The message of the Head of State says that the harmonious development and happy childhood of the younger generation is our national task.
Maternal and child health protection is one of the important and priority areas of the healthcare system.
YEAR OF CHILDREN
Statistics of children's health care.
More than 6.6 million children live in our country.
Children under the age of 5 - 2.5 million.
3.4 million schoolchildren .
Medical care is provided free of charge within the guaranteed scope and MSHI.
Today, a multi-level approach to providing medical care to children has been implemented.
Outpatient care is provided by 5690 PHC facilities.
8,130 children's beds have been deployed for inpatient care on the basis of 204 central district hospitals, 10 city and 13 regional children's hospitals.
At the republican level, there are 815 beds in three main Centers - the Scientific Center of Motherhood and Childhood in Astana, the Scientific Center of Pediatrics and Pediatric Surgery and the Aksai University Clinic in Almaty.
These organizations provide regional supervision, organizational, methodological and practical assistance.
Children are hospitalized in republican-level centers to provide high-tech medical care, clarify the diagnosis and determine the tactics of further management.
There are 249 maternity organizations operating in the Republic, including 39 perinatal centers, where 140 beds are deployed to provide assistance to newborns.
There are 49 children's rehabilitation centers, including 3 of the republican level (the National Center for Children's Rehabilitation in Astana, the Balbulak Rehabilitation Center, the Alatau Children's Clinical Sanatorium).
In 2022, 118 million consultative and diagnostic appointments of children were conducted at the outpatient level, 576 thousand children were treated in a round-the-clock hospital.
More than 100 thousand operations were performed for children.
402 thousand children were born this year.
In cases of impossibility of treatment within the country, children receive treatment within the framework of the "Foreign Treatment" program.
During 2022, 71 children were sent abroad, for a total amount of more than 1 billion tenge, in such areas as hematopoietic stem cell transplantation, sclerosis using electroparation, radionuclide therapy and others.
The main countries of the direction were Turkey, Germany, India, and Russia.
In 2022, the total amount of financing of medical care for children amounted to 560 billion tenge.
Human resources potential.
Today, 2,640 pediatricians and 773 neonatologists work in the healthcare system.
The shortage of pediatricians is about 200 specialists, neonatologists 100.
198 pediatric specialists (pediatricians, neonatologists, pediatric surgeons, pediatric onco-hematologists) graduated this year.
Currently, 548 residents are being trained in the specialties of the children's profile.
This year, the state order has been distributed for 292 educational residency grants, according to specialties: "Pediatric surgery", "Neonatology", "Pediatrics", "Oncology and hematology for children".
Drug provision.
One of the priority tasks of the national healthcare is the uninterrupted provision of medicines to the population of our country.
As part of outpatient drug provision in 2022, 622 thousand children under 18 years of age were provided for 121 diseases, in the amount of 34 billion tenge for Juvenile arthritis, Epilepsy, Pneumonia, Iron deficiency anemia, Diabetes, Rickets, Dermatitis, Acute respiratory diseases, etc.
As for the provision of orphan medicines, by Order of the Ministry, the List of a Single Distributor was supplemented with 40 names of orphan drugs to provide patients with diseases: Spinal muscular Atrophy, Duchenne Muscular Dystrophy, Cystic fibrosis (Cystic Fibrosis), Epilepsy, etc. More than 8 thousand patients have been provided for orphan diseases.
The Republic of Kazakhstan adheres to the recommendations of the World Health Organization on the promotion and introduction of exclusive breastfeeding.
At the same time, if there are medical and social indications, children of the first year of life are provided with adapted milk mixtures free of charge. On average, up to 3 billion tenge is allocated for this per year.
Fetal protection is the protection of childhood.
To improve the quality of prenatal screening, 18 fetal protection centers have been created.
Ultrasound and biochemical screening of pregnant women, consultation of geneticists, obstetricians and gynecologists are carried out. Upon detection of fetal development pathology, the further tactics of management and delivery are determined at the prenatal consultation.
Prenatal care covered 400 thousand pregnant women, 1.2 million fetal screenings were conducted. 3.5 thousand congenital malformations were detected, 1340 pregnancies were interrupted for medical reasons.
More than 400 thousand newborns were examined for phenylketonuria and congenital hypothyroidism.
Phenylketonuria was detected in 29, congenital hypothyroidism in 53 newborns.
Screening of psychophysical development covered 1.5 million children under 3 years of age, audiological screening - 2 million children under 6 years of age.
Interdepartmental interaction with the education system is improving.
For further correctional support, according to the results of psychophysical screening, 11 thousand children were sent to the psychological, medical and pedagogical commission.
According to the results of the audiological screening, 845 children were sent to the psychological, medical and pedagogical commission.
In cases of diagnosis of hearing loss of 3-4 degrees and the establishment of disability, children are provided with hearing aids by the social protection authorities of the population.
To increase the equipment of medical organizations, within the framework of general transfers, it is planned to purchase 142 units of equipment for audiological screening, totaling 850 million tenge.
Retinopathy of prematurity is a severe pathology of the eye that develops only in premature infants, associated with impaired development of retinal vessels due to immaturity. The earlier the baby was born, the more extensive the lesion areas.
In our country, screening of premature infants for retinopathy of prematurity is carried out at the maternity hospital level.
For 11 months. 7.5 thousand premature newborns were covered.
In order to minimize the risks to the child, in most cases, surgical treatment of retinopathy of prematurity is carried out directly in the maternity hospital.
For 11 months, 470 retinal laser coagulation operations were performed in premature infants with retinopathy.
The effectiveness of treatment was 98%.
Previously, these children remained disabled.
In addition, a new method has been introduced for the treatment of aggressive forms of retinopathy of prematurity - intraocular drug administration.
To this end, 32 ophthalmologists from all regions of the country have been trained in drug administration skills.
This method, combined with retinal laser manipulation, makes it possible to preserve as much of the retina and the child's vision as possible.
Together with the public fund "Kazakhstan Khalkyna", it is planned to purchase 24 units of equipment for ophthalmological screening. Additionally, the Ayala Charitable Foundation purchased 11 units.
The issue of providing the necessary equipment will be resolved in the near future.
As a result of the measures taken, according to the results of 11 months of 2022, in comparison with the same period last year, the coverage of children with screenings increased from 3 to 12%.
Thus, the coverage of neonatal screening was 91%, - audiological 75%, psychophysical 86%, ophthalmological 92%.
In order to strengthen the health of children, preventive examinations are carried out annually for children from birth to 18 years old.
This year, the packages of preventive examinations of children from 0 to 18 years old have been revised and expanded to include additional laboratory research methods.
For 11 months, 4.5 million children were covered by preventive examinations.
Patronage.
In accordance with the universally progressive model of the patronage service, in order to identify and reduce the risks of a medical or social nature, the polyclinic nurse conducts at least 2 prenatal patronage visits to a pregnant woman and 9 visits to children under 5 years old.
School medicine.
School medicine is one of the important areas of PHC work, the main purpose of which is the early detection and prevention of diseases of the school period.
In total, 7319 schools operate in the Republic of Kazakhstan. The number of schoolchildren, as mentioned above, is 3.4 million.
Today, more than 7000 thousand medical workers work in school medical centers, including 200 doctors (curators of school medicine).
The per capita standard of financing for 1 student was increased by 19% and amounted to 654 tenge.
As a result, the total amount of financing has been increased to 27 billion tenge.
The leading positions according to the results of professional examinations of schoolchildren are occupied by pathology of the organs of vision, neuropsychiatric diseases and posture disorders.
The project "Schools promoting Health Promotion" has been resumed, bringing together teachers, nutrition services, students, families, school leaders, school nurses, social workers.
Today, the project covers 1,200 (15.6%) schools.
As a result, the number of overweight students is expected to decrease to 90 per 100 thousand children by 2025 (94.3 at the beginning of the year).
Vaccination
Vaccination is recognized worldwide as the most effective, cost-effective and affordable means of fighting infections.
About 5 million people are vaccinated annually in Kazakhstan, including 1.3 million children.
Financial resources within 30 billion tenge are allocated for this program.
Vaccination of the population is carried out free of charge, according to the National Vaccination Calendar against 20 infectious Diseases.
In order to provide children with vaccines of guaranteed quality, vaccines certified by the World Health Organization are purchased.
The proportion of refusers is less than 1% of the number of persons subject to vaccination.
So 5359 refusals were registered, at the same time, thanks to explanatory work, 1,273 people changed their attitude to vaccination and agreed to it.
In 2005, Kazakhstan registered the largest outbreak of measles among adolescents and adults in the last 20 years (more than 16 thousand cases). This outbreak of measles was stopped with the help of mass immunization of the population, which once again proves the effectiveness of vaccination in the fight against infectious diseases.
Recent years have been very difficult for the healthcare system. All the resources of the health system were directed to the fight against the pandemic.
The Ministry pays special attention to the course of COVID-19 in children, 30 thousand children have received inpatient treatment in three years.
The clinical protocol "COVID-19 coronavirus infection in children" has been developed. Seminars and meetings are being held on the provision of medical care to the children's population during the COVID-19 pandemic with all regions. Since the beginning of the pandemic, 211 specialists have been trained in organizing medical care for children and newborns during the COVID-19 pandemic online.
In addition, the Ministry has organized practical assistance to the regions for the management of children with Multi-inflammatory (Kawasaki-like) syndrome. During the pandemic period, 99 children were treated with this diagnosis.
Dentistry
Planned and emergency dental care for children under 18 years of age is provided free of charge within the framework of the OSMS.
Since this year, dental care for children, including those with disabilities, in the presence of indications, is provided under anesthesia.
Development of specialized care.
One of the main achievements in preserving the health of the child population is the development of highly specialized care in neonatology (the period from birth to 28 days).
Since 2008, children with a body weight of 500 grams have been nursed in the country.
Thanks to the introduction of effective perinatal technologies, the principles of safe motherhood recommended by WHO, the development of neonatal resuscitation, positive results have been achieved over 10 years.
- survival rate of children with extremely low body weight increased by 4 times;
- infant mortality has decreased by 1.5 times (from 13.56 in 2012 to 8.44 in 2021). and today the indicator remains stable;
- infant mortality decreased 1.6 times (from 16.36 in 2012 to 10.04 in 2021) (infant mortality for 9 months was 10.04, at the level of last year).
With the development of neonatal surgery and the transfer of these technologies to the regions, the survival rate of newborns with congenital malformations was 86%.
On average, 1,500 newborns with congenital malformations receive surgical treatment every year.
The share of minimally invasive endo-videosurgery in newborns has increased to 40%.
In 2022, a plan to improve neonatal surgery was approved.
Kazakhstan is the only state in Central Asia where cardiac surgery is performed from birth.
In 11 months of 2022, 1800 open heart surgeries were performed on children with congenital heart defects, 75% of them were performed on children under one year of age
With the involvement of foreign specialists from Germany and Turkey, 24 children with complex defects were operated on as part of the master class.
In the most severe cases, telemedicine technologies and medical aviation have been implemented in Kazakhstan to save the lives of children.
497 sanaviation flights were carried out, of which 271 flights to newborns. Medical assistance was provided to 1072 children.
273 children were transported, 93 of them to the cities of Astana and Almaty.
A roadmap for improving oncohematological care for children until 2024 has been approved.
On average, 500-600 children are detected per year, 41% of them with acute leukemia, 14% with tumors of the central nervous system, 9% with soft tissue sarcomas and other diseases.
The detectability in children of stage 1-2 oncology was 38%.
In the age structure, 33% are children from 3 to 10 years old.
In total, 3,833 children with various oncological and hematological diseases are under dynamic supervision, of which 968 patients continue to receive specific pathogenetic therapy on an outpatient basis.
High–tech modern methods of diagnosis and treatment have been introduced - immunohistochemistry, immunophenotyping, determination of specific cancer markers, high-dose chemotherapy for bone and soft tissue sarcomas, organ-preserving methods of surgical treatment for bone sarcomas.
Over the past five years, 335 children underwent hematopoietic stem cell transplantation, 49 of them this year.
As a result, the 5-year survival rate of children with oncohematological pathology is above 75%.
On behalf of the Head of State, the Ministry has developed a comprehensive plan to combat oncological diseases, which, until 2025, provides for measures to strengthen the material and technical base of children's cancer hospitals, improve drug provision and professional development of specialists of this service.
It is planned to create a National Oncohematology Center for children.
Medical rehabilitation of children.
Every year, the provision of medical care to children with hearing impairment is improved.
Since September of this year, operations with the use of modern hearing aids have been carried out at the expense of the state.
The average cost of cochlear implantation with the Bonbridge device is 5.2 million tenge. To date, 20 successful operations have been carried out.
Financing of medical rehabilitation of children has increased to 15 billion tenge.
For the first time in the country, measures have been launched to introduce the institute of "early intervention" for children under 3 years old.
Currently, there are 7 "Kamkorlyk" early intervention centers operating on the bases of children's medical organizations (in Akmola, Aktobe, Almaty, Abai, Mangistau, Turkestan regions and Astana).
By the end of 2023, it is planned to open 13 more early intervention centers "Kamkorlyk" across the country, which will annually cover more than 10 thousand young children.
49 children's rehabilitation centers are functioning, including 8 rehabilitation centers opened in 2022 as part of the initiative "Kamkorlyk", in each of which over 600 children receive assistance.
It is predicted that this will increase the coverage of children with rehabilitation services by 5,000 children annually.
For 11 months of 2022, 83 thousand children received rehabilitation at the level of round-the-clock and day hospitals, which is 18% more than last year.
12 thousand children received medical rehabilitation services at polyclinics.
The child's home.
In total, there are 19 orphanages in Kazakhstan, with a total bed fund of 1,285.
To date, there are 849 children in orphanages, 546 of them children in difficult life situations (temporarily placed).
During the year, 60% were returned to blood families, 17% were placed under guardianship, 10% were assigned to foster care, 1.5% are in foster families under a contract and 8% were transferred to other institutions.
All children in children's Homes are provided with round-the-clock medical supervision. A comprehensive approach to child care (medical, pedagogical, social, rehabilitation assistance) has been implemented.
"Kazakh Sabi"
As part of the President's instructions, a special program "Ansan Sabi" is being implemented in the country, within which 7,000 women have access to IVF.
In 2022, 6.5 thousand women are covered by the program (the rest are on the waiting list).
As a result of IVF procedures performed, 3,110 long-awaited children were born in 2,654 families within the framework of the implementation of the special program "Ansan Sabi".
In order to improve the care of pregnant women and newborns in the country, it is planned to build 11 modern perinatal centers that meet international standards.
The future of our country depends on the well-being and health of the growing Kazakhstanis.
Therefore, in the Year of Children, the Ministry has formed new initiatives, the further implementation of which will ensure the systematic strengthening and development of child protection.
The Ministry will continue to work for the benefit of children