Kazakhstan. MoH reports on progess of Unified National Health System
IHS Global Insight perspective
Significance
The Ministry of Health of Kazakhstan has reported on the details of the progress that is being made in the implementation of the Unified National Health System across the country. The system was initially introduced in 2010.
Implications
Apart from a “stable” decline in mortality rates for cardiovascular disease, tuberculosis and a decrease in infant mortality rates, the MoH also reported an increase in funding for medical organisations, improvement in the provision of specialised care, and an increase in the funding of mobile health centres in 2012.
Outlook
From 2013, the system is also expected to focus further on the financing of services in rural areas, reflecting the government’s aim of improving access to medical services in the remote areas of the country.
The Kazakh Ministry of Health (MoH) has reported on the progress made in implementing the Unified National Health System (UNHS) which was introduced in the country in 2010, reports Pharmnews.kz. The "basic principles" of the UNHS include giving patients an ability to choose between medical organisations; ensuring transparency in the selection of services and suppliers; supporting the creation of a competitive environment; as well as implementing principles of "money follows the patient " and "pay for the end result".
The (MoH) therefore reported the following details for the progress in the implementation of the system.
Priority funding for healthcare, which was introduced with the framework of implementing the UNHS, has led to an increase in the funding for medical organisations financed from the state budget. Therefore, compared with 2009 the level of funding in 2012 had increase by 89% (taking into consideration the growth of wages and inflation). Consequently, this has led to improvements in the availability of medical services. In the first nine months of 2012 the total amount of medical care increased by 9% compared with the same time period in 2010.
The development of highly specialised medical care, and technology transfer from abroad to the regions had grown during 2010-2012, with the provision of specialised medical care increasing three-fold in 2012 in comparison with 2012.
A "level playing field" for the public and private sectors for the provision of guaranteed free medical care (GFMC), has lead to an increase in the proportion of private sector providers to 17%.
Access to health care in remote areas was enabled by the provision of mobile health centres, which were equipped with modern medical and diagnostic technology. These were undertaken through three "consultative and diagnostic trains – Densauly?, Zh?rdem and Salamatty Kazakhstan". The funding for these trains amounted to KZT213 million (USD1.39 million) in 2012 compared with KZT123.9 million in 2011, which enabled the provision of more than 380,000 of medical services.
A system of payment through an "integrated tariff" for cancer patients registered in the "OncoRegister" was implemented in 2012 with the aim of improving the system of financing for oncology services. This is further aimed at ensuring access to comprehensive cancer care for each patient. Funds for medical care for cancer patients under GFMC, including the costs of drug provision at all levels, are to come from national and local budgets.
Overall, there has been a "stable" reduction in cardiovascular diseases, cerebral vascular disease, and tuberculosis, as well as a stable decrease in maternal and infant mortality.
Outlook and Implications
The Unified National Health System (UNHS) was developed at the request of the President of Kazakhstan, Nursultan Nazarbayev, and introduced in 2010 with the objective of ensuring quality and accessibility of health services across the country. The implementation of UNHS forms a part of several large-scale initiatives undertaken by the government aimed reforming its healthcare and pharmaceutical sector under programmes such as the government healthcare plan from 2011 to 2015, "Salamatty Kazakhstan", which also includes a project on technology transfer and institutional reform in healthcare, which is part of the loan agreement between Kazakhstan's government and the International Bank for Reconstruction and Development (see Kazakhstan: 17 April 2012: Kazakh MoH Wants to Extend Deadline for Institutional Reforms on Healthcare to 2015). From 2013, the above system will also focus on improving the financing of services in rural areas. The increase in funding, mobile healthcare centres, the focus on oncology, as well the decrease in mortality (the exact details of which have not been disclosed) reflects the government's intent to improve and modernise healthcare services across the country through improved diagnosis and treatment, which in its turn would help increase access of drugs and medical services to patients. It had been reported earlier that the implementation of the UNHS was being finalised, with around 30% of patients already having the right to a free choice of medical organisation on hospitalisation (see: Kazakhstan: 22 November 2012: Kazakhstan reports on progress for healthcare modernisation reforms).
Priority funding for healthcare, which was introduced with the framework of implementing the UNHS, has led to an increase in the funding for medical organisations financed from the state budget. Therefore, compared with 2009 the level of funding in 2012 had increase by 89% (taking into consideration the growth of wages and inflation). Consequently, this has led to improvements in the availability of medical services. In the first nine months of 2012 the total amount of medical care increased by 9% compared with the same time period in 2010.
The development of highly specialised medical care, and technology transfer from abroad to the regions had grown during 2010-2012, with the provision of specialised medical care increasing three-fold in 2012 in comparison with 2012.
A "level playing field" for the public and private sectors for the provision of guaranteed free medical care (GFMC), has lead to an increase in the proportion of private sector providers to 17%.
Access to health care in remote areas was enabled by the provision of mobile health centres, which were equipped with modern medical and diagnostic technology. These were undertaken through three "consultative and diagnostic trains – Densauly?, Zh?rdem and Salamatty Kazakhstan". The funding for these trains amounted to KZT213 million (USD1.39 million) in 2012 compared with KZT123.9 million in 2011, which enabled the provision of more than 380,000 of medical services.
A system of payment through an "integrated tariff" for cancer patients registered in the "OncoRegister" was implemented in 2012 with the aim of improving the system of financing for oncology services. This is further aimed at ensuring access to comprehensive cancer care for each patient. Funds for medical care for cancer patients under GFMC, including the costs of drug provision at all levels, are to come from national and local budgets.
Overall, there has been a "stable" reduction in cardiovascular diseases, cerebral vascular disease, and tuberculosis, as well as a stable decrease in maternal and infant mortality.
Outlook and Implications
The Unified National Health System (UNHS) was developed at the request of the President of Kazakhstan, Nursultan Nazarbayev, and introduced in 2010 with the objective of ensuring quality and accessibility of health services across the country. The implementation of UNHS forms a part of several large-scale initiatives undertaken by the government aimed reforming its healthcare and pharmaceutical sector under programmes such as the government healthcare plan from 2011 to 2015, "Salamatty Kazakhstan", which also includes a project on technology transfer and institutional reform in healthcare, which is part of the loan agreement between Kazakhstan's government and the International Bank for Reconstruction and Development (see Kazakhstan: 17 April 2012: Kazakh MoH Wants to Extend Deadline for Institutional Reforms on Healthcare to 2015). From 2013, the above system will also focus on improving the financing of services in rural areas. The increase in funding, mobile healthcare centres, the focus on oncology, as well the decrease in mortality (the exact details of which have not been disclosed) reflects the government's intent to improve and modernise healthcare services across the country through improved diagnosis and treatment, which in its turn would help increase access of drugs and medical services to patients. It had been reported earlier that the implementation of the UNHS was being finalised, with around 30% of patients already having the right to a free choice of medical organisation on hospitalisation (see: Kazakhstan: 22 November 2012: Kazakhstan reports on progress for healthcare modernisation reforms).
Source: IHS
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