Background Cardiovascular diseases (CVD) occupy leading positions in the mortality of the Republic of Kazakhstan (RK). In RK CVD screening is performed with 40-years of age. Objectives: to evaluate the effectiveness of screening over time. Methods We conducted a survey of 121 patients with CVD, identified on screening. Results The average age patients in survey-54.3 [95% CI: 52.64;55.96], of which 38% are men and 62%-women. Fact smoking mark 64 persons (52±8), alcohol-(37.2±11.6), family history-66 (54.5±8.1) daily physical activity-34 person (28.1±14.3). Middle systolic blood pressure (BP) is 144.3 [95% CI: 141.61;146.99] and diastolic BP 90.2 [95% CI: 89.02;91.38] mm.Hg. Most of the respondents have different degrees of obesity. The average BMI is 31.8 [95% CI: 30.93;32.67]. The average waist size is 89.1 [95% CI: 86.88;91.52], with the waist size of women over 80 cm (91.9 [89.03;94.77] and the waist size of men 86.1 [82.31; 89.89]. Mean values for total cholesterol of 5.9 [95% CI: 5.85;5.95]. To evaluate the effect of various factors on the increase in BP, we calculated the analysis of variance. According to our calculations, gender does not affect BP, however, age, BMI and waist size affect. We interviewed patients for complaints, analyzed outpatient cards, a check-up journal: chest pains or interruptions in the heart during exercise are noted by 25 people (20.7±17.5), improvement of the subjective state-29 (24±15.9), regularly receive basic therapy-59 (48.8±9.1), call the ambulance team-43 (35.5±12), are urgently hospitalized for a year-31 (25.6±15.2) and 7 person participate in the school of CVD. There is a statistically significant relationship between gender and smoking, gender and alcohol, gender and regular intake of basic therapy at a significance level of p < 0.05. Conclusions Identifying the low effectiveness of CVD screening over time requires the revision of a comprehensive training program for doctors-nurses and the public. Key messages Patients in Kazakhstan generally do not change their lifestyle after screening for a disease. The effectiveness of the screening depends on the teamwork of the doctor, nurse and patient.

Background Employment of graduates of medical universities is one of the traditional problems of health care in the Republic of Kazakhstan (RK). The annual graduation of medical universities of RK exceeds 4500 young specialists. Despite this, as well as the positive dynamics of employment, the health care industry continues to experience a shortage of medical personnel. Methods To take effective measures to improve the employment performance of graduates of medical education organizations, to cover the shortage of medical personnel, an analysis was made of the employment of graduates of internship programs at 8 medical universities for the period from 2014-15 to 2016-17 school years Results For three years, medical schools of RK prepared 12019 people, of whom 8921 people studied under the state and 1343 under the rural grant. The total number of employed was slightly more than half of the graduates-6533, which amounted to 54.4%. At the same time, the number of those employed in urban hospitals is 1.5 times higher than the number of those employed in rural medical organizations. High percentages are persons who have continued their studies in residency/magistracy, and this figure tends to increase every year. The trend towards an increase is maintained by the free distribution index for pregnant women and people caring for children under the age of 3 years, for a total of three years it was 1,452 (12.1%) of a person. At the same time, those employed in rural health facilities are only 19.1% of those who studied under the grant and 31.5% of those who studied according to the rural quota. Conclusions Thus, the percentage of employed graduates, as well as graduates who studied under the state and rural grant, barely exceeds 50%. Even the employment of persons trained in rural quotas in rural health care facilities is only 31.5%. Universities do not fully monitor the employment of graduates, especially those who studied under a state or a rural grant. Key messages To create and implement an electronic platform with a complete database of students and graduates. To monitor employment and track the graduate’s work route; to organize employment services at universities.

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Issue Constantly emerging new challenges for national health systems (HS) and new technologies require the creation of conditions for the continuous provision of the HS with the necessary number of health workers (HW) with the appropriate level of qualifications. In this regard, the high relevance acquires the formulation of a structured description of levels of qualifications in the HS, the requirements for the future and existing qualifications, taking into account the priorities of the HS development, as well as mapping of occupations by the qualification level. Description of the Problem The main problems in regulating the sectoral qualifications system (SQS) in Kazakhstan is the lack of a sectoral framework of qualifications (SQF) and professional standards governing the requirements for specialists in the HS, and the lack of a clear distinction of competencies by the qualification level. Accordingly, there is a discrepancy between educational programs and practical health care needs, and an imperfection of the HWs certification system. Changes: We have incorporated into the National Code 'On the health of the people and the HS' points that define the SQS basic principles and regulation. As SQS has been defined set of legal and institutional mechanisms to control demand of HWs from the labor market and the qualifications offer from the health education system. SQS includes SQF; professional standards; state compulsory health education standards; system for assessing the professional preparedness and certification of specialists; system of continuing professional development of HWs. For a structured description of the levels of qualifications recognized in the HS we developed SQF. In SQF all HWs were divided into sub-sectors: medicine, pharmacy, public health and intersubsectoral processes. Lessons The presence of an effective SQS will create the conditions for providing the HS with human resources that meet the needs of the state, business and society. Key messages We have analyzed the existing system for regulating the qualifications of health professionals and have proposed legislative mechanisms for regulating the SQS in the field of healthcare. This made it possible to ensure conditions for effective legal regulation of the HWs qualification demands from the labor market and the supply of qualifications from the health education system.

Currently, in the Republic of Kazakhstan, the institution of professional managers and transparent forms of health organizations management, including modern management technologies, are being implemented.  Thus, sufficient professional competency of managerial decision-makers should be one of the most important factors in ensuring the development of a national health system and implementation of all current reforms in the industry. This article aims to investigate the high relevance of the evaluation of health care manager’s competencies and the development of measures to improve its level.In this cross-sectional study, we have analyzed managerial competencies of different levels of healthcare managers using a special questionnaire, which was developed by EPOS health management group to assess their competencies. We interviewed 61 managers of different levels. On the basis of feedbacks, core competencies and their possession by hospital managers were identified.At the first stage, respondents were asked to assess the importance of different competencies required for their work activity. All levels of management showed the high practical importance of assessed competencies. Results of the basic level demonstrated a practical importance of competencies ranging from 73% to 85%, the middle-level managers were from 83% to 93%, and senior level results were 97% to 98%.  The next stage of the survey was an assessment of respondent’s average level of self-esteem for the competencies they possessed.  Mid- level managers showed a higher possession of competencies than other levels, from 56.8% to 70.2%; the basic level was from 46.9% to 59.6%; and senior level was from 41.6% to 54.7%. The questionnaire was designed in a way to highlight the training gaps as the difference between the importance attributed to the command of a given piece of knowledge, competency or skills, and the level of proficiency the managers are demonstrating currently.  Finally, the third stage assessed the training required, wherein each management level has their specific training requirements.  As research shows, senior managers have the highest level of required training.  For senior level, the greatest needs for training are “self-management” and “quality management.”  For basic level, trainings are in “HR management” and “quality management.”  For middle managers, their training needs are in all domains of management.There is a discrepancy between the required and the actual competencies that different levels of health managers’ have. The largest gap between mandatory and existing competences exists at the basic level, in “Personnel Management.”  A gap in the mid-level was in “Information and Financial Management”; and it was in “Quality Management” for the senior level.  The proposed questionnaire could help to identify the most important training required to fill these gaps.