UDK 614:614.25:331.1

Analysis of Health Care Personnel Dynamics in the System of Preparation of Medical Specialists in the Republic of Kazakhstan

Baiganova Z.A., Dubitsky A.A., Magsumova R.Z.

Republic of Kazakhstan

Medical University Astana

Key words: personnel policy, health care system, preparation of medical personnel.

Actuality. Efficiency of personnel policy in health care includes problems concerning planning, preparation and usage of health manpower resources.Planning the number, strength and health care manpower structure must be based on the Constitution of Kazakhstan Republic, Code of Republic of Kazakhstan “About the Population’s Health and Health Care System”, Labour Code of Republic of Kazakhstan, national program of health care development in the years 2011-2015,conception of manpower resources development in health care for the years 2012-2020 meeting the requirements of the population in preventive medical, diagnostic, rehabilitation help. The number and personnel structure are developed according to the strategic development of the country.

Realization of basic stages of health care reformation as to providing the population with high quality medical aid inseparably linked with constant monitoring, training and development of personnel over the whole period during which a specialist works. Improvement of the continuing lifelong medical education, providing guaranteed employment for graduates demand new approaches and solutions:

- development of science- based approaches to the formation of the state order for specialists’ training according to the real profile needs of regions and formation of targeted enrolling of students to higher medical schools.

-creation of new models of interrelations, regulating rational use of graduates having studied both on educational grants and contract basis

-development and realization of science-based approaches to the estimation of medium-term (to 2020 year) and long-term forecasting (to 2030 year) of needs in specialists in the health care system.

Aim. To study personnel dynamics of health care in the system of medical specialist training in Kazakhstan.

Materials and methods. Secondary data of statistical digest of the Republic of Kazakhstan and regulatory legal acts of the Republic of Kazakhstan are used. Informational analytical method, content analysis and comparative approach are used.

Results and their Discussion. In the last years significant measures have been taken to preserve, maintain, develop regular personnel, to raise their professional level. Integrating actively into international educational space since 2007 a new compulsory national standard for medical and pharmaceutical staff training has been adopted (undergraduate school-magistracy-PhD or undergraduate school-residentura-PhD). The educational program on MBA training in the field of hospital management was adopted in 2008 within the framework of which undergraduates are trained in the USA, Austria, Turkey. On the basis of each medical school educational clinical centers were created and they made it possible to accentuate on clinical training of students and interns. On a national level the center of independent assessment of practical skills and clinical competence of graduates of medical universities was founded. National standards of institutional accreditation have been worked out and are being successfully implemented. Since 2012 public health specialists and nursing staff have been graduating from medical universities. The work started on the improvement of regulatory legal base of health care personnel, the nomenclature of specialty and posts have been developed and their description and characteristics were developed also. The requirements concerning assessment of medical staff skills were reconsidered .In 2014 on the basis of the republican center of health care development of ministry of health and social development of the Republic of Kazakhstan national observatory of health manpower resources was established , it is the coordinating center working on the problems of manpower policy and research in health care. However, at the present stage manpower policy in new social economic conditions should be developed with due regard for the changes that are taking place both in the system of health care and in our society on the whole:

- There is a tendency towards the population’s health declining

- Birth rate being increased

- Growth of the number of noninfectious diseases

- Finance deficit, lack of finance allocated for health care

In the light of health care reforming and moving to joint and several responsibility for a man’s health within the framework of insurance medicine restructure and transition to economic management is inevitable and that will accordingly demand training of personnel with careful study of such sections as health care economics, the problems of obligatory insurance medicine, price formation, pricing policy in the system of health care , social and administrative management, marketing of medical services , modern information technologies. New medical technologies, implementation of latest science achievements into medical practice also require constant improvement of the system of medical personnel training.

According to the data of the statistical digest “ Living standards of the population of Kazakhstan 2009-2013” the statistics committee of national economy ministry of the Republic of Kazakhstan the number of doctors stably increases in the country (table 1) and within 5 years it increased to 8,73% compared to 2009 year. Provision indicator for 10 000 population also changed to 2,64 % accordingly.

Table 1. The Number Dynamics of doctors in KZ within 5 years

№	Title	2009 year	2010 year	2011 year	2012 year	2013 year
1	The number of the doctors of all specialties( without dentists), thousands of people	60,7	63,2	62,2	64,4	66,0
2	Provision for 10 000 people of the population	37,8	38,8	37,6	38,4	38,8

The number of paramedical personnel, nursing staff is increasing (table2) and within the period 2009-2013 it increased for 22,36 %, the provision indicator for 10 000 people also increased to 15,6% for the period being analyzed.

Table 2. The number of nursing personnel dynamics in Republic of Kazakhstan within five years

№	Title	2009 year	2010 year	2011 year	2012 year	2013 year
1	The number of nursing personnel, thousands of people	138,6	143,8	159,9	168,7	169,6
2	Provision of 10 000 of the population	86,4	87,5	96,5	100,4	99,5

The Indicator of nursing personnel correlation to the doctors increased in the country on the average to 12,28% from 2009 to 2012 years to 2,56 in 2013.

In the system of medicals staff training some positive tendencies can be seen, for example, from 2009 till 2012 the number of medical personnel of medical universities increased to two units (table3) and medical schools increased to 11 units (table 4).

The number of students of medical universities increased to 3 %.The number of enrolled students within 4 years period increased to 4,5% and the number of the medical graduates increased to 10,82 %.

Table 3 .Training of medical personnel in medical universities

№	Title	2009 year	2010 year	2011 year	2012 year
1	The number of medical universities	7	7	7	9
2	The number of the students at the beginning of the academic year	30181	27707	29230	31106
3	The number of the students having been enrolled in medical universities at the beginning of the academic year	6410	6863	6358	6831
4	The number of the graduates at the end of the academic year	2956	3568	3436	3276

The number of the students and the number of graduates in medical schools increased to 13, 2% and 8,3 accordingly.

Table 4. Training of the medical personnel of secondary level in medical schools.

№	Title	2009	2010	2011	2012
1	The number of medical schools of secondary level	52	55	55	63
2	The number of the students at the beginning of the academic year	46375	47498	44072	53402
3	The number of enrolled students	15568	16677	-	-
4	The number of the students having graduated	10511	15128	11423	12090

The indicator of the correlation of the students having graduated from secondary medical schools to the graduates of medical universities slightly changed to 3,9% ( it is 3,55 in 2009 and 3,69 in 2013).

Conclusions

1. Provision indicator for medical practitioners for 10 000 of the population is 38,8%;

2. Indicator of the correlation of doctors – nursing personnel is not enough 1:2,56.WHO recommends for one doctor should be four nursing personnel;

3. The indicator of correlation of nursing staff to doctors (2,56 in 2013) in the country is less than the same indicator among graduates (3,69 in 2013);

4. The analyses of the received indicators revealed the necessity to increase the number of nursing personnel in order to decrease doctors’ workload and pressure and to improve the quality of their work for the fulfillment of the main medical manipulations for their patients.

Literature.

1. Constitution of the Republic of Kazakhstan, August 30^th 1995.

2. The Code of Republic of Kazakhstan “About people’s health and health care system (with changes and addendum10.07.2012.

3. Labour Code of Republic of Kazakhstan 2007 May 15 № 251.

4. Education Act of Republic of Kazakhstan. - 2007, July 27.

5. National Program of health care development of Republic of Kazakhstan for the period of 2011-2015 years. - November 29. – 2010. - № 1113. – 36 с.

6. Government Regulation of Republic of Kazakhstan 2011 February 25 № 183 “Strategic Plan of Health Care Ministry of Republic of Kazakhstan within the years 2011-2015”.

7. National Program of Reforming and Development of Health Care of Republic of Kazakhstan within the period 2005-2010.

8. Integrated Plan of Measures and Steps for Health Manpower Resources Development of Republic of Kazakhstan for the years 2013-2016.

9. Statistical Digests of Health Care Ministry of Republic of Kazakhstan;

10. Statistical Digest “The Population’s Living Standards of Kazakhstan 2009-2013 years” of the Statistical Committee of National Economy Ministry of Republic of Kazakhstan.