Applicability of the Clinical Care Classification in the Electronic Document Management of Nursing Staff to Improve the Efficiency of Medical Services in the Health System of the Republic of Kazakhstan: Policy Brief

Currently, the nursing process is at the core of nursing education and practice, creating a scientific base for nursing care. The nursing process is one of the basic and integral concepts of the modern model of nursing service. This concept was given birth in the United States in the mid-50s and over the years of testing in clinical settings has proved its feasibility. In the health system, the professional group of secondary medical personnel is the most numerous and has a significant impact on ensuring the quality, availability of medical care, and efficiency of the entire system. Over the years, nurses from different countries have sought to gain recognition for their profession. The main goal was to establish the boundaries of their professional activities, the differences between medical and nursing duties, to create a terminological and conceptual apparatus of the profession and to determine the scientific method of providing nursing care to patients (clients). One of the most relevant areas of healthcare reforms in Kazakhstan is the development and expansion of the functions of nursing staff, including the maintenance of nursing documentation, the establishment of a nursing diagnosis, monitoring and management of patients, etc. What is the problem? 1. Lack of a single terminological and conceptual apparatus for all nurses; 2. Workload of general practitioners; 3. Implementation of patient attendance by nurses under the doctor's login; 4. Lack of payment to nurses for services rendered; 5. In appreciation of the role of the average medical worker in the treatment process; 6. Low potential in the nursing service. Policy options Scenario 1. Institutionalization of CCC in the health system of the Republic of Kazakhstan through the gradual introduction into information systems of the international classification of nursing diagnoses and nursing interventions in the practice of secondary medical workers. Scenario 2. Interaction of vertical links in the implementation of the CCC by making appropriate changes to regulatory legal acts. Scenario 3. Financing of nursing services by including nursing services in the medical services tariff. The vision for the implementation of the scenarios/policy options. Each of these policy options can contribute to improving the efficiency of providing medical care to the population, the status of secondary medical personnel, and the development of their critical thinking. However, given the different options in the direction of actions, resources and methods used, these policy options can provide a more significant achievement of the goal in improving the quality and effectiveness of introduction when they are implemented in association.

Improving the Rational Use of Medicines by Assessing Antibiotic Consumption to Solve the Problem of Antibiotic Resistance in the Republic of Kazakhstan

The aim. Develop policy options to improve the rational use of medicines by assessing antibiotic consumption to address antibiotic resistance in the Republic of Kazakhstan. We used the data of the Republican Center for Healthcare Development’s report on the assessment of the consumption of antibiotics in the Republic of Kazakhstan, purchased by the Single Distributor within the guaranteed volume of free medical care for 2019, in comparison with the period 2017-2018. Three policy options have been developed: 1. Improving the rational prescription and use of antibacterial drugs. 2. Raising awareness and understanding of antimicrobial resistance issues through information policy and increased training 3. Strengthening control of prescription dispensing of antibacterial drugs in pharmacies. For each policy option, measures are identified to achieve them, as well as possible barriers. A combined implementation of each policy option is necessary, as this issue requires a systematic approach. The implementation of all points of measures will contribute to ensuring the use of antibacterials rationally, according to strict therapeutic indications, with an individual selection of dosages and will exclude self-medication with antibiotics, which in turn will help prevent antibiotic resistance in the future and will give a chance for effective, high-quality and successful treatment of bacterial infections. Key words: medicines, systemic antibiotics, consumption of antibiotics, antibiotic resistance, rational use of medicines, Kazakhstan.

Approaches to improve the effectiveness of social support measures provided to young professionals and graduates of medical education organizations. Policy Brief

What is the problem? • Imperfection of the regulatory legal framework for the provision of various measures of social support to young specialists, graduates of medical education and science organizations of the Republic of Kazakhstan and, accordingly, a low level of travel and employment of young specialists at the place of their personal distribution. • Lack of transparency and insufficient efficiency of the distribution mechanism and provided measures of social support for young specialists, university graduates at the republican and regional levels. • Low motivation and satisfaction of medical workers, including young professionals, arriving to work in rural areas of the Republic of Kazakhstan. Policy options Variant of politics 1. Perfection of normative legal base, qualificatory effective measures on social support of young specialists, graduating students of medical Institutions of higher learning. Variant of politics 2. Цифровизация and automation of distribution of young specialists, graduating students of organizations of education and science mechanism, and also the measures of social support rendered to them for an openness and transparency of process on the platform of www.enbek.kz. Variant of politics 3. Development and implementation of a separate section on employment and social support measures in the Concept for the Development of Rural Medicine, taking into account the existing domestic and international experience. Vision for implementing policy options. Estimating possibility of introduction of the offered variants of politics taking into account present barriers and possibilities, we come to the conclusion, that all three variants of politics complement each other. However, taking into account distinctions of variants in the orientation of actions, used resources and methods, more substantial achievement of aim of increase of efficiency of the measures of social support, rendered to the graduating students of organizations of medical education and science, these variants of politics can give during their сочетанной realization.

Introduction of professional liability insurance for legal and financial protection of medical workers: Policy brief

Main elements: Professional liability insurance of medical workers covers unintentionally incurred risks as a result of the performance of their professional duties, and caused damage to the health and life of the patient. In fact, this is a type of property insurance, in which there is a satisfaction of property claims made to health workers, due to omissions and errors of professional activity For the purpose of administrative and civil protection of medical workers, the issue of introducing professional liability insurance in the medical sphere will increase the level of public confidence in the domestic health care and constructively address medical incidents that have caused damage to the health and life of patients. During the analytical study, 3 policy options were proposed: 1. Establishment of an independent non-profit fund for compulsory insurance of professional liability of medical workers; 2. Insurance of professional liability of health workers through functioning insurance companies; 3. Insurance through professional associations of medical workers of the Republic of Kazakhstan. The vision for the implementation of policy options Each of these policy options will contribute to the development of legal and financial protection for health professionals. To achieve the best results, it is necessary to choose the most effective and implemented policy. Keywords: insurance, professional responsibility, medical workers.

Development of Scientific Medical Journals of Kazakhstan: Editorship Opinion. Policy Brief

What is the problem? • Weak editorial policy: most of scientific medical journals in Kazakhstan do not have their own website and do not support open access to their content that makes difficulties in acceleration of the circulation of scientific knowledge; low level of peer review or its complete absence; frequent violation of the principles of publication ethics; • Poor quality of the content of issues of domestic scientific medical journals: low level of scientific significance of published articles, which are not always relevant for the international scientific community and are little cited; low proportion of English-language articles, as well as insufficiently high level of their style and grammar; • Absence of a comprehensive and dynamic system of expertise, monitoring and certification of scientific medical journals, standardization and regulatory control of editorial and publishing activities in general. Policy options Option 1. State support for the promotion of Kazakhstani scientific medical journals into international scientometric databases by: - development of a program for the development of scientific medical journals in Kazakhstan with a clear funding mechanism; - development and implementation of specific measures to increase the demand for developing Kazakhstani scientific medical journals among domestic scientists (stimulating the development of highly cited research projects; revising the requirements for awarding academic titles in favor of domestic scientific journals; increasing the number of points awarded for articles published in domestic journals during rating assessment) ; - development of effective mechanisms to attract reputable foreign scientists as authors and reviewers for Kazakhstani scientific medical journals; - creation of an association of editors of scientific medical journals in Kazakhstan and systematic training of members of the association on best practice in publishing. Option 2. Intensive development of scientific medical journals in Kazakhstan in accordance with the main international publishing standards at the level of the publishing house-owner, by: - creating your own website for a medical scientific journal that meets the basic international requirements; - introduction of a system of double "blind" reviewing; - strict adherence to the principles of publication ethics. Option 3. Creation of an integrated and dynamic system of examination, monitoring and certification of scientific medical journals, standardization and regulatory regulation of editorial and publishing activities at the level of the Ministry of Education and Science of the Republic of Kazakhstan, by: - the introduction of a comprehensive and dynamic system of examination and monitoring of the activities of scientific, including medical, journals (as an option, on the basis of the National State Book Chamber in close cooperation with subdivisions of state governing bodies in charge of the development and quality of science at the national and sectoral level, and also with associations of scientific journal editors; close cooperation of the team implementing the program for the development of scientific journals in Kazakhstan with the Content Selection Advisory Board of the Scopus team; - joint responsibility of all participants in the publication process (editorial offices of journals, authors and organizations - universities, scientific organizations, etc.) for the preparation of high-quality manuscripts and the development of scientific medical journals in Kazakhstan. Policy options realization perspective Abovementioned three policy options are mutually supportive. Combined realization of these policy options will raise domestic medical scientific journals to a qualitatively new level. Key words: editorial and publishing activity, international scientometric databases, scientific medical journals, editorial policy, Kazakhstan.

Creation of an institutional framework for the development of a sectoral qualifications system in the field of health care through the formation of the Sectoral Council for Professional Qualifications: Policy Brief

What is the problem? • Lack of a permanent body for the coordination and development of the sectoral qualifications system (SQS) in the healthcare system of the Republic of Kazakhstan; • Lack of the SQS’s expert community, expert and analytical structures for the development of professional qualifications in the field of healthcare; • Decisions (that are made in matters of the SQS development) are often based on the opinion of individuals and do not have a sufficient evidence base and agreement with the professional community; • Lack of systematic information on the state and development of USC in the field of health care; • Formation of the basic elements of the sectoral qualifications system (sectoral qualifications framework (SQF) and professional standards (PS)) is carried out on the basis of the implementation of single ("one-off") projects, without further regular updating and support for further implementation of these documents. Policy options • Option 1. Creation of the Sectoral Council for Professional Qualifications in Healthcare (SСPQ) by: o Adoption of an appropriate normative act on the establishment of the Council for Professional Qualifications with the inclusion of all interested parties (representatives of the Ministry of Health of the Republic of Kazakhstan, associations of employers, workers, educational organizations, organizations for assessing professional qualifications, etc.) o Anchoring in the Regulation of the SСPQ and other normative acts and regulations of the role and powers of the SСPQ in the development of the SQS (monitoring the development of the SQS and evidence-informed policymaking in the field of qualifications, developing and updating, introducing and evaluating the effectiveness of using the SQF and PS); o Determination of the SСPQ working body responsible for the methodological and organizational support of the SСPQ work, allocating funding to support the SСPQ activities and conducting research and development in the field of the SQS; o Development of a Strategy and a Roadmap for the progress of the SQS in the field of health, defining the priority directions and mechanisms for the SQS development, quality assurance and regulation of the qualifications market with the involvement of all stakeholders. • Option 2. Formation of the expert community of the sectoral qualifications system in the context of all specialties and specializations in the field of health care, by: o Development and launch of standardized modular courses for training experts on the development of SQS; o Training and formation of the register of experts on the SQS development in the context of all specialties and specializations in the field of health care; o Creation of committees for professional qualifications in key specialties at the SCPQ, including the most experienced and authoritative specialists in the relevant specialty. • Option 3. Ensuring transparency and accessibility for all stakeholders of information on the state and development of the SQS by: o Launch of a single on-line resource about the SQS in the field of health care (administered by the SCPQ working body); o Developing the SCPQ and its health working body as a Knowledge Translation Platform for professional qualifications in health policy making; o Introduction of the practice of regular (annually or once every two years) publication of a report on the state of the SQS in the field of health care; o Conducting forums on a regular basis and organizing dialogue platforms on the development of the SQS; o Establishing close interaction and dialogue between the SCPQ in the field of health care and the SCPQ of other sectors, whose specialists contribute to the formation of public health.