State-Run Program of Reforming and Development of Healthcare to be implemented in 2005-2010
State-Run Program of Healthcare Sector Development
The “Kazakhstan 2030” Strategy defines population’s health protection as one of the major long-term priorities in development of the society. Population’s health and economic development of the country are interconnected. It is impossible to set a task of achieving sustainable development without taking population’s health in due consideration, and vise versa, it is impossible to strive for improvement of population’s health without achieving sustainable economic development. Population’s health condition is an integral indicator of level of social safety net provided by the government, measuring responsibility of the state for its citizens.
In recent years Kazakhstan has seen stabilization of a number of major medical-and-demographic indexes – birth rate, death rate and life expectancy rate. Stable decline of infant and maternal mortality rate has been recorded. A number of positive medical-and-demographic changes have taken place. As of 2003, population of the republic grew by 49.6 thousand against 1999; as of early 2004 total population reached 14951.2 thousand. Birth rate in 2003 made up 17.2 per 1000 people, 1.2 times increase against 1999. Birth rate upward trend has been recorded in the republic since 1999.
In recent years average life expectancy has leveled at 65.9 years (as of the end of 2003); men’s life expectancy made 60.5 and women’s life expectancy - 71.5 years.
Number of medical doctors in the republic has reached 54.6 thousand, paraprofessionals – 115.0 thousand. Medical doctors availability per every 10 000 people made up 36.5, paraprofessionals – 76.9.
Still, social diseases morbidity rate remains high. Mental and drugs related disorders, diabetes, bronchopulmonary and cardiac pathologies, tuberculosis, sexually transmitted diseases, malignant tumors remain a serious problem. Unfortunately as of today, healthcare is mostly treatment-oriented rather than prevention-targeted; and the population itself is insufficiently focused on guarding their own health. For example, increase of the number of cases of identification of tumors only at advanced stage and high cardiac mortality rate testify to this fact. Due to pandemia of AIDS/HIV, Kazakhstan faces a threat of HIV spread in its territory, including inside its penitentiary network. With the view of this, Kazakhstan has adopted and is currently implementing the AIDS Epidemic Prevention Program for 2001-2005. As a whole, the reasons of Kazakhstani population’s poor health are low level of prevention measures, insufficient responsibly of population for its own health, inefficient inter-sector interaction in terms of health protection and socio-economic problems of transition period.
In spite of measures taken, provision of population with good drinking water remains an acute issue; only 75.1% of the republic’s population have access to running drinking water.
It should be noted that there about 50 natural hot spots of diseases highly dangerous for people (plague, anthrax, tularemia and Crimean-Congo hemorrhagic fever), located in 8 oblasts of Kazakhstan. For instance, 39% of the country’s territory is a natural hot spot of plague, and the fact that its occurrences among population in those risk zones are singular testifies that measures taken to prevent them – especially targeted immunization – are effective.
Documents guiding development of the sector today used to be adequate at the time of their elaboration, but at the present time they have fallen behind the country’s economy and other sectors. Problems that have been accumulated call for a radical revision of approaches to healthcare management. Presidential Address to the Nation of Kazakhstan of 2005 pointed out that the sector requires significant transformations to improve management, financing and medical care provision administration systems, as well as enhancement of funds usage efficiency.
State-Run Program of Healthcare Sector Reforming and Development in the Republic of Kazakhstan for 2005-2010 elaborated by Ministry of Healthcare of the Republic of Kazakhstan is being implemented. Objectives outlined in the Program are: creation of efficient system of medical care with due consideration of principles of joint responsibility for health protection between an individual and the state with emphasis on primary medical care; adoption of international principles of medical care administration, with emphasis on primary medical care; improvement of maternal and child health care; improvement of medical-and-demographic situation; decrease of social diseases morbidity rate; improvement of social status and image of medical doctors and technicians.
In the framework of the Program Government should hit the following targets in the nearest years:
- to divide responsibility for health protection between an individual and the state;
- to adopt international principles of medical care, with emphasis on primary medical care;
- to create a new model of healthcare management and a unified information network for the sector;
- to improve maternal and child health care, to improve medical-and-demographic situation;
- to decrease social diseases morbidity rate on annual basis;
- to carry out medical education reform.
Funds from the central budget and from local budgets will be used for the Program in 2005-2007. Total expenses of the state budget on realization of the Program will make up KZT 165658.5 million.
Funding of the sector should be increased during 2008-2010 to reach up to 4% of GPD in 2010.
In the course of implementation of the Program the following results will be achieved:
- creation of optimal healthcare model meeting demands of population, those of medical sector and the state;
- provision of equal access to medical treatment for all the citizens; division of responsibility for health protection between an individual and the state;
- increase in the amounts of preventive and sanitary measures;
- manning primary medical care centers with qualified medical staff and paraprofessionals and furnishing them with equipment meeting the standards by 2010;
- improvement of the system of financing, elimination of deficit in financing of guaranteed free medical treatment;
- increased efficiency of usage of funds from the state budget and population in the healthcare sector;
- creation of unified information network of the healthcare sector;
- improvement of health index of children and women of reproductive age; stable decrease in maternal and infant mortality;
- stabilization of situation with social diseases; decrease in virulent and noninfectious diseases morbidity rate;
- drop of TB morbidity rate from 160.4 (as of 2003) to 150.0 by 2007, and to 135.0 by 2010 per 100 thousand people.
- improvement in efficiency of state regulation of pharmaceuticals turnover;
- enhancement of production of competitive domestic pharmaceutical and medical products;
- implementation of present-day diagnostic methods and international treatment standards;
- improvement of medical training and retraining programs;
- expansion of rights, increase in responsibility, improvement of social status and image of medical doctors and technicians.
