Reforms of healthcare: results and prospects

Mr. Mussinov, how do you assess the preliminary results of 2012 in the sphere of healthcare? Tell us about the progress in implementation of "Salamatty Kazakhstan" Program.
The Ministry's activity was focused on prevention of the main causes of mortality and disability of people. The life expectancy increased by 0.6 years (68.4) comparing with 2010 and made 69.01 years. The maternal mortality reduced by 19% and infant mortality reduced by 8%. The mortality made 8.7% over 1000 people against 8.97 in the previous year. The mortality from circulatory diseases reduced by 27%, from incidents, intoxications and injuries - by 5%, from tuberculosis - by 10%.
The sanitary epidemiological situation in the country remains stable. The spread of the HIV infection in the age group 15-49 is at the level of 0.2%.
Besides, the work on attraction of non-governmental organizations to implementation of the public social order continues. Within this order 18 projects were implemented in 2011 and 25 - in 2012, Primeminister.kz site informs.
The Ministry of Healthcare jointly with the akimats of the regions completed construction of 13 healthcare facilities including 4 facilities built within "Construction of 100 schools and 100 hospitals" project and "Construction of 350 healthcare facilities" project at the expense of the national and local budgets in 2012.
The National Screening Program was introduced in the country in 2012. Presently, more than 500 psychologists and 2100 social workers work in the country.
The National Scientific Cardiac Surgery Center opened on the initiative of the President of Kazakhstan successfully functions in Astana. Unique operations and research work are conducted in the Center. During the work of the Center, more than 2000 operations have been performed there. The transplantation of a donor here and artificial left ventricle was successfully held there for the first time.
The operation on transplantation of a liver from a family member was held in the Scientific Surgery Center named after A. Syzganov in Almaty as well as the first operation on transplantation of a kidney and pancreatic gland.
Besides, the road rescue points were additionally opened at dangerous sections of the roads and the air ambulance service was established.
In 2012, we began implementation of the program on development of oncologic service in Kazakhstan for 2012-2016 which was approved by the Resolution of the Government of Kazakhstan in March 2012.
Medical services became more available for people living in rural areas by means of 49 mobile medical complexes which, in turn, provided their services to more than 500 thousand people since the beginning of the year. We continue to introduce telemedicine, and presently 186 telemedicine centers are functioning in the country. Over 12 thousand consultations have been held so far with the help of these centers.
What can you tell about financing of some of the specific directions of the healthcare system? What is new about incentives for doctors and the other healthcare workers?
I would like to note that within the improvement of ambulatory pharmaceutical provision some categories of patients are provided medicines at the expense of the state. KZT 2.4 bln was allocated from the national budget for these purposes. KZT 23 bln was allocated in 2012 for providing medicines for treatment of patients at the ambulatory level within the guaranteed volume of free medical care. In 2011, the volume of these funds was KZT 19 bln.
Currently, the Ministry jointly with the World Bank implements an innovative project on transfer of technologies and conducting of an institutional reform in the sector of healthcare. The project provides for modernization of financing and management of healthcare, restructuring of the hospital sector, reforms of medical education and science, development of innovative system of healthcare, improvement of pharmaceutical provision, security of food products within the accession to the WTO.
As you know, the quality of the implementation of the programs depends directly on effective management at all levels. The management serves as a conductor of modern methods of administration including new principles of remuneration. This principle is aimed at the final result of the work which implies the quality of treatment and patient's satisfaction with it. The average salary with the consideration of incentives of doctors made KZT 116 thousand and KZT 75.4 thousand for paramedical workers.
Since 2011, the introduction of per capita incentive component at the level of guaranteed free medical care began which also depends on final results. It allowed to pay additionally to the salaries of doctors up to 85 thousand every quarter, 48 thousand to nurses and up to 32 thousand to social workers and psychologists.
Tell us about the prospects for 2013. What are the plans and forecasts of your Ministry for this year?
The Ministry will continue to work on the priority directions of the State Program including the events on reduction of maternal and infant mortality, mortality from circulatory diseases, oncology diseases, injuries and tuberculosis. Secondly, this year we will open stroke centers in all the regions of the country, thirdly, this year will focus on development of the transport medicine.
We will also work on further improvement of ambulatory pharmaceutical provision, development of transplantation, introduction of common responsibility for people's health, introduction of innovative projects and transfer of advanced technologies to the national healthcare system, etc.