six groups: the quality of services; lack of qualified personnel; drug supply, updating of medical equipment; as well as informing the public on the implementation of the Compulsory Social Health Insurance; transparency of the health care system; low level of health of citizens.
In order to improve the quality of medical care, especially at the level of primary health care, the ministry plans to take a number of necessary measures within the framework of the State Program. So, by the end of 2019, the ministry will reduce the burden on the general practitioner through the creation of new sites and the development of small forms of primary health care, including through public private partnerships.
“Until the end of 2019, local executive bodies need to reduce the workload to 1,700 people per doctor,” said Birtanov.
As part of the further development of family practice, the clinical examination will be transformed into disease management programs that determine more than 60% of the causes of death.
“By 2020, the coverage of disease management programs will be increased from 11% to 30% of patients registered for three diseases (arterial hypertension, diabetes mellitus and chronic heart failure). In this regard, local executive bodies need to train all primary care physicians and nurses in this program by 2020,” the minister reported.
In addition, Birtanov pointed out the need to continue the digitalization of the activities of all clinics through a full transition to a paperless turnover, thereby, it will reduce the unnecessary burden on medical staff.
Another aspect of improving the quality of medical care is aimed at ensuring safe obstetric care and reducing maternal mortality. The state program provides for further professional development of medical workers, bringing staff of obstetricians and gynecologists and anesthesiologists and intensive care specialists to 95%.
“Akimats need to ensure the hiring and retention of all the necessary specialists, as well as timely registration and dynamic monitoring of all pregnant women. In accordance with the network standard, ensure the integration of single-industry hospitals into multi-profile, including maternity hospitals and perinatal centers. It is necessary to fully equip medical organizations in accordance with the minimum standards. Local executive bodies need to provide training for all ambulance workers and hospitals, to introduce an approved standard,” said Birtanov.
Regarding the quality of medical care, initiatives to improve the health care infrastructure are envisaged: this is the legislative consolidation of the competence of the ministry to approve the Single Perspective Development Plan (the draft law has been submitted to the Mazhilis of Parliament). The plan involves bringing the entire network of medical organizations to an approved standard in the country.
Also it is planned to build 35 facilities for 31 billion tenge in 2018. In 2019 construction and installation works are planned at 33 facilities for an amount of 55.6 billion tenge, where private investment will be the source of financing for more than 60%.
In the framework of improving staffing and raising the level of qualification of medical workers, since 2019 several activities have been planned within the framework of the State Program. Among them: the introduction of an additional exam for selection in medical universities and colleges; legislative consolidation of mandatory independent assessment of graduates. According to the Minister of Healthcare, the responsibility of akimats to provide measures of social support to young specialists will be strengthened (it is necessary to increase from 32% to 60%).
“Dear akims! The issues of staffing in rural areas, their motivation, social support are in your hands! I’m asking you to take the sounded problems under personal control,” said Birtanov.
One of the most pressing issues is the observance of the rights of citizens to drug provision. The state program provides for the provision of personalized electronic records of the issuance of all free medications. Also it is planned to launch a price control system for all drugs from 2019 and introduce a pilot drug tracking system. By 2020, there will be a full transition to electronic distribution of prescription drugs through the drug supply information system.
As for the medical equipment updating, the creation of an information system of the National Medical Equipment Base, the purchase of 150 pieces of medical equipment within budgetary funds and PPP mechanisms as part of the Comprehensive Cancer Control Plan, and the introduction of online monitoring of the efficiency of medical equipment use are envisaged. In accordance with the Plan of the Nation "100 Steps" a fund for 100.5 billion tenge has been created. From January 1, 2018, the Fund is the sole purchaser of the Guaranteed Free Medical Care services.
To increase the transparency of the healthcare system in the framework of digitalization, it is planned to launch a single interoperability platform for commercial operation, integrate all information systems; Paperless medical records in the industry from January 1, 2019; Synchronization of local electronic health passports with the national one. According to the Ministry of Healthcare, already today 10 million people have notes in the electronic health passport. By 2020, 100% of the population will have an electronic health passport.
In accordance with the order of the Head of State, in May 2018 a plan of measures to manage public health was approved. The main directions of the plan are the promotion of a healthy lifestyle with an annual budget of 2.3 billion tenge and coverage of 10–12 million people. The propaganda highlights such provisions as reducing the consumption of sugar, salt, tobacco, and alcohol. Other measures to manage public health envisaged an increase in the effectiveness of preventive examinations of the population to cover up to 11.5 million people.
Thus, in the new Densaulyq State Program the indicators “Life expectancy level” and “Level of satisfaction of the population” were revised upwards. Based on the methodology of the UN Development Program, the Health Index indicator has been revised. Three health indicators were excluded and other six were included. Also, 24 new measures were added.
Birtanov stressed that it is necessary to increase the personal responsibility of the heads of local executive bodies in the implementation of the program. To create regional project offices at the local level for the implementation of the Densaulyq State Program’s measures.
“It is a systematic approach to the activities of the State Program that will allow us to effectively carry out the tasks set and ensure the satisfaction of our citizens with the quality of medical care,” concluded Birtanov.
Also in the course of the meeting, the heads of a number of regions, akims of the Mangystau region Yeraly Tugzhanov, Akmola — Malik Murzalin, Kyzylorda — Krymbek Kusherbayev, Almaty — Bauyrzhan Baibek, Atyrau — Nurlan Nogayev, North Kazakhstan — Kumar Aksakalov, Kostanay — Archimed Mukhambetov, deputy akim of the East Kazakhstan region Yerlan Aimukashev made reports on the ongoing work at the local level.