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Report on achievement of key performance indicators of the Memorandum signed between the Prime Minister and the Minister of ZSR of Kazakhstan as of 1 October 2016

For the achievement of the indicator "Total mortality per 1000 population" (the target value was 7.56)

According to preliminary data of statistics Committee of the Ministry of national economy of the Republic of Kazakhstan for the first 7 months of 2016, the death rate of the population of Kazakhstan decreased by 4.5% and amounted to 7.5 per 1000 population against a 7.85 in the same period last year (with the forecast set at the end of 2016 was 7.56).

Since the beginning of this year launched a new State health development program "Densaulyk" for the years 2016-2019.  The main activities of the Ministry aimed at further reduction of mortality from main causes, including diseases of the circulatory system, malignant neoplasm and accidents, injury and poisoning, as well as maternal and infant mortality.

To this end, the PHC level is being implemented the Program of disease management for three diseases: hypertension, chronic heart failure and diabetes. It provides personalized timely registration, prevention and provision of quality health care feature of the Program is the conclusion with the patient of the social contract. The programme is implemented in pilot mode in 7 regions.

Along with the strengthening of preventive measures at the level of PHC, measures are taken to improve the quality of patient care through implementation of the integrated model disease with direct impact on the demographics of the country.

Currently established five Coordination councils in five disease groups, the roadmap, and identifies the responsible national organization.

During the reporting period, Coordinating councils carried out an analytical work in which a number of problems of personnel and logistics, for which following work performed.

Conducted regionalization 1313 medical organizations. The author analyses the normative-legal acts on the provision of medical care on profiles, and clinical protocols and standards. Work on mainstreaming.

Composed of the indicators of the quality level of medical care for the profiles. Developed training programs for professionals at all stages, processes and levels and a schedule of training.

  For the achievement of the indicator "Maternal mortality rate (hereinafter – MS), per 100 thousand live births" at the end of 8 months of 2016 (the target value of 11.5)

For the first 8 months of 2016 was 32 cases, the rate per 100 thousand live births was 11.4 against 12,0 per 100 thousand live births of the same period last year, a decline of 5%.

At the same time, the highest rates of maternal mortality registered in Pavlodar (24,0), West Kazakhstan (22,8), Aktobe (22,4), Karaganda (18,5), Zhambyl (17,2), South Kazakhstan (17,0), East Kazakhstan (13,0) regions.

In the structure of MS causes associated with pregnancy and childbirth, amounted to 34.3% of not related to pregnancy and childbirth – 53,2%. There is a decrease in mortality from controllable causes.

The level of perinatal care the death occurred at the first level in 1 case (3,1 %), II – 4 (12,5%), at III – 25 (78%), national level – 1 (3,1 %), private clinic – 1 (3,1%). Analysis of the mortality of regionalization showed that the mortality rate at the second level 2 times.

 For the achievement of the indicator "Infant mortality (hereinafter – MLS) per 1000 live births" at the end of 7 months of 2016 (the target value of 9.6)

According to the Committee on statistics of MNE of RK in 7 months of 2016, the infant mortality rate of 9.28 per 1000 live births against of 9.77 for the same period in 2015.

The highest rates of infant mortality recorded in Kyzylorda (12,26), South Kazakhstan (10,9), Mangystau (10,2), East Kazakhstan (10,06), Aktobe (of 9.96), Zhambyl (of 9.48), Kostanay (9,40).

In the structure of causes of infant mortality are the leading conditions originating in the perinatal period (PP) is 54.5% and congenital malformations (cm) is 22.2 per cent, from sepsis (6,5%), respiratory diseases (6.4 percent).

To reduce maternal and infant mortality in the State health development program "Densaulyk" for the years 2016-2019 approved a roadmap for improving the effectiveness and implementation of the integrated model of maternity care and childhood. In each region jointly with the regional governments developed and approved a similar road map.

Developed and approved by decree of the Minister of health and social development No. 695 of August 3, 2016 "On the procedure of hospitalization of pregnant women, pregnant women, postpartum women and children in the Republic of Kazakhstan".

The coordination Council on implementation of the integrated service model improved the analysis of the legal and regulatory framework in line with international practice and who guidelines.
So, analyzed more than 51 of the PPA, more than 96 clinical protocols on obstetrics and child, prepared for revision of more than 30 clinical protocols. The developed Standard of the organization of delivery of obstetric care and the Standard of pediatric care to children under the age of 5 years in the Republic of Kazakhstan, the revised order to conduct a confidential audit of maternal mortality, critical cases in obstetric practice. 2016 implemented confidential audit of perinatal mortality, this will reveal the true reasons, not only related to the health care system, but also with other spheres (education, law enforcement).

To address the issue of shortage of personnel is planned in 2016 to prepare specialists of residency (61 obstetrician-gynecologists, neonatologists 77, 13 anesthesiologists).

On a regular basis the filling of the Register of pregnant women at PHC level, is carried out daily monitoring of the "movement" of pregnant women, depending on risk.

For the achievement of the indicator "Coverage of the measures to promote employment: the unemployed and unproductive self-employed" (the target value of 54.4% versus 19.1%)

In the framework of its competence the Ministry of health and social development of the Republic of Kazakhstan conducts management and inter-sectoral coordination in the field of employment in accordance with the legislation of the Republic of Kazakhstan.

The calculation of this indicator is conducted by including the share of the unemployed and unproductive self-employed covered by the employment measures under the Comprehensive plan to promote employment of the population by 2016, including a Road map of employment-2020 and indicators of the labor market.

Comprehensive plan to promote employment for the year 2016 was developed and was implemented on 1 April 2016. Since April this year, actively started implementation of the employment Road map 2020 (repair of infrastructure projects, micro-credit, etc.).

As of September 1 of the current year, the employment promotion measures under the Comprehensive plan to promote employment of the population by 2016 covered 313,5 thousand, of which KZT 235.7 thousand unemployed (52.3%) and 77.8 thousand. unproductive self-employed (15.2 per cent).

In General, planned activities expected performance in full.

For the achievement of the indicator "the Share of employed population covered by the funded pension system" (the target value of 70.8%)

The calculation of this indicator is produced by the ratio of the number of participants in the cumulative pension system to the employed population.

Official data on employment are taken from the website of the Committee on statistics of the Ministry of national economy of Kazakhstan, data on the number of participants in the cumulative pension system are provided by JSC "Information-analytical center on employment issues".

According to the number of employed people in August 2016 was 8 519,8* thousand people, the number of depositors in accumulative pension system in the first seven months amounted to 5 437,9 thousand people, so figure for the month of August was exceeded by 1.2%.

The main activities aimed at the achievement of this indicator is to monitor the participants of the accumulative pension system (NPS) and conducting advocacy on issues of pension (social) security.

In addition to the General monitoring of coverage of the employed population of NPS by the Ministry on a monthly basis work on monitoring of enterprises, which allowed the reduction of participants in the cumulative pension system in two or more times.

Advocacy work is conducted on an ongoing basis in the framework of activities provided for Media plans of the Ministry of health and its subordinate organizations.

The work is conducted in accordance with the plan.

*Estimated

 To achieve the indicator "the share of the working-age population in the number of TSA recipients" (target value – 30%)

As of 1 October this year targeted social assistance is assigned 26.0 thousand people less in comparison with the situation on 1 October 2015 by 25.3%, while the amount of appointments – 615,9 million tenge (in comparison with the similar period of 2015 decreased by 18.1 %). The average size of the ASP for the period was – 2636,6 tenge that is more by 9.5% compared to the same period of 2015.

Payment of ASP is carried out promptly and in full. This issue is under constant control of MIO.

It should be noted a downward trend in the number of able-bodied persons in the composition of recipients of ASP, which amounted on October 1, 2016 – 27.5 %, in comparison with the similar period of 2015 decreased by 2.1 % (to 1 Oct 2015 – 29,6 %, by the end of 2015 – 29,2 %, 2014 is 30.8 %, in 2013 – 31.4 percent). This is largely due to the pilot project "Orleu" in the regions to provide conditional cash assistance to poor citizens on the basis of a social contract, implemented by order of the President.

This figure has a high degree of volatility, ASP is appointed to the quarter, and the structure of the recipients changes significantly upward in the next quarter, and accordingly, the number of employable persons is increasing, namely the self-employed; women sitting on care of children, invalids of groups 1 and 2; wage earners; the unemployed consisting on the account in employment offices. For example, as of 1 January 2014, the proportion of the working-age population in the number of TSA recipients is 29.9% and at the end of 2014 (1 January 2015) is gradually increased to 30.8%, i.e. 0.9 percentage points

        On 1 September 2016, conditional cash assistance under the project "Orleu" is assigned to 27.1 per thousand for the total amount of 739,4 million tenge, in active forms of employment assistance was by 6, 174 or 89.4% of the total working-age participants of the project "Orleu".

In General, the planned event is expected to perform in full.

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