The Main Directions in Solving the Problems of the Endoscopic Service in the Republic of Kazakhstan

Abstract

What is the problem?
To conduct the analysis, the authors, including the President of the Kazakh Endoscopy Society, PhD, head of the Center for Expert Endoscopy and Interventional Radiology of the National Cancer Research Center (NROC) Batyrbekov K.U., took data on the organization of endoscopic care to the population at the outpatient and inpatient levels, provided at the request of the NROC by the health departments of the regions of the Republic of Kazakhstan by the results of 2021 and 9 months of 2022. It should be noted that the report on endoscopic activity involved almost only subordinate organizations of the health departments of the regions and received isolated data from private medical organizations.
Questions about the state of endoscopic care in the republic, the solution of urgent problematic issues of the service have been raised repeatedly in recent years, but to date have not received proper consideration and solutions.
The first open question is the lack of a regulatory framework for the endoscopic service:for 15 years of the absence of the specialty endoscopy in the nomenclature of specialties and specializations in the field of healthcare of the Republic of Kazakhstan, the endoscopic service exists without a proper methodological and regulatory framework.
The second, interrelated with the first and rather acute issue in the organization of endoscopy is the recruitment and training of personnel. To date, according to available data, taking into account the population density, only 6 regions are most staffed with endoscopists (Astana, Karaganda, Kyzylorda, Kostanay, Pavlodar regions, Zhetysu region). In the southern regions (Shymkent, Zhambyl, Turkestan regions), staffing is average, in the western region, according to data for 2021 and incomplete current data, the lowest provision of endoscopists. One of the urgent problematic issues of the service is low tariffs: it is necessary to improve, revise tariffs for a number of endoscopic examinations.
Visions for the implementation of problem solving. In this analytical review, the authors consider the current situation regarding the organization of endoscopic services in the Republic of Kazakhstan. The key problematic issues of the service are identified and ways to solve them are proposed. The importance of a systematic management approach in the formation of a strategy for the development of the service and the establishment of effective control on the ground, in order to increase the availability, quality and effectiveness of endoscopic care, early detection of malignant neoplasms of screening localization (colorectal cancer) in the regions of the republic was noted.
Conclusions and suggestions are intended for use by the sectoral state body (Ministry of Health of the Republic of Kazakhstan), health care organizers in the preparation of regulatory legal acts and the formation of management decisions to improve the organization of endoscopic care to the population.