One of the top-priority task of any state is the protection of children's health and development child health. In the best interests of the child in the health is being maintained and improved free health care to children. Thus, the issues of infant, child and maternal mortality rates in the Republic remain relevant and are under special control. Especially neurosurgical care to patients of children's age in a large city.
Relevance of the study. One of the priorities of the state policy and an important element of national security is to protect the health of the population. The problem of the population's health is determined by many factors. Leading among them are heredity, the environment, lifestyle and place of residence of the person [1, 2].
According to experts of the world health organization to cause more than a quarter of all preventable diseases in the world is the low quality of the environment (figure 1).
Modern socio-economic conditions of life for the majority of the population of Kazakhstan in the early 21st century led to the deterioration of their health. The health-care reform, the formation of new economic relations, a gradual transition to the system of mandatory social health insurance (MSHI) and private medicine called for the design of stabilization measures for the improvement of medical care [3, 4, 5] (figure 2).
The child health and development child health are priority tasks of the government [6].
In the best interests of the child in the health is being maintained and improved free health care to children. Children under 18 years with certain diseases (States), including children with disabilities, according to testimony, free of charge on an outpatient basis, are provided with drugs and specialized medical products according to the approved List of medicines and medical devices [6].
By improving social and economic conditions of life of Kazakhstan, in the country there is a trend to improve the basic health and demographic indicators. Thus, a decrease in mortality, increase in natural population growth [6].
№ |
Name areas |
Natural increase |
Fertility |
Mortality |
|||
9 months 2014. |
9 months 2015. |
9 months 2014. |
9 months 2015. |
9 months 2014. |
9 months 2015. |
||
1 |
RK |
15,41 |
14,98 |
23,13 |
22,69 |
7,72 |
7,71 |
2 |
Akmola |
7,26 |
6,68 |
17,76 |
17,26 |
10,50 |
10,58 |
3 |
Aktobe |
17,09 |
16,94 |
23,81 |
23,64 |
6,72 |
6,70 |
4 |
Almaty |
17,98 |
18,06 |
24,85 |
25,39 |
6,87 |
7,33 |
5 |
Atyrau |
22,35 |
21,08 |
28,46 |
27,13 |
6,11 |
6,05 |
6 |
East Kazakhstan |
6,60 |
6,09 |
17,10 |
16,70 |
10,50 |
10,61 |
7 |
Zhambyl |
19,91 |
18,75 |
26,87 |
25,48 |
6,96 |
6,73 |
8 |
West Kazakhstan |
11,70 |
10,90 |
20,55 |
19,78 |
8,85 |
8,88 |
9 |
Karaganda |
8,26 |
7.70 |
18,16 |
17,84 |
9,90 |
10,14 |
10 |
Kyzylorda |
21,13 |
19,52 |
27,30 |
25,47 |
6,17 |
5,95 |
11 |
Kostanay |
3,65 |
3,59 |
14,56 |
14,35 |
10,91 |
10,76 |
12 |
Mangistau |
27,15 |
25,73 |
31,84 |
30,49 |
4,69 |
4,76 |
13 |
Pavlodar |
7,29 |
6,89 |
17,37 |
16,94 |
10,08 |
10,05 |
14 |
North-Kazakhstan |
1,98 |
2,17 |
14,28 |
14,50 |
12,30 |
12,33 |
15 |
South Kazakhstan |
24,56 |
23,90 |
30,13 |
29,48 |
5,57 |
5,58 |
16 |
Astana city |
24,32 |
25,25 |
28,57 |
29,78 |
4,25 |
4,53 |
17 |
Almaty city |
12,22 |
12,08 |
19,46 |
18,73 |
7,24 |
6,65 |
According to the statistics Committee of the RK |
Table 1 - Coefficients of natural movement of population (January-August 2014-2015) per 1,000 of population
Thus, the issues of infant, child and maternal mortality rates in the Republic remain relevant and are specially monitored [6]. Despite of this, currently the health system in the context of reforms to date cannot solve the basic problems of providing comprehensive, efficient and high-quality neurosurgical care to children. An aggravating factor is insufficient funding, obsolete equipment, high cost of drugs, personnel problems [7, 8].
In large cities the main institution providing primary health care to children remain of city and regional children's hospitals. However, optimizing the provision of neurosurgical care at this level has not been reached [9, 10].
Research on the integrated study of children's health, is currently still small. Moreover, research mostly relate to some of the problems or on certain areas of medico-social assistance.
All of the above suggests that a provision of neurosurgical care to children living in a large city, require a more in-depth study and the development of appropriate programs for the preservation and strengthening of their health.
Conclusion.
Considering all the above, we propose on the basis of comprehensive medical and social research to justify modern organizational forms of neurosurgical care to the children of a large city. To achieve this goal it is necessary to solve following
tasks: to study the dynamics of medico-demographic indicators of Astana for 2016 - 2019; to assess the state of health of child population residing in a large city; to reveal the peculiarities of the organization of preventive and curative care for children's population of a large city; to explore the opinion of medical professionals on medical and organizational features of the delivery of neurosurgical care to children living in a large city; to suggest ways of improving the work of health facilities providing neurosurgical help to children living in a large city.
REFERENCES
- Denisov I.N., Chernienko E.I. Improving the organization of primary health care // Handbook of General Practitioner: a monthly scientific and practical journal. - 2008. - №11. - P. 1346-1352.
- Schepin О.P., Belov V.B. Shchepin, OP The role of health in the formation of public health // Problems of social hygiene, public health and history of medicine. - 2007. - №3. - P. 3-5.
- Law of RK «On mandatory social health insurance» № 405 -V SAM on November 16, 2015: http://adilet.zan.kz/rus/docs/Z1500000405
- Acharya A, Vellakkal S, Kalita S, et al. Do Social health insurance schemes in developing country settings improve health outcomes and reduce the impoverishing effect of healthcare payments for the poorest people? . Available at: http://r4d.dfid.gov.uk/PDF/Outputs/SystematicReviews/FINAL-Q40-Social-Health-Insurance-Protocol-DFID-LSHTM.pdf. Accessed 18/04/16
- Cutler, D. M. and R. J. Zeckhauser The Anatomy of Health Insurance // Handbook of Health Economics. - Newhouse. North Holland: Elsevier Science, 2000. - №1. - Р. 563-643.
- Report on the situation of children in the Republic of Kazakhstan [Electronic resource]. - Access mode: https://www.bala- kkk.kz/sites/default/flles/upload/flles/%20%204.12.2015.doc%i2B%2B%2B%281%29.pdf.
- Chicherin L.P. The further development and implementation of the principles of social pediatrics // Rossiyskiy pediatricheskiy zhurnal. - 2013. - №6. - Р. 28-30.
- Al'bitskiy V.Yu., Ustinovа N.V., Kulikov O.V., Kim A.V. et аl. The order of organization of department of health and social care for children's clinic // Voprosy sovremennoy pediatrii. - 2013. - №4. - Р. 12-16.
- Baranov A.A., Al'bitskiy V.Yu., Ustinova N.V. Status, problems and prospects of the organization of medical and social care for children // Rossiyskiy pediatricheskiy zhurnal. - 2013. - №3. - Р. 4-6.
- Medvedevа O.V., Dmitriev A.V., Petrova E.I. Organization of health and social care for children in diffi cult situations // Saratovskiy nauchno-meditsinskiy zhurnal. - 2012. - №8(2). - Р. 305-307.