Kyzylorda Oblast, Kazakhstan Challenges

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© Umirbai Tumenbayev, official photographer for Kyzylorda Oblast Youth Health Center region coversanareaof226000km Republic ofKazakhstanincentralEurasia.The Syrdariya Riverinthesouth-westernpartof Kyzylorda Oblast(region)issituatedalongthe General overview Kyzylorda Oblast,Kazakhstan can reach46 °Candinwinterdropto -37°C.In variations intemperatures, whichinsummer pronounced continental climatewithgreat One ofthechallengesin theregionisitsvery 71.9 years(67.8formen and76.3forwomen) According to2015data,totallifeexpectancyis more thanthehalfofwhichlivesinruralareas. is 780 235(390857menand389378women), February 2018). Thetotalpopulationoftheregion first halfof2017(approximatelyUS$2632as 21 domestic productpercapitawasT839300inthe salt andundergroundmineralwaters.Thegross metals (leadandzinc),uranium,vanadium,white most importantbeinghydrocarbons,non-ferrous It hasawiderangeofmineralresources,the east, andtheRepublicofUzbekistaninsouth. the north,SouthKazakhstaniOblastinsouth- Oblast inthenorth-west,Karaganda the oldestincountry. ItbordersonAktobe – theregionismorethan190yearsold,oneof districts andthecapitalcity–alsocalledKyzylorda and southernmostborders(1).Comprisingseven distance of1000kmbetweenitsnorthernmost 2 witha (1). to thesustainabledevelopment ofpopulation of theutmostimportance. Otherkeychallenges climate change,particularly insummertime,is disaster, the adaptionofthepopulationto and healthrisksresulting fromtheAralSea Considering thehighlevelofenvironmental quality oflife,particularlyinruralareas. The mainchallengeintheRegionistoimprove Baikonur SpaceBase. The Regionhoststhespace-launchcomplex, becoming asourceofincome. in theSea,asanindustry, isrevivingandagain the appearanceofsomespeciesfish.Fishing of salinityisdecreasing,whichhasresultedin the northernpartofAral.Currently, thelevel it possibletoincreasethewaterlevelslowlyin In 2008,aprojecttoconstructseawallmade salinity oftheremainingwaterexceeds100 g/l. environmental disastersoftheworld” Aral Seahasbeendescribedas“oneoftheworst located inthesouthernpartofregion.The of theshrinkingAralSea–Smallis storms canoccurinsummer. Theremainingpart There aremanydayswithstrongwind,anddust it isonlyinwinterthatthesoilreceivesmoisture. summer, precipitationgenerallyevaporates,and Kyzylorda City Medical Center, The Kyzylorda Oblast (2). The health include limited access to clean water Historically, the rate of morbidity from and sanitation, especially in villages. Efforts communicable diseases in Kyzlorda Oblast has have been made to build networks of drinking- been high since it is home to several zoogenous water supplies in the rural areas, but problems infections, such as plague, Congo-Crimean relating to access to improved sanitation and the hemorrhagic fever, anthrax and brucellosis. implementation of water, sanitation and hygiene Through the effective organization of sanitary and (WASH) standards, especially in educational and epidemiological welfare services, epidemiological health-care facilities, require special attention and surveillance is being carried out successfully in all are yet to be resolved. communities of the Oblast. The aim of the current National Health On the other hand, the level of morbidity from Development Programme, “Densaulyk” (2016– noncommunicable diseases (NCDs) is high 2019), is to improve population health and despite the health-system reform, which is achieve sustainable socioeconomic growth in in progress at the national level to improve the country. The regional health system is an population health with a focus on prevention. integral part of the national health system, which The reform, which is being managed at the is controlled by the Ministry of Health of the national level, is the shared responsibility of Republic of Kazakhstan. The Ministry takes all the the Government, the health system and the policy decisions regarding health at the national population. Tackling prevention and promoting level, while health-care facilities have a certain healthy lifestyles are challenging for health-care degree of independency at the local level. Health- facilities at the regional level. Primary-health-care care services are provided free of charge by the (PHC) professionals lack sufficient competencies state and private specialized diagnostic centres in the field of NCDs. Improvement is also needed licensed by the Regional Health Department. The in the promotion of healthy lifestyles, healthy health system is financed through national and eating and physical activity. local budgets.

Strengths

The strengths of Kyzylorda Oblast include: 99 high investment in the health sector, including the 99 the National Programme 2016–2019, “Densaulyk” ; provision of resources for health-care facilities and 99 effective organization of epidemiological and health human resources’ capacity-building; monitoring.

Aspirations

The Oblast is interested in: 99 learning about new ways of accessing information about best practice at the global level; 99 sharing its experience in the development of public health and PHC; 99 introducing the health-for-all approach.

Kyzylorda Oblast, Kazakhstan Challenges

These are: 99 an excessive load on PHC doctors; 99 too few NCD-prevention programmes; 99 need to increase NCD-related competencies; 99 insufficient access to safe water and sanitation; 99 need to better motivate health professionals; 99 need to promote the rational use of fresh-water 99 difficulties in the delivery of preventive services; ecosystem.

Potential areas of collaboration

Kyzylorda Oblast is interested in collaborating with other regions on: 99 improving health behaviour and health literacy among 99 combatting the effects of climate change and the population with a view to NCD prevention; providing access to clean water and sanitary services. 99 protecting women’s health, particularly women of childbearing age;

Working groups

Kyzlorda Oblast is interested in participating in working groups on: 99 environment; 99 women’s/men’s health; 99 health systems/primary health care.

People active in the Regions for Health Network (RHN)

Political focal point Bayan Uristambekovna Buranbayeva Krymbek Eleuovich Kusherbayev Health Care Management Sector Lead Governor of Kyzylorda Oblast Kyzylorda Oblast Health Department Email: [email protected] Zhaksylyk Abylkasymovich Abdusametov (on health- care issues) Zhanar Amageldiyevna Kalmakova Deputy Head Director Kyzylorda Oblast Health Department Kyzylorda Oblast Youth Health Center Email: [email protected] Email: [email protected]

Technical focal point Laura Zhenisovna Utemissova Akmaral Sharipbayevna Alnazarova Technical Assistant Head, Kyzylorda Oblast Health Department Kyzylorda Oblast Youth Health Center Tel.: +7 (724)400451 ext. 3041 Email: [email protected] Email: [email protected]

Kyzylorda Oblast, Kazakhstan References

1. Official data of the Department of Statistics of Kyzylorda Oblast. Kyzylorda: Department of Statistics of Kyzylorda Oblast; 2017. 2. Shrinking Aral Sea underscores need for urgent action on environment – Ban. In: UN News [website]. New York: United Nations; 2010 (https://news.un.org/en/story/2010/04/334402, accessed 8 May 2018).

Kyzylorda Oblast, Kazakhstan