Evaluation of a national framework for rational use of medicines in Kazakhstan and its role in improving medicine use practices at the organizational and national levels

Abstract Background Kazakhstan inherited the Semashko health system model, known for the centralized adoption of rules at the Ministry of Health (MoH) level that regulate the healthcare system. In 2019 MoH established a national framework with indicators aimed at collecting qualitative and quantitat...

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Main Authors: Gulzira Zhussupova, Ainur Aiypkhanova, Saule Zhaldybayeva, Dinara Satmbekova, Tamila Akhayeva, Sholpan Kaliyeva
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Health Services Research
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Online Access:https://doi.org/10.1186/s12913-024-12172-9
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author Gulzira Zhussupova
Ainur Aiypkhanova
Saule Zhaldybayeva
Dinara Satmbekova
Tamila Akhayeva
Sholpan Kaliyeva
author_facet Gulzira Zhussupova
Ainur Aiypkhanova
Saule Zhaldybayeva
Dinara Satmbekova
Tamila Akhayeva
Sholpan Kaliyeva
author_sort Gulzira Zhussupova
collection DOAJ
description Abstract Background Kazakhstan inherited the Semashko health system model, known for the centralized adoption of rules at the Ministry of Health (MoH) level that regulate the healthcare system. In 2019 MoH established a national framework with indicators aimed at collecting qualitative and quantitative data from healthcare organizations as part of their annual self-evaluation, and biannual external evaluation by the National Research Center for Health Development (NRCHD). The purpose of this study was to pilot the MoH framework on rational use of medicines and evaluate its effects on medicine use practices in health care organizations and at the national level. Materials and methods This cross-sectional study was conducted from October to December 2019 at 22 state-owned primary health care organizations (polyclinics) serving adults and children in Astana, Kazakhstan. Data were collected by trained surveyors visiting each organization. Data were converted to numeric values to arrive at compliance scores for each organization and analyzed to assess each organization’s compliance with set indicators. Results The evaluation showed the rational use of medicines was assessed as “excellent” (90% < compliant) in 2 organizations (9% of the sample), “good” (75–89% compliant) in 7 organizations (32%), and “satisfactory” (50–74% compliant) in 13 organizations (59%), with an average compliance rate of 71% across the sample. 22 organization-specific evaluation reports were developed by the evaluator (NRCHD) and sent to health care organizations for corrective actions. Evaluation data triggered two improvements at the national level: correction of the default setting for trade names to international nonproprietary names within the physician ordering feature of the national health information system for medicines, and adoption of a national policy that allowed the exchange of unused stocks of medicines between polyclinics. Conclusions Using the national framework allowed the evaluator agency and healthcare organizations to identify organization-specific gaps and triggered improvements in the use of medicines.
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spelling doaj-art-da1cb1beb1eb4a89a2e8070dc58faf8b2025-08-20T02:40:35ZengBMCBMC Health Services Research1472-69632025-01-0125111210.1186/s12913-024-12172-9Evaluation of a national framework for rational use of medicines in Kazakhstan and its role in improving medicine use practices at the organizational and national levelsGulzira Zhussupova0Ainur Aiypkhanova1Saule Zhaldybayeva2Dinara Satmbekova3Tamila Akhayeva4Sholpan Kaliyeva5Center for the Development of Scientific and Research Activities, Astana Medical UniversityMinistry of Health, Republic of KazakhstanThe Republican State Enterprise On the Right of Economic Management “National Research Center for Health Development Named After Salidat Kairbekova” of the Ministry of Health of the Republic of KazakhstanAl-Farabi Kazakh National UniversityDepartment of Fundamental Medicine, Faculty of Medicine and Healthcare, Higher School of Medicine, Al-Farabi Kazakh National UniversityDepartment of Clinical Pharmacology and Evidence-Based Medicine, NCJSC “Karaganda Medical University”Abstract Background Kazakhstan inherited the Semashko health system model, known for the centralized adoption of rules at the Ministry of Health (MoH) level that regulate the healthcare system. In 2019 MoH established a national framework with indicators aimed at collecting qualitative and quantitative data from healthcare organizations as part of their annual self-evaluation, and biannual external evaluation by the National Research Center for Health Development (NRCHD). The purpose of this study was to pilot the MoH framework on rational use of medicines and evaluate its effects on medicine use practices in health care organizations and at the national level. Materials and methods This cross-sectional study was conducted from October to December 2019 at 22 state-owned primary health care organizations (polyclinics) serving adults and children in Astana, Kazakhstan. Data were collected by trained surveyors visiting each organization. Data were converted to numeric values to arrive at compliance scores for each organization and analyzed to assess each organization’s compliance with set indicators. Results The evaluation showed the rational use of medicines was assessed as “excellent” (90% < compliant) in 2 organizations (9% of the sample), “good” (75–89% compliant) in 7 organizations (32%), and “satisfactory” (50–74% compliant) in 13 organizations (59%), with an average compliance rate of 71% across the sample. 22 organization-specific evaluation reports were developed by the evaluator (NRCHD) and sent to health care organizations for corrective actions. Evaluation data triggered two improvements at the national level: correction of the default setting for trade names to international nonproprietary names within the physician ordering feature of the national health information system for medicines, and adoption of a national policy that allowed the exchange of unused stocks of medicines between polyclinics. Conclusions Using the national framework allowed the evaluator agency and healthcare organizations to identify organization-specific gaps and triggered improvements in the use of medicines.https://doi.org/10.1186/s12913-024-12172-9Rational use of medicinesKazakhstanIndicatorsPrimary health care
spellingShingle Gulzira Zhussupova
Ainur Aiypkhanova
Saule Zhaldybayeva
Dinara Satmbekova
Tamila Akhayeva
Sholpan Kaliyeva
Evaluation of a national framework for rational use of medicines in Kazakhstan and its role in improving medicine use practices at the organizational and national levels
BMC Health Services Research
Rational use of medicines
Kazakhstan
Indicators
Primary health care
title Evaluation of a national framework for rational use of medicines in Kazakhstan and its role in improving medicine use practices at the organizational and national levels
title_full Evaluation of a national framework for rational use of medicines in Kazakhstan and its role in improving medicine use practices at the organizational and national levels
title_fullStr Evaluation of a national framework for rational use of medicines in Kazakhstan and its role in improving medicine use practices at the organizational and national levels
title_full_unstemmed Evaluation of a national framework for rational use of medicines in Kazakhstan and its role in improving medicine use practices at the organizational and national levels
title_short Evaluation of a national framework for rational use of medicines in Kazakhstan and its role in improving medicine use practices at the organizational and national levels
title_sort evaluation of a national framework for rational use of medicines in kazakhstan and its role in improving medicine use practices at the organizational and national levels
topic Rational use of medicines
Kazakhstan
Indicators
Primary health care
url https://doi.org/10.1186/s12913-024-12172-9
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