Evidence based practice
Evidence based practice is life-long problem-solving approach to the delivery of health care that integrates the best evidence from well- designed studies and integrates it with a patient’s preferences and values and a clinician’s expertise, which includes internal evidence gathered from patient data. Even though multiple positive outcomes are the result of evidence-based care, including improvements in healthcare quality, safety, and costs, it is not consistently delivered by clinicians in healthcare systems throughout the world.Since becoming independent, Kazakhstan has undertaken major efforts in reforming its post-Soviet health system.
Two comprehensive reform programmes were developed in the 2000s: the National Programme for Health Care Reform and Development 2005-2010 and the State Health Care Development Programme for 2011-2015 Salamatty Kazakhstan. Changes in health service provision included a reduction of the hospital sector and an increased emphasis on primary health care.
However, inpatient facilities continue to consume the bulk of health financing. Partly resulting from changing perspectives on decentralization, levels of pooling kept changing. After a spell of devolving health financing to the rayon level in 2000-2003, beginning in 2004 a new health financing system was set up that included pooling of funds at the oblast level, establishing the oblast health department as the single-payer of health services. Since 2010, resources for hospital services under the State Guaranteed Benefits Package have been pooled at the national level within the framework of implementing the Concept on the Unified National Health Care System. Kazakhstan has also embarked on promoting evidence-based medicine and developing and introducing new clinical practice guidelines, as well as facility-level quality improvements. However, key aspects of health system performance are still in dire need of improvement. One of the key challenges is regional inequities in health financing, health care utilization and health outcomes, although some improvements have been achieved in recent years. Despite recent investments and reforms, however, population health has not yet improved substantially (Katsaga, et al., 2012).
The quality of scientific research in Kazakhstan remains poor, which is partly due to years of underinvestment in facilities and equipment (Ministry of Health 2004). The National Programme of Health Care Reform and Development for 2005–2010 envisages the development of medical science through the following activities:
- development and application of modern technologies for disease prevention, early detection, treatment and rehabilitation;
- fundamental and applied medical research in areas identified by the Ministry of Health;
- strengthening the links between medical research and its practical applications in the health sector;
- development of international partnerships;
- integration of medical science, education and practice;
- monitoring and evaluation of health reform initiatives;
- implementation of evidence-based medicine ) (Kulzhanov, Rechel, 2007).
Because of all listed issues, the project will organize a 5-day masterclass workshop, from November 12th to November 26th. The workshop will try to join project partners and other participants. The masterclass will aim at higher education teachers of medical faculties in Kazakhstan, who teach evidence-based practice. Learning from the international good practices will accelerate the development required for the reforms that are on progress in Kazakhstan. The collaboration between the HEIs, their university clinics as well as with health care sector can be developed based on the results achieved already in Europe and evidence based nursing research.
Written by ABFHC and SSMU