The social campaign “100 problems-100 solutions-100 days”

№

Problem description

Ways to address

Measures to address

 the problems 

1

Absence of a single source of information for the population about medical services

To develop a concept (PR-plan) of the national policy of informing the population about health care (issues of CSHI, access and receipt of medical services, GVFMC, attachment of the population to the PHC organization, quality of services, public health, corruption, punitive measures). To organize portals in specialized areas for the possibility of online consultations.

PR-plan for informing

 the population about

health care issues.

2

Lack of access to information about health services

To introduce unified call centers in the regions on issues of public awareness in accordance with the PR concept.

Report to the Ministry

3

Weak feedback between the population, the heads of the health care organizations, and state bodies (MH, local executive bodies)

All medical organizations, irrespective of the level, forms of ownership of the medical organization, establish permanent feedback with the population through their own website, e-mail and social networks; timely replenish information on the site.

Availability of existing and updated sites, e-mail and social networks.

4

Low joint responsibility and awareness of the population about the advantages of disease prevention

To include in the concept (PR-plan) of national policy to inform the population about health care issues of preventive medicine.

PR-plan for informing the public about health care issues.

5

Low awareness of the population about specialized services: vaccination, methadone therapy, preventive examinations, etc.

To include in the PR plan issues for specialized care (separately for vaccination, methadone therapy, preventive examinations).

PR-plan for informing the public about health care issues.

6

Low awareness of the population about the provision of services (hospitalization, high technology medical services, preventive examinations, IVF, etc.)

To create an interactive platform for the possibility of direct consultation on public services for the population (hospitalization, screenings, medical examinations, high technology medical services with an open access point.

Information resource

7

Negative attitude towards the introduction of European standards in the production of domestic pharmaceutical products

To include in the PR plan issues on public awareness about standardization of  pharmaceutical production.

PR-plan for informing the public about health care issues.

8

Negative attitude to payment of medical services to oralmans and stateless persons in the Compulsary social health insurance (CSHI)

To include in the PR plan issues of public awareness about organization of assistance to citizens, oralmans, and stateless persons in the context of CSHI.

PR-plan for informing the public about health care issues.

9

Problems in public awareness on disability issues

To include in the PR plan issues of public awareness on providing assistance to persons with disabilities, including the possibility of on-line counseling, the possibility of filling out an electronic application, providing medical supplies etc.

PR-plan for informing the public about health care issues.

10

Distrust and fear of the CSHI system

To ensure extensive coverage of the introduction of CSHI (use of all types of media and organization of explanatory work at the local level) with a focus on the rights of citizens in the CSHI system, mechanisms for containing corruption, guaranteeing the reliability and safety of insurance savings.

Media plan

11

Problematic issues of donation

To develop a program to stimulate and raise awareness of the donation of blood, tissues and organs.

PR-plan for informing the public about health care issues.

12

Inadequate work, a formal approach to the implementation of social projects

To consider the implementation of a peer-to-peer pilot project in some regions under the PHS strategy.

Proposal to the Ministry of Health of the RK, work plan

13

Low awareness of health care workers about new initiatives, roadmaps and changed requirements of the normative legal acts (NLA) in the field of health care

To inform the media in a timely manner, including using the website of the Ministry of Health, the RCHD, the Republican center for electronic healthcare, the National center for expertise of medicines, medical devices, and medical equipment (NCED), Health authority (Department of public health), "NLA" section (weekly update), the drafts of the NLA, road maps, adopted orders (with comparative tables and justification); Journal "Health Manager" 

Press releases of the Ministry of Health on updates in the NLA. Reports of the website on public NLA. Reports from the MH website on ongoing discussions of projects. Information of specialized non-governmental organizations (NGOs) within the framework of road maps

14

The insufficient role of professional NGOs

To develop regulations for the accreditation of professional NGOs; to implement accreditation, to create a database 

Order of the Ministry of Health of the Republic of Kazakhstan; database of accredited NGOs

15

Insufficient involvement of the main freelance specialists in reforming the core services, including at the regional level

To revise the rules of appointment and work of the main freelance specialists of the Ministry of Health of the RK (electivity of position, published reports, etc.)

The order of the Ministry of Health of the RK dated April 30, 2011 No. 248 "On the main non-staff specialists of the Ministry of Health of the Republic of Kazakhstan" with the publication on the website

18

Problematic issues of assessing the competence of the first leaders of the medical organizations (MO), as well as evaluating the work of medical practitioners

 To conduct an assessment of the competencies of the first managers of the MO, including through feedback (questionnaires, the "360 degree" method) based on the principles of HR management.

Estimates of the first leaders of the MO.

.

19

Absence of a binding of work quality assessment of staff members and a payment  

To introduce in the MO a typical human resources management program and an assessment of the work of staff members

Human Resource Management Program in the MO

20

Unsatisfactory quality of test questions and tasks in assessing the knowledge of health professionals

All NGOs should review the tests to assess knowledge and objectives to confirm the qualification category

Letters from NGOs with tests and tasks to be excluded, and a list of test tasks to be included

21

Inadequate competence of medical personnel in the provision of first aid

To introduce an assessment of knowledge on the "stations" of first aid in assessing the knowledge of doctors without a category

Modified knowledge assessment programs

22

Absence of profile tasks and stations in assessing knowledge for qualification categories

To strengthen the qualification exam in the category with the accentuation of the assessment of professional knowledge and skills on profiles

Modified knowledge assessment programs

23

Non-protection of rights and low socio-legal status of health workers

Together with professional NGOs, to develop a roadmap for creating a system for legal protection of the professional responsibility of medical personnel, including changes in the legislative framework, and drafting  or amending the current NLA for the protection of professional responsibility

roadmap

24

Insufficient level of doctor in the professional framework of qualifications

To raise the doctor in the national and sectoral framework of qualifications to the 7th level, and the graduates of the residency to the 8th level (with regard to the longer term of training of doctors)

Draft NLA (draft law or other NLA to protect the professional responsibility of medical personnel)

25

Insufficient motivation of specialists in further training

To develop a roadmap for improving the quality of vocational education, including professional competitions ("the best in the profession" at the level of each region and in certain medical professions in NGOs); methodology for differentiated wages with motivational surcharge (including when receiving state awards); the development of measures to stimulate lifelong learning in the workplace, including using remote access to educational resources; within the work of NGOs, activities for the delegation of candidates for congresses and conferences,  participants - authors of abstracts, posters, articles; activities to develop a list of rating specialists on professions, etc.

roadmap

26

The problem of increasing incidents of attacks on health workers, insults at the workplace etc.

To hold an interdepartmental meeting on the definition of responsibility for an attack, insult and defaming health worker

Report of the interdepartmental meeting, the draft of the NLA, changes in the contract for the provision of medical services with the patient

27

Low remuneration of health workers, the need to change the wage system (including co-payments for psychoemotional workload / working conditions) For example, the absence of a significant difference between the wages of doctors and mid-grade medical staff

Identify the best examples of differential wages and high level wages among the MO in the form of REM and medical organizations of the non-state sector and encourage through national recognition in the ranking of the best MO and develop proposals for a mechanism of systemic salary increases

Proposals to the Ministry of Health of the RK

28

Insufficient HR policy in medical organizations

To implement modern HR technologies, and also require MO to implement a personnel policy (HR management program)

Indicators in plans for development of MO

29

The lack of a strategy in the MO to raise the salaries of health workers

To include in the development plans a step-by-step plan to increase the wage fund in each medical organization under conditions of CSHI focused on the outcome

Indicators in plans for development of MO

30

Problematic issues of obtaining certificates / categories / verification (simplification of procedures and required documents)

Review the rules for assigning certificates / categories for simplification, amend the NLA and develop a work plan for the transition to licensing of medical activities in accordance with international standards

Work plan to change the system for assessing the knowledge of health professionals

31

Inefficient learning system

To develop a flexible model for the implementation of resident programs, integrated with continuing medical education programs, based on the fact that in the residency at the first stage the basic course in the main specialty is studied and further courses are selected that allow obtaining additional subspecialty. To implement a program of academic mobility with clinics - strategic partners of universities. At the same time, after the termination of the residence, the working doctor should be able to master the sub-specialty or related specialty by studying a certain amount of modules in the courses of advanced training with the passing of a licensing examination to obtain admission to a new specialty / sub-specialty.

Updated residency programs

32

Offensive / incorrect attitude of personnel to patients

To organize training of personnel on the topic: "Psychological basis of communication and interaction" in the form of training cycles, master classes for staff and managers of medical organizations according to the schedule in all medical organizations.

The education program agreed with NGOs

33

Insufficient awareness of medical personnel on liability for negative and offensive attitude to patients and colleagues

To develop measures of responsibility of health workers for unethical behavior within the framework of interdepartmental interaction (fines, penalties, exclusion from NGOs, criminal and administrative responsibility); To introduce the code of ethics in medical organizations

Methodical recommendations on the organization of work on ethical behavior with applications - information tabs on the level of responsibility for violations of legal norms in relation to the behavior of medical workers

35

Shortage of staff

To analyze and publish a report on the shortage of personnel in terms of levels and profiles of medical care; to develop a plan of measures to attract migrant staff, residents in scarce sectors

Report, plan of activities

36

The need to strengthen the role of clinical protocols (Issues of quality and legitimacy of clinical protocols (CP), standardized methods of treatment and diagnosis, the procedure for their revision and approval.

To revise the rules for the development and approval of CP and standards for core services (to include systematic assessment of clinical and economic efficiency for making decisions on the inclusion of new expensive drugs, methods of treatment and diagnostics, system monitoring and analysis of innovative drugs, methods of treatment and diagnostics (horizonscanning), (Including free of charge)

Regulations for the

development of CP and standards for core services (the decision of the JQC)

For example, for the treatment of cystic fibrosis, ophthalmology

38

Insufficient synchronization of profile CPs with clinical guidelines of international profile societies

To bring the CP in line with similar CPs of developed countries based on evidence base.

The decision of the JQC, the plan for reviewing and developing the CP

39

Lack of consistency of CP and lists of ED, Electronic register of inpatients, Electronic Register of Cancer Patients, ALO

To develop an algorithm, a scheme for automatically replenishing and revising lists of medicines (KNF, outpatient medicines, a list of orphan drugs, a list of Electronic register of inpatients, Electronic Register of Cancer Patients, a list of ED) and services (a tariff plan, a list of Electronic register of inpatients, a basis for lists of GVFMC and CSHI) after the adoption and amendment

in the CP; to update all lists of medicines, medical services with adopted CPs

Decision-making procedure; Orders of the Ministry of Health of the Republic of Kazakhstan (ALO, Electronic register of inpatients, ED, Electronic Register of Cancer Patients, etc.)

40

Lack of consistency of the rules of expertise and CP

All NGOs develop rules of expertise, taking into account the profile directions based on CP and standards for the provision of services; to provide trained profile experts for the lists of the Committee for the Protection of Public Health

Rules of external and internal expertise - decision of the JQC, orders of the Ministry of Health of the Republic of Kazakhstan; list of experts

41

Formality of internal audit, absence of analysis of neglected cases involving all parts of medical care

Organize (renew) the planned work of medical and preventive councils in the regions with the participation of specialized NGOs, research institutes, scientific centers, where to disassemble on a permanent basis the facts of violation of the use of CP and development of recommendations for the elimination of violations  

Information reports to the Ministry of Health of the Republic of Kazakhstan

42

Low quality of laboratory services due to lack of mandatory external quality control and accreditation standards

To develop standards for the accreditation of clinical laboratories on the basis of international standards and the plan for the introduction of a laboratory accreditation system

Draft standards for the accreditation of clinical laboratories, submitted for approval in the Ministry of Health of the Republic of Kazakhstan; work plan

43

Insufficient administrative and legal support for the work of the Internal Audit Service (IAS) in the medical diagnostic process

To implement post-accreditation monitoring of medical organizations (focus on implementing IAS recommendations or patient support services); implementation of current plans of corrective measures by medical organizations

The procedure for post-accreditation and post-licensing monitoring of the MO (order of the Ministry of Health of the RK). Data on post-accreditation monitoring for the first quarter of 2017

44

The punitive nature of the consideration of maternal deaths, medical errors

 Revise the working methods of staffs, strengthen the principle of comprehensive and unbiased analysis, develop a plan for motivating measures to improve the quality of care (for medical organizations and doctors)

Algorithm and regulation of the work for the staff for specialized care (including motherhood and childhood); plan of measures

45

Ineffective work with citizens' appeals, a formal approach to the consideration of complaints, lack of results on the measures taken, violation by personnel of medical organizations of their official duties

To conduct a review of compliance with the procedure for examining complaints in the MO in specific cases and develop a plan of work on citizens' appeals at all levels of the health organization

Data from the review of the Committee for the Protection of Public Health on compliance with the procedure for examining complaints in the MO and the work plan

46

Ineffective work of specialized services, in particular, ophthalmology, hepatology, reproductology, transplantology, etc.

Together with NGOs, to develop roadmaps for improving the status of service at all levels

roadmaps

47

Lack of information on the direction of citizens of Kazakhstan abroad

To conduct and publish the analytical report of the program for 5 years with the outcomes of diseases, including long-term,  analysis of cost-effectiveness

analytical report

48

Insufficient list of diseases and technologies for sending for treatment abroad

To revise the current list of diseases in which citizens of the Republic of Kazakhstan are sent for treatment abroad on the basis of an analysis of the lack of treatment technologies in the context of profiles

Draft Government decision of the RK

49

Long-term deployment of citizens of Kazakhstan for treatment abroad, poor-quality provision of services

To describe the processes, standardize, including the procedure for selecting a clinic and organize the possibility of electronic submission of documents on the website of the Ministry of Health of the RK and the Department of public health

Regulation and standard of service

50

Referral for treatment abroad to clinics with insufficient experience in providing similar services

Create a database of clinics, primarily from the number of strategic partners

Electronic database, published on the website of the Ministry of Health of the Republic of Kazakhstan

51

The lack of unified approaches to information security of electronic health resources

To develop rules for compulsory passage of all information systems that will or plan to interact with the Information Systems of the Ministry of Health for the Attestation Examination for compliance with information security requirements.

Order of the Ministry of Health of the RK

52

Necessity of revision of the admittance system to High technology medical services (HTMS); to increase the accessibility of the evaluation of medical technologies for applicants HTMS

To revise the procedure for approving HTMS - to eliminate the requirement to accurately determine the planning of the number of cases within a particular type of HTMS, to reduce barriers when introducing new technologies outside the GVFMC.

Regulation for approval of the HTMS.

Orders of the Ministry of Health of the Republic of Kazakhstan

53

Lack of accessibility to the evaluation of medical technologies at the initiative of individual MO and / or NGOs

To implement a constantly accessible service for the evaluation of medical technologies for a fee for applicants seeking to evaluate medical technologies.

The procedure for the evaluation of medical technologies at the RCHD and the price list for the services

54

The problem of the period for holding a tender (the choice of supplier) for the provision of services under the GVFMC

Review the procedure in the framework of the government's work on deregulation of the NLA (Order of the Ministry of Health of the RK of July 30, 2015 No. 638 "On Approval of the Rules for choosing a provider of services to provide a Guaranteed Volume of Free Medical Care and reimbursement of expenses").

Order of the Ministry of Health of the RK

55

Distrust and fear of the CSHI system

To develop, together with NGOs, process maps (patient routes, expertise, payment algorithm) for profiles and levels; to conduct a comprehensive  analysis of the risks of disrupting the CSHI system, a full review and continuous updating of the NLA base; to include points on interaction with other departments and state bodies in the implementation plan of the CSHI

Map of processes, routes and algorithms by profiles;

 report; work plan

56

Insufficient involvement of non-governmental medical organizations for the provision of GVFMC in the CSHI

To ensure the principles of equal conditions, regardless of the form of ownership, in the NLA projects for the implementation of CSHI. Additionally, to develop mechanisms for supporting private medicine within the framework of PPP development; to revise the order limiting the treatment of patients in the non-governmental sector; to include representatives of the non-governmental sector in the JQC and the Public Council

list of NLA, draft NLA, list of members of Public Council

57

Lack of equal access of the population to medical services

To develop a plan for reviewing the NLB and synchronizing information resources for the implementation of the "money for patients" policy - to introduce a system of mutual settlements between medical organizations, including different subordination and territorial affiliation

work plan

58

Ineffectiveness of the organizational and legal form of REM and insufficient implementation of corporate governance generally in medical organizations

To develop the National plan for introduction of principles of corporate governance in the medical organizations

Approved National Plan for introducing principles of corporate governance in medical organizations;

59

Definition of the competence, authorities and work plans of the new (reorganized) committees of the MH with a focus on eradicating corruption and reducing punitive measures

To develop and approve statue on the MH Committees within the framework of the strategic goals and objectives of the MH RK and work plans 

Order of the Ministry of Health of the RK, work plans published on information resources

60

Lack of constant communication about the problems of unethical and corrupt behavior of health sector leaders

To create an e-mail address at the RCHD, for trusting non-anonymous feedback, with the protection of the informer from punitive measures

E-mail address,

press release

61

Presence of artificial barriers in NA, creating corruption risks

To revise the entire NLB of the Ministry of Health of the Republic of Kazakhstan, including the rules for examination, licensing, restrictive standards (sanitary norms and regulations, Building Codes, lists of equipment, etc.) to identify the creation of artificial barriers and lobbying

Plan for the revision of the NLB, draft orders

62

Non-transparency of procedures for the distribution of services, examination

To identify, describe, standardize business processes (planning of medical services in the regions, medical organizations, distribution of GVFMC, CSHI, post-licensing, post-accreditation monitoring, licensing, accreditation, etc.) 

Algorithms with described processes

63

Long-term coordination of applications, clarifications, etc.

All processes should be made transparent: oblige all health departments, committees, MH RK to work in a unified information system, eliminating paper duplication; to submit documents for the placement of medical services and perform the procurement of drugs in the electronic public portal

Report to the MH RK; module on the website of СКФ, Committee for medical service payment, Social health insurance fund, Department of public health

64

Absence of planning at the level of Department of public health, services, certain MO. Distribution of the volume of services without taking into account the need and potential

To develop a methodology for planning services within the framework of GVFMC and CSHI; to form forecasted plans of PHC, Clinical and diagnostic department, High technology medical services, ambulance, sanitary aviation, blood service based on the needs within the framework of  methodology and analyze with the fact (in the context of the profiles of the services of medical organizations)

methodology;

analytical report

66

The need to re-profile beds and optimize the network of medical organizations in the framework of master plans for the regions

Ministry of Health of the RK to cancel the requirements to staff standards (order MH No. 238), giving the opportunity to plan personnel and beds to the leaders of the MO in accordance with the regional master plans for restructuring the network of medical organizations and the needs of patients.

Order of the Ministry of Health of the RK

67

Absence of perspective actual demand-driven plans for the development of regions

RCHD and MH RK to draw up a plan for updating and implementing regional master plans for optimizing the network of medical organizations and ensuring the implementation of regional plans

Plan for updating, implementing and monitoring regional master plans for optimizing the network of medical organizations.

 Reports on the implementations

68

Electronic accounting / reporting

To prepare a work plan for the implementation of a unified platform for statistical reporting and informatization, to solve the problem of interaction in the medium term.

work plan

69

Overload of MO by reporting and accounting forms

To conduct analysis of input data (appropriateness, completeness of processing, etc.), revise and shorten existing forms of reporting documents filled in by the doctor. To introduce the electronic medical records system.

analytical report;

Orders of the Ministry of Health of the Republic of Kazakhstan

70

Insufficient role of disease prevention within the framework of the work of the Committee for the Protection of Public Health

The work plan of the Committee for the Protection of Public Health to harmonize with the plans of international partners in the field of public health development (WHO, CDC, UNFPA, UNICEF).

PR-plan for informing the public about health care issues.

71

Non-involvement of specialized NGOs in the disease prevention strategy

All NGOs should submit proposals on the prevention of diseases for inclusion in the work plan in accordance with international standards, in particular to identify, monitor and treat chronic noncommunicable diseases

Proposals of NGOs in the form of information letters to the Ministry of Health of the Republic of Kazakhstan

72

Necessity of revising the NLA in the field of Sanitary and epidemiological service (requirements for medical organizations, food facilities, housing conditions, etc.)

To amend the NLA in the field of sanitary and epidemiological control and public health to maintain better housing conditions within the work of the public health service

The draft of the NLA, revised by the working group

73

Side effects after receiving vaccinations and doubts on the quality of products

To strengthen the quality control of imported vaccines and ensure the detection of contraband or counterfeit products through the NLA (revise NLA).

Conclusion of experts on the revision of the NLA.

74

Lack of active monitoring of adverse events of vaccination and complications

To implement a system to actively detect side effects after vaccination and immunization

The model of active detection of side effects after vaccination and immunization with feedback from PHC organizations, patients and a press release on the introduction

75

Insufficient competence of health workers in matters of indications, contraindications, and monitoring during vaccination

To develop a training plan for doctors and mid-grade medical staff on the definition of contraindications to vaccination (relative and absolute), rules for pre-screening, detection of complications, prevention of complications, providing first aid for complications

Plan for education

76

Lobbying for the interests of pharmaceutical organizations

To approve the Rules of ethical promotion of medicines (including feedback channels for physicians and the MO).

Approved Rules of Ethical Promotion of Drugs.

To inform the public, the pharmaceutical industry.

Press release and other attention on informing stakeholders.

To establish a feedback channel (e-mail address and call center at the RCHD)

Data of performance monitoring by the Committee of Pharmacy MH

To review all NLB in the field of drug planning 

Plan for the revision of the NLB

To include in a single automated process, based on clinical protocols the process of inclusion in restrictive lists (Electronic register of inpatients, Electronic Register of Cancer Patients, ED, outpatient, orphaned lists)

Algorithm for including drugs in lists

To organize a single portal for the issuance of electronic prescriptions with the standardization of the prescription of medications with the designation of INN with the electronic signature of the doctor

Prescription Drugs Portal

To inform about violations of the ban of over-the-counter drugs in pharmacies

 Plan of inspections

To promote Website of the Kazakhstan national formulary among the population for informing the population about trade names of drugs

Plan of work of the Committee of Pharmacy

and the Drug Information-Analytical Center with the population to promote KNF (Kazakhstan National Formulary)

To hold a meeting of NGOs and pharmaceutical companies on the site of the Ministry of Health of the RK, to adopt a unified resolution on the need for educational activities, including visits to conferences and congresses only through NGOs and by developed rules (the need for abstracts, posters, research or expert programs for visiting foreign congresses), the knowledge of the English language of a potential candidate, etc.

protocol of the meeting

To publish joint programs, sponsorship transfers, grants, etc. on the NGO websites, Memorandums of work with the pharmaceutical sector

NGO report, information on the website

Clearly allocate the roles, responsibilities and functions of organizations that make decisions in the field of drug policy: the description of regulations -Department of Standardization of Medical Services

Order, the regulation of interaction

Planning and reporting - Department of organization of medical aid, NGO; Making decisions on synchronization of lists of drugs and CP - JQC,

Quality control – Committee of Pharmacy, etc.

77

Irrational use of medicines, low awareness of the work of the KNDF, non-transparency of the Formulary Commission work, a limited country quota for opioids in palliative care. For example, there is intentional polyprogram, irrational use of medicines in the MO, insufficient training of the patient to take drugs (including ALO). The records of the meetings of the Formulary Commission are not posted on the MH website, the basic medicines from the approved treatment protocols are not included in the KNDF (622 orders of the Ministry of Health), access to opioid analgesics is limited.

To improve the work of internal and external audit

1. To cancel the status of legitimacy of the order MH RK from July, 15th, 2016 № 622

To revise the Regulations on the National Formulary Commission.

2. To separate the list of drugs to be procured within the GVFMC from the list of KNDF drugs.

3. To permit the posting of the records of the meeting of the Republican Formulary Commission on the website: http://www.knf.kz/ index.php / en / 

4. To conduct the mandatory procedure for assessing health technology for each drug, included in the GVFMC in the future

5. Amendments and additions to the "Code about Health of the People and the Health System"

To approve the KNDF separately from the list of drugs procured under the GVFMC and place it in open access to the Internet (Order of the acting MH SD  of July 15, 2016 No. 622 "On approval of the Kazakhstan National Drug Formulary for Drug Provision under GVFMC" - 622 order ")

Order

To create an e-mail address for confidential, non-anonymous feedback, with the protection of the informer from punitive measures at the RCHD.

Email address,

press release

To implement a training program for primary care physicians on analgesic therapy and palliative care.

training program

79

Negative attitude towards the introduction of European standards in medicine

To include in PR plan issues of public awareness of the application of European standards.

PR-plan for informing the public about health care issues.

80

Problems of the availability of medical devices, transport etc

To include issues of updating equipment when drafting the budget, develop mechanisms for updating / purchasing equipment under PPP

Предложение  в МЗ

To update standards for minimum ambulance equipment and sanitary aviation

Order

To develop an action plan to increase and optimize the financing of sanitary aviation  and ambulance and to seek additional investments for upgrading the material and technical equipment

Plan of action

To revise the standards for equipping healthcare organizations with medical vehicles, including with the possibility of attracting outsourcing services and PPPs

Order

To equip medical organizations with necessary vehicles

Report to the Ministry of Health of the Republic of Kazakhstan

81

Absence of marginal prices for medical devices - corruption due to significant variations in price among the MO, procuring medical devices

To develop a single reference book of medical devices with the inclusion of information on registration, the timing of its revision, the manufacturer, the technical specification and the recommended price

 Single reference book of medical devices

82

High prices for medical devices

To compile an analysis of the prices of medical devices and medicines in the countries of the Eurasian Union, the European Union, the United States, Korea, India, Japan, and others.

Analytical published report

83

Insufficient production of domestic medical devices

To develop a plan for attracting and localizing local production of medical devices based on the results of the analysis.

Work plan to attract producers

84

Absence of a wide-scale high-quality domestic production of medicines, medical devices, medical furniture

To analyze production bases of the RK and develop a plan for the development of domestic production

Report to the Ministry of Health of the RK and plan of measures

85

Non-transparency of expertise during drug procurement

To review the planning and procurement procedure for drugs, medical devices, equipment

Проект Регламента услуг с изменениями

To develop the possibility of electronic submission of documents for competitions

information resource

To develop rules for attracting and working experts

Proposals

To publish expert opinions for general publicity

Reports on the website of СКФ, NCED, MH RK

86

Non-transparency of examination and long-lasting procedure for registration of medicines, medical devices and toolkit

To conduct an analysis comparing the number and types of registered drugs, medical devices with partner countries

Report to the Ministry of Health of the Republic of Kazakhstan

To describe the process of registration and certification, develop a service schedule with a clear fixation of the terms of consideration in the context of each stage

Service regulations - the order of the Ministry of Health of the RK

To introduce an electronic way of applying for registration and certification with the publication of summary and interim reports

Information resource

To identify the qualifications of experts, create a database of experts

Qualification characteristics

To consider the issue of simplification (recognition) for registered drugs and medical devices in the countries of the Eurasian Union

Suggestions to the rules, to the order

87

Dissatisfaction with the organization of the provision of medical care in PHC (queue, workload of doctors, etc.) - accessibility problems

Clearly delineate the functions of GP physicians, therapists, pediatricians, obstetrician-gynecologists, statisticians, mid-grade medical staff

Orders of the Ministry of Health of the RK on the nomenclature of specialties, professional standards

To introduce a home health check-up program for a certain contingent (with the participation of the trained mid-grade medical staff) (pregnant women, children, disabled people, patients in remote regions)

PHC programs for the implementation of home health services, including preventive and screening visits to a specific target group

To implement a program for servicing profile specialists in remote regions with a visit

Primary health care programs in cooperation with clinical and diagnostic department in remote regions

To revise plans for mobile medical complexes, medical trains on the basis of planning and real needs

Plans for works of mobile medical unit

To consider the need to transfer mobile medical complexes to clinical and diagnostic department

The act of transfer of mobile medical unit to clinical and diagnostic department

88

Incomplete inclusion of services in the competence of PHC, planning of a part of specialized outpatient care outside PHC

All profile outpatient services, including consultations of family doctors, dental services, should be planned for the population through a comprehensive per capita standard and PHC organizations

Orders of the Ministry of Health of the Republic of Kazakhstan

1. To revise the form of management of PHC organizations,

Revision of the NLB on the distribution of GVFMC, the selection of the supplier, the organization of work of PHC with the inclusion of family doctors in the form of individual entrepreneur

2. To include the possibility of combining of the IP of family doctors with the planning of services by the appropriate distribution of GVFMC and CSHI; 

3. To change the number of sites and revise the order of attachment

89

Absence of informatization and modern technologies for involving remote access of profile specialists

To develop a plan for the informatization of plots

The act of implementing information systems

To include the program of telemedicine in the work of PHC with the participation of clinical diagnostic department and republican medical organizations

PHC reports on the use of telemedicine

90

Overload of PHC staff with non-core reporting work

To revise all accounting forms filled in primary health care for information needs

Order of the Ministry of Health of the Republic of Kazakhstan on accounting and reporting forms

Accounting and reporting should be functionally distributed to statistical and organizational departments

Order of the MO

91

Insufficient level of PHC competence

To revise the standard staffing list of medical PHC organizations

Order of the MO

To develop a PHC training plan with profile NGOs

Plan for training and working with PHC and NGOs

92

Insufficient integration of professional NGOs in PHC

 To consider the work of professional NGOs in the regions with PHC (out-of-school cycles) within the framework of social orders and / or other sources of financing.

Report to the Ministry of Health of the Republic of Kazakhstan

93

Problematic issues of school medicine

To revise the standards and algorithms of processes and procedures used in school medicine, including planning physical education, prevention, rehabilitation, adolescent reproductive health, recommendations for proper nutrition and healthy lifestyles

SOP, programs, teaching-aid package

To develop training programs

Plan for improving skills and knowledge assessment

To develop a plan to upgrade the skills of school health workers

Certificates of specialization

Update the plan of health improvement activities for each educational institution and consolidate it into a single calendar

Plans for health programs in the context of each academic institution with the consolidation into a common calendar of events

94

Problematic issues of screening organization

To conduct an analysis of the effectiveness of screening programs: costs, the level of detected diseases in the early stages, the percentage of cure and the percentage of survival gain. Financial and economic analysis of performance

Analytical report

To revise the focus groups, standardize screening processes

Order

To include in the screening national programs the issues of effective prophylactic medical examination of precancerous diseases

Order

95

Problems of obtaining / prolonging disability

To review the NLA on this issue for simplification, to include the issues of this section in the road map of the public awareness activities with the population in the main directions and rules in health care

Plan to review the NLB

To hold an interdepartmental meeting on the issues of determining the degree of incapacity for work, the onset of disability, especially children's age with the participation of NGOs

Meeting records,

work plan

Carrying out of the analysis (NLB, analysis in the context of each profile according to epidemiological indicators (number and specific gravity, percentage of well-being, etc.)

Report to the Ministry of Health and the MLSP of the Republic of Kazakhstan

To describe the processes of obtaining disability, publish

Infographics services

To introduce the electronic format for applying for and receiving disability reviews

Information resource

To develop a plan of measures to increase the availability of survey, including at home and / or in a hospital

Plan of measures

96

Lack / absence / procedures for obtaining products (prostheses, implants)

To describe the procedure for obtaining the service

standard of service

To carry out an analysis of necessity

analytical report

To conduct a meeting with the local executive bodies and MLSPP and develop a joint work plan

work plan

97

Lack of inclusion

To envisage the implementation of a pilot project in some organizations under the PHS Strategy

Meeting records,

work plan

98

Need to implement

To include the direction of 3D-printing in the list of tasks of scientific programs funded under the targeted funding for 2017-2019 and new scientific research project planned for funding for 2018-2020

scientific research project

3-D printings

99

The need to introduce self-diagnostics through gadgets

To develop an additional plan of measures to incorporate innovative developments in the practice of medical organizations and the population

plan of measures

100

The need to introduce robotics

To include the direction of robotics in the list of tasks of scientific programs funded under the targeted funding for 2017-2019 and new scientific research project planned for funding for 2018-2020

scientific research project