Ministry of Health of the Republic of Kazakhstan Public Health Service model Y. Birtanov, Minister of Health, 2017
Background and definitions • Background : « Densaulyk » 2016-2019 State healthcare development program: formation and development of the Public Health Service • WHO definition: « Public health - the art and science of preventing disease, prolonging life and promoting health through the organized efforts of society » Medicine Public Health • The list of 10 Essential Public Health Operations was approved by Member States at the 62nd session of the WHO Regional Committee in 2012 2
Essential public health operations defined by WHO 1: Surveillance of population health and well-being 2: Monitoring and response to health hazards and emergencies 3: Health protection, including environmental, occupational and food safety and others 4: Health promotion, including action to address social determinants and health inequity 5: Disease prevention, including early detection of illness 6: Assuring governance for health 7: Assuring a competent public health workforce 8: Assuring organizational structures and financing 9: Information, communication and social mobilization for health 10: Advancing public health research to inform policy and practice 3 Source: http://www.euro.who.int/ru/health-topics/Health-systems/public-health-services/policy/the-10-essential-public-health-operations
Public Health Services worldwide Страна Название соответствующей службы USA United States Public Health Service England Public Health England S anté publique France France Canada Public Health Agency of Canada Israel Israel Center for Disease Control 4
Communicable and non-communicable disease incidence • Communicable diseases 9862334 constitute only 2% of all 8944440 10000000 8729538 disease incidence 8000000 • The burden of disease is accounted for by chronic 6000000 non-communicable diseases 4000000 2000000 266290 250543 д д 239933 Non-communicable diseases 0 Communicable diseases 2014 2015 2016 Major non-communicable diseases Circulatory Malignant Trauma and Chronic Diabetes system neoplasms injury obstructive diseases pulmonary disease 5
Communicable diseases and non-communicable diseases expenditure 500 000 000 450 000 000 Инфекционные заболевания Communicable diseases 414 749 449,00 397 360 142,00 400 000 000 Неинфекционные заболевания 373 646 050,00 Non-communicable diseases 360 084 455,39 350 000 000 300 000 000 268 534 390,45 250 000 000 213 466 170,78 • Communicable diseases 200 000 000 expenditure constitutes 4-5% of total health expenditure 150 000 000 • Non-communicable diseases 100 000 000 expenditure is growing and constitutes 95-96% of all health 50 000 000 expenditure 0 2010 2011 2012 2013 2014 2015 6
Preventive measures expenditure 13454,2 235,6 19% 3% Расходы на Preventive measures Preventive measures Расходы на профилактические expenditure (in expenditure (in профилактические услуги, тыс.долл thousands USD) thousands USD) услуги, тыс долл Current health Текущие расходы на Текущие расходы на Current health expenditure (in здравоохранение, expenditure (in здравоохранение, thousands USD) 67335,4 тыс.долл thousands USD) тыс.долл 8021,1 Preventive measures include: • Informative, educational and consultative programs • Immunization programs • Early disease detection/screening programs • Communicable, non-communicable disease and injury surveillance • Health environment programs 7 *Current health expenditure – final consumer expenditure of residents on medical products and services
Conceptual framework of the Public Health Service Mission: protection and promotion of health of the population of Kazakhstan through recognized measures Цель 3: Objective 1: Objective 2: Analytical evidence- Implementation of health promotion measures Institutional development of the based work Public Health Service Communicable and Advocacy and communication Assuring a sufficient and competent non-communicable public health workforce disease Monitoring and response to public health emergencies surveillance Assuring governance for health and Health protection, including environmental, wellbeing Public health occupational, food safety and others research Assuring sustainable organizational Health promotion structures and financing Disease prevention, including early detection of illness 10 EPHOs 8
Cross-sectoral implementation of principal areas of activity of Public Health Service Coordinating body: National Coordination Council on Health Protection under the Government of the Republic of Kazakhstan Operating body: Ministry of Health of the Republic of Kazakhstan Ministry of Information and Ministry of Agriculture Ministry of Internal Affairs Communications • Preventing road traffic accidents • Assuring compliance with anti-tobacco & anti- • Publishing information materials on • Assuring food safety alcohol legislation • Soil and natural water reservoir behavioral risk factor prevention • Narcotics control contamination control • Preventing and responding to emergencies • Preventing tuberculosis in the correctional Ministry of Culture and Sports system • Control of import of contraband products • Stimulating physical activity Ministry of Energy • Sports propaganda • Engaging children in sports • Monitoring environmental media Local executive bodies, NGOs, • Waste management • Preventing air contamination businesses Ministry of Education and Science • Construction of bicycle lanes, common areas with sports grounds and exercise equipment • Educating children on healthy lifestyles Ministry of Finance • Access to drinking water, sewerage, utilization • Implementing behavioral risk factors • Increasing excise duties on alcohol and of domestic waste, heating, power supply etc and suicide prevention programs in • Implementation of the WHO Healthy City tobacco products schools • Control of alcohol and tobacco products program trade . 9 9
Public Health Service structure Republican level Regional level National Coordination Council on the protection of population’s Interdepartmental coordination councils on the protection of population’s health health Ministry of Health Departments of Health Committee for Protection of Public Health Departments of Committee for Protection of Public Health Department of Strategic Development and Public Health of the Public Health Divisions at the Departments of Health Ministry of Health Central executive bodies (Ministry of Culture & Sports, Ministry of Local executive bodies Information & Communications, Ministry of Internal Affairs, Ministry of Education & Science, Ministry of Agriculture, Ministry of Investment and Development) National Center for Expertise Regional branches Public Health Research Center Healthy Lifestyle Development Centers 10
Creation of the National Public Health Center Mission – strengthening the capacity of the public health service, disease control and prevention Hygiene and epidemiology research center named Creation of the NPHC by merging the National after K. Zhumatov Center for Problems of Healthy Lifestyle Kazakh research center for quarantine and zoonotic Development with the following enterprises diseases named after M. Aikimbayev (branches) Objectives and duties of the National Public Health Center 1. Coordination of the Public Health Service 4. Developing disease management programs activities 2. Monitoring communicable and non- 5. Training the Public Health Service communicable diseases workforce 3. Evaluating the risks of the effects of 6. Public health research and developing methods of environmental factors on population health influencing the population health 11
Principal areas of activity of Public Health Service 1. Forming the legislative framework and budgetary programs 1.1. Deregulation of control and supervision duties with refocusing on preventive activity 2. Developing the List of services of the Public Health Service (similar to the List of guaranteed volume of free medical care) 3. Strengthening the capacity of the Public Health Service 3.1. Developing the infrastructure of the Public Health Service 3.2. Creating a unified IT-platform of the Public Health Service 3.3. Developing the workforce capacity of the Public Health Service 4. Developing public-private partnership through involvement of business 12
Stimulating business activity in the health industry Healthy (eco-) food: Fitness centers, sports deliveries, production, clubs, swimming pools restaurants Occupational safety: Active leisure and manufacturing of safety eco-tourism products; private (infrastructure, laboratories accessories) Mass media: advertising, IT-products, remote billboards, shows, health monitoring programs solutions (healthy lifestyle image) 13
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