I.O'S ORDER. MINISTER OF HEALTH OF THE REPUBLIC OF KAZAKHSTAN

of November 10, 2009 No. 685

About establishment of target groups of persons which are subject to routine medical examinations and also rules and frequency of carrying out these surveys

According to Item 7 of article 155 of the Code of the Republic of Kazakhstan of September 18, 2009 "About health of the people and health care system" I ORDER:

1. Establish:

1) the Target groups of persons which are subject to routine medical examinations according to appendix 1 to this order;

2) Rules and frequency of performing routine medical examinations of target groups of the population according to appendix 2 to this order.

2. To department of strategy and development of health care of the Ministry of Health of the Republic of Kazakhstan (Aydarkhanov A. T.) provide in the procedure established by the legislation of the Republic of Kazakhstan state registration of this order in the Ministry of Justice of the Republic of Kazakhstan.

3. Assign to the republican organizations of health care carrying out methodical management and the analysis of routine medical examinations of separate target groups of the population according to appendix to this order.

4. To department of administrative and legal work of the Ministry of Health of the Republic of Kazakhstan (Bismildin F. B.) after state registration of this order to provide in the procedure established by the legislation of the Republic of Kazakhstan its publication in mass media.

5. Recognize invalid the following acts:

the order of the Chairman of the Agency of the Republic of Kazakhstan for health care of December 27, 2000 No. 853 "About prevention of diseases and dynamic medical observation of separate categories of patients" (registered in the Register of state registration of regulatory legal acts for No. 1372, published in "The bulletin of regulatory legal acts of the central executive and other state bodies of the Republic of Kazakhstan", 2001, No. 15, the Art. 366);

the order of the Minister of Health of the Republic of Kazakhstan of November 7, 2002 No. 999 "About entering of amendment into the order of the Chairman of the Agency to the Republic of Kazakhstan for health care of December 27, 2000 No. 853 "About prevention of diseases and dynamic medical observation of separate categories of patients" (registered in the Register of state registration of regulatory legal acts for No. 2055, published in "The bulletin of regulatory legal acts of the central executive and other state bodies of the Republic of Kazakhstan", 2003, No. 2, the Art. 768).

6. To impose control of execution of this order on the Vice-Minister of Health of the Republic of Kazakhstan Voshchenkova T. A.

7. This order becomes effective after ten calendar days after day of its first official publication.

Appendix 1

Approved by the Order of the acting minister of health care of the Republic of Kazakhstan of November 10, 2009 No. 685

Target groups of persons which are subject to routine medical examinations

№ of payment order	Target group	Type of routine medical examination
1	Children aged up to 18 years	On early detection of diseases
2	Men and women at the age of 30-70 years undergoing screening on early detection of arterial hypertension, coronary heart disease, diabetes, glaucoma, oncopathology	On early detection of behavioural risk factors
3	The women at the age of 30-70 years who are not consisting on dynamic observation with malignant new growths of neck of uterus	On early detection of cancer of neck of uterus
4	Men and women at the age of 40-70 years who are not consisting on dynamic observation with arterial hypertension, coronary heart disease and diabetes	On early detection of arterial hypertension, coronary heart disease and diabetes.
5	Men and women at the age of 40-70 years who are not consisting on dynamic observation with glaucoma	On early detection of glaucoma
6	The women at the age of 40-70 years who are not consisting on dynamic observation with malignant new growths of mammary gland	On early detection of breast cancer
7	Men and women at the age of 50-70 years who are not consisting on dynamic observation with high-quality and malignant new growths of thick gut	On early detection of colorectal cancer
8	Risk groups: 1) health workers: - the organizations of service of blood, the carrying-out invasive procedures participating in blood conversion; engaged in hemodialysis; - surgical, dental, gynecologic, obstetric, hematologic profiles, also carrying out invasive methods of diagnostics and treatment; - clinical, immunological, virologic, bacteriological, parasitological laboratories; 2) persons arriving on planned and emergency surgeries; 3) patients of the centers and departments of hemodialysis, hematology, oncology, transplantation, cardiovascular and pulmonary surgery; 4) the patients receiving hemotransfusions, transplantation and organ transplantation (part of bodies), fabrics, sexual, fetalis, stem cells and biological materials; 5) expectant mothers; 6) persons using injecting drugs, the men practicing sex with men, workers of sex	on early detection of viral hepatitises B and C

 

Appendix 2

to the Order of the acting minister of health care of the Republic of Kazakhstan of November 10, 2009 No. 685

Rules and frequency of performing routine medical examinations of target groups of the population

Chapter 1. General provisions

1. These rules and frequency of performing routine medical examinations of target groups of the population (further - Rules) determine procedure and frequency of performing routine medical examinations of target groups of the population.

2. The terms and determinations used in this order:

1) the Terminological Bethesda system - standardization of result of cytologic research;

2) dynamic observation - systematic observation of the state of health of the patient, and also rendering necessary medical care by results of this observation;

3) the Medical information system (further - MIS) - the information system providing conducting business processes of the medical organizations in electronic format;

4) total rating scale of cardiovascular risk - rating scale of risk of fatal cardiovascular disease of the next 10 years (further - SCORE scale);

5) Quetelet's index - indicator of assessment of harmony of physical development of organism, body weight ratio to growth;

6) classification of analysis system and recording of results of beam researches of mammary gland - standardization of descriptions of mammography researches (further - BI-RADS classification);

3. The list of researches for target groups of children aged up to 18 years and adult population of subjects to routine medical examinations, with separation on packets of the guaranteed amount of medical care (further - GOBMP) and compulsory social medical insurance (dalee-OSMS), is carried out according to appendices 1, 2 to these rules by the subjects of health care having the license for this type of activity according to article 28 of the Law of the Republic of Kazakhstan of May 16, 2014 "About permissions and notifications".

4. Local authorities of public administration by health care of areas, provide the cities of republican value and the capital:

1) annual performing routine medical examinations of target groups of the population according to these rules;

2) entering of data on passing of routine medical examinations into MIS;

3) monitoring and analysis of performing routine medical examinations.

5. Routine medical examinations with the subsequent dynamic observation (further - DN) and improvement perform the PHC organization:

1) for urban population - the PHC organization irrespective of patterns of ownership;

2) for rural population - medical aid stations, medical and obstetrical centers, medical out-patient clinics, district clinics, with use of portable medical complexes based on special motor transport and rail transport (train).

6. PHC organization:

1) is created by target groups of persons which are subject to routine medical examinations from among the population attached to the medical organization;

2) provide succession with the profile medical organizations for carrying out these surveys;

3) inform the population on need of passing of routine medical examinations;

4) enter data on passing of routine medical examinations to MIS;

5) carry out the monthly analysis of the performed routine medical examinations.

7. Persons which are on DN on which profile of disease routine medical examination is performed are not subject to routine medical examinations.

8. Additional diagnostic testings and inspections of profile specialists are performed according to indications.

9. Average medical personnel of the PHC organization or the responsible person of the PHC organization by results of the performed routine medical inspection verify the list of the patients of target group invited to inspection, who had routine inspection and directed to additional examination. The direction is entered into MIS and transferred by means of information exchange.

Chapter 2. Procedure for performing routine medical examinations of target groups of the population

Paragraph 1. Procedure for performing routine medical examinations of children aged up to 18 years

10. Routine medical examinations of the children of preschool age visiting preschool institutions, school students, pupils and students of specialized secondary and higher educational institutions up to 18 years are carried out by specialists of the PHC territorial organization with departure in the territory of the organizations of education.

11. Routine medical examinations of the children of preschool age who are not visiting preschool institutions are carried out to the PHC organizations for the place of attachment.

12. Performing routine medical examinations of children up to 18 years includes preparatory stage, routine medical examination and the final stage.

13. The preparatory stage consists of forming of target groups of children up to 18 years and information maintenance. The preparatory stage is performed by average medical personnel of the PHC organization: medical aid station, medical and obstetrical center, medical out-patient clinic, district, city clinic, average medical personnel of the organization of education (in case of its availability), including preschool institution, also includes:

annual forming and creation of the list of the target groups which are subject to routine medical examinations forthcoming year till November 15 of calendar year with the subsequent monthly correction of target groups;

the notification of parents of children of target groups and their legal representatives about need and conditions of passing of routine medical examinations;

the organization by the health worker of the organization of education (in case of its availability), including preschool institution and the PHC organization of departure of specialists of the PHC territorial organization in the territory of the organizations of education (in case of its availability), including preschool institutions for performing routine medical examination of children of preschool age (the visiting preschool institutions), school students, pupils and students of specialized secondary and higher educational institutions aged up to 18 years.

14. Routine medical examination provides survey by specialists and filling of data on passing of routine medical examination to MIS.

15. Routine medical examination includes pre-medical, pediatric and specialized stages.

The pre-medical stage is carried out by average medical personnel of medical aid station, medical and obstetrical center, medical out-patient clinic, district, city clinic, average medical personnel of the organization of education (in case of its availability), including preschool institution, and includes:

1) determination of growth and body weight;

2) measurement of amount of the head and thorax of children of early age (up to 3 years);

3) assessment of physical and psychosocial development;

4) measurement of arterial pressure (children have 7 years and is more senior);

5) carrying out plantografiya and its assessment (children have 5 years and is more senior);

6) visual acuity determination;

7) auditory acuity research. At children of 3 years the research is also more senior at least 5 meters between the average health worker and the child are conducted by means of the shepotny speech on both ears serially, in the quiet room at distance.

The pediatric stage is carried out by the pediatrician, the therapist (for children aged from 15 up to 17 years) or VOP and includes: assessment of the state of health of the child, psychophysical, sexual development, identification of signs of ill treatment taking into account data of pre-medical inspection. During stage are carried out:

1) survey of integuments and hairy part of the head;

2) survey of visible mucous membranes: conjunctivas of eyes, oral cavities, pharynx. It is paid attention to dental health, bite, height of standing of hard palate, size and type of palatal almonds, voice function (sonority of voice);

3) survey and palpation of area of thyroid gland.

4) palpation of peripheral lymph nodes: submaxillary, inguinal, axillary;

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