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11. Healthcare institutions in Kazakhstan.
12. The development of healthcare in our country
Life expectancy at birth in Kazakhstan is 148th in the world, below most developed nations and some developing nations. It is below the average life expectancy for the European Union.[
The World Health Organization (WHO), in 2000, ranked Kazakhstani health care system as the 64th in overall performance, and 135th by overall level of health (among 191 member nations included in the study). The quality of health care, which remained entirely under state control in 2006, has declined in the post-Soviet era because of insufficient funding and the loss of technical experts through emigration. Between 1989 and 2001, the ratio of doctors per 10,000 inhabitants fell by 15 percent, to 34.6, and the ratio of hospital beds per 10,000 inhabitants fell by 46 percent, to 74. By 2005 those indicators had recovered somewhat, to 55 and 77, respectively. Since 1991, health care has consistently lacked adequate government funding; in 2005 only 2.5 percent of gross domestic product went for that purpose. A government health reform program aims to increase that figure to 4 percent in 2010. A compulsory health insurance system has been in the planning stages for several years. Wages for health workers are extremely low, and equipment is in critically short supply. The main foreign source of medical equipment is Japan. Because of cost, the emphasis of treatment increasingly is on outpatient care instead of the hospital care preferred under the Soviet system. The health system is in crisis in rural areas such as the Aral Sea region, where health is most affected by pollution.
The most common diseases are respiratory infections, cardiovascular conditions, and tuberculosis. Since 2000, the incidence of human immunodeficiency virus (HIV) has increased, as has the incidence of environment-linked cancers. In 2003 an estimated 23,000 citizens had HIV. Because of increasing numbers of people in high-risk categories, such as female sex workers and intravenous narcotics users, experts forecast an increase in that figure. In 2003 an estimated 80 percent of cases were narcotics-related. In 2006 an outbreak of juvenile HIV caused by improper hospital techniques gained national attention. In the first nine months of 2006, some 1,285 new cases were reported officially.
37 mothers died per 100,000 live births in 2009. The maternal mortality rate had gone down slightly in comparison to 2008.
Officials reported very high numbers for suicides in Kazakhstan.
Health care in Kazakhstan is provided by a network of primary, secondary and tertiary care facilities. Health care facilities are largely owned and operated by the public sector represented by the Ministry of Health. Health insurance is now primarily provided by the government in the public sector.
Health care providers in Kazakhstan encompass individual health care personnel, health care facilities and medical products.
In Kazakhstan, ownership of the health care system is mainly in public hands.
The public hospitals share of total hospital capacity has remained relatively stable (about 70%) for decades. There are also privately owned for-profit hospitals as well as government hospitals in some locations, mainly owned by county and city governments.
There is a nationwide system of government-owned medical facilities open to the general public. The national Department of Defense operates field hospitals as well as permanent hospitals (the Military Health System), to provide military-funded care to active military personnel.
Hospitals provide some outpatient care in their emergency rooms and specialty clinics, but primarily exist to provide inpatient care. Hospital emergency departments and urgent care centers are sources of sporadic problem-focused care. Hospice services for the terminally ill who are expected to live six months or less are most commonly subsidized by charities and government. Prenatal, family planning care is government-funded obstetric and gynecologic specialty and provided in primary care facilities, and are usually staffed by nurse practitioners (midwives).
A big share of medical health care is delivered through a vast network of primary care facilities called ambulatories and policlinics.