DEVELOPMENT OF THE REGIONAL CHILDREN'S CLINICAL HOSPITAL FROM 2011 TO THE PRESENT
The Head of State and the Government pay special attention to health issues, referring them to the rank of national priorities, improving the health of the population. Further development of the industry is considered by the President of the country as a prerequisite for Kazakhstan's entry into the number of competitive countries of the world. The Development Strategy of Kazakhstan until 2030 proclaimed long-term benchmarks and health system is tasked to improve the health status of the population by increasing the level of real availability of high-quality medical care for the general population.
Historically, regional children's hospitals are the center for providing medical care to the children's population of the region, there are the best staff concentrated here and the most severe patients. The hospital staff is represented by experienced and qualified staff. Doctors with qualification categories - 70%, nurses - 60%. For merits in the protection of children's health and high performance in work, more than 50 hospital employees were awarded Government awards: medals, President's Algyskhat, badge "Excellence in Healthcare of the Republic of Kazakhstan", Diplomas of the Ministry of Health. In 2005, 2010, 2015 and 2016, 2018, five employees of the hospital were awarded the title of "Person of the Year of the Region". In 2007, in the first National Competition "Childhood Friend", the hospital was awarded a 1st degree diploma, in 2010 it became the winner in the "Best Hospital" nomination of the regional akim competition "Shapagat".
The Regional Children's Clinical Hospital is the base of clinical departments of the West Kazakhstan Medical University named by Marat Ospanov: pediatric surgery, internship and postgraduate training, maxillofacial surgery, otorhinolaryngology, neurology, endoscopic surgery. In these departments working 6 professors, 15 associate professors and candidates of sciences.
In 2011, the regional children's clinical hospital, which is the flagship of the pediatric service of the Aktobe region, moved to a new building, built under the state program "100 schools, 100 hospitals". The equipment of the hospital corresponded to world standards: 64-slice multi-spiral computed tomography, 1.5 Tesla MRI, clean rooms, breathing and anesthesia breathing equipment, CSO. At the opening ceremony, the Minister of Healthcare S. Z. Kairbekova noted that with the commissioning of the new hospital building, specialized medical care for children of Aktobe region will receive an impetus for further development. The hospital administration together with the healthcare department trained young specialists: neurologists, cardiologists and cardiac surgeons, hematologists and oncologists, neurosurgeons, traumatologists, urologists, neonatal surgeons, endocrinologists, nephrologists, pulmonologist, gastroenterologist. Currently, the regional children's clinical hospital provides specialized medical care in 25 specialties.
In 2009, 2010 and 2015, the hospital successfully passed an external comprehensive assessment for compliance with the standards of medical care.
The priority areas for the development of the region's pediatric service are:
1) the provision of curatorial assistance to the districts to provide specialized assistance in all profiles,
2) development of neonatal surgery, cardiac surgery, including neonatal cardiac surgery, urology, neurosurgery.
3) reduction of infant and postnatal mortality and mortality in children under 5 years of age;
The availability of specialists and appropriate equipment allowed the hospital to provide highly specialized medical care to children. Without a referral to the National Research Institute and the National Center in Nur-Sultan and Almaty, high-tech medical services began to be provided in the region, which is of great and important importance for the local population.
In neurosurgery technologies have been injected for excision of the damaged area of the spinal cord or spinal membranes in newborns with congenital spinal hernias, and for the surgical treatment of hydrocephalus.
Reconstructive operations are performed on newborn infants with congenital anomalies in the development of the maxillofacial region (cleft of the upper lip and cleft of the hard and soft palate, etc.).
Employees of the regional children's clinical hospital provide highly specialized and specialized surgical care for newborn babies of the city and region, as well as children of Western Kazakhstan suffering from various developmental defects, including those from the Ural, Mangistau and Atyrau regions. The head of the department of neonatal surgery is a surgeon of the highest category Ilyasov M. T., he is assisted by a surgeon, candidate of medical sciences. Bisaliev B. N., neonatal anesthesiologist-resuscitator Abdullaeva G. Z., neonatologist Sergazina T. S.
The development of neonatal surgery made it possible to save the lives of newly born babies with corrected congenital pathology. The number of newborns operated on over the past 5 years is more than 300, postoperative mortality has decreased 3.2 times and amounted to 11.2. The survival rate after such operations is 88.8%. Survival with such malformations as esophageal atresia and gastroschisis appeared.
In the hospital, on the basis the surgical and endoscopic departments, such types of highly specialized medical care for congenital malformations have been introduced as endoscopic reconstruction of the biliary tract, laparoscopic reconstruction of the urinary tract, laparoscopic support for operations on the large intestine, endo-surgical technologies for congenital diaphragmatic hernias. Most of these operations are performed only in the regional children's clinical hospital in Aktobe.
By order of the Health Department of the Aktobe region in 2012, in accordance with the Roadmap centralization of the region's cardiological care was carried out in the regional children's clinical hospital. For the first time, open heart surgery for children began to be performed in 2009 at the Medical Center of the West Kazakhstan State Medical University. With congenital heart defects, pathological changes on the part of other internal organs are always noted and consultation and treatment of related specialists is necessary - a pediatrician, a pediatric neurologist, a pediatric nephrologist and a pulmonologist. In addition, for the further development of cardiac surgery, it became necessary to reduce the age and weight of operated children, up to newborns. There is a need to transfer the cardiac surgery department to a children's hospital.
In accordance with the order of the Health Department of the Aktobe, in November 2015, a department of cardiac surgery and cardiology was opened in the regional children's clinical hospital. The department is fully equipped and includes a heart-lung machine, an extracorporeal membrane oxygenation apparatus, an angiograph, ventilators, perfusions and lineomats. Head of the cardiac surgery department Dosmagambetov A.S., doctor of the first category. Head of cardiac resuscitation department Talipova N.T., doctor of the highest category. During the existence of the department, employees do not stand still. With the growth of specialists' qualifications, operations for critical heart defects in newborns have been mastered and performed, artificial circulation has been introduced in newborns, extracorporeal membrane oxygenation has been introduced in newborns, hybrid operations using occluders for congenital heart diseases have been mastered. From 2015 to 2020, more than 700 open heart surgeries were performed using an infrared device and closed endovascular ones.
Given the absence of a pediatric cardiac surgery service in WKO, Mangistau, Atyrau regions, children with CHD, in the absence of places in the NSCC, are sent to Aktobe. The production capacity of the department allows to expand the number of operations. Over the specified period time, more than 80 operations were performed for children from other cities. The number of children would have been greater if there was an established air ambulance.
Since the opening and up to the present time, more than 100 open-heart surgeries with IR have been performed, the lowest age among operated children was the first day of life.
Master classes were organized and conducted with the participation of the head of the pediatric cardiac surgery department of the National Scientific Center for Cardiac Surgery –
With the support of the Akimat of Aktobe region, an angiograph was purchased for the department and installed in December 2016. Since January 2017, about 25 endovascular interventional surgeries for congenital heart disease have been performed.
The hospital has a coordinating role as the head center for pediatric services throughout the region. Specialists provide consultative and diagnostic services with an annual planned visit to the supervised areas, as well as an emergency visit through the air ambulance. In 2015-2016 alone, the hospital's specialists carried out more than 200 air ambulance trips to the regions of the region to provide specialized care to children with pathologies of the respiratory system, central nervous system, and injuries.
Since 2008, the country has embarked on the implementation of a strategy for the integrated management of childhood illnesses and early childhood development in the Republic of Kazakhstan. The Integrated Management of Childhood Illness Strategy (IMCI) is a key strategy of the World Health Organization aimed at improving child health, improving the quality of medical care for children from 0 to 5 years old, reducing child mortality, the frequency and severity of diseases and disabilities, and improving the growth and development of children. In 2012, by order of the health department of the Aktobe region, the IMCI Center was transferred to the regional children's clinical hospital. To date, more than 300 doctors and 500 PHC nurses have been trained. The use of the IMCI strategy has led to an improvement in intermediate indicators such as: exclusive breastfeeding coverage; timely introduction of complementary foods; knowledge of the population of dangerous signs of diseases and signs, achieving a decrease in infant mortality rates from controlled causes, as well as reducing daily mortality and mortality at home.
At present, the area of the IMCI center has been expanded to 500 m2 for further strengthening the material and technical base of the Center, the purchase of imitation medical equipment has been carried out; classes of manipulations were prepared, which allows practicing the practical skills of doctors and nurses to automatism (intramuscular and intravenous injections, catheterization of the subclavian vein, lumbar puncture, tracheal intubation and chest compressions, etc.). There is a process of creating a mechanism for continuous improvement of the knowledge of all medical workers of the region in the Center, expanding the staff of the Center with trained instructors and a full 100% coverage of training on the IMCI strategy of medical workers in the region, and primarily PHC.
Taking into account the acute shortage of pediatric personnel associated with the closure of pediatric faculties, the lack of specialists in the city's polyclinics and districts has become an acute problem of providing specialized care to children in the city and region. At this most difficult time, an enormous burden fell on the shoulders of the staff of the regional children's clinical hospital, since huge flows of patients daily sought medical help at the admission department and KDO hospital. Since 2014, on the basis of the hospital, 5 Centers for the provision of medical diagnostic and rehabilitation assistance to sick children have been opened and began to function actively, and since 2017, 4 more centers have been opened additionally:
Summing up the results of the work in the period of 2011 to the present, we can say with confidence and pride that a lot has been done, but I would like not only to preserve what has been achieved, but also to be confident in the further dynamic development of the regional children's clinical hospital.