The WHO Regional Oce for Europe The World Health Organization (WHO) is a specialized agency of the United Nations created in 1948 with the primary responsibility for international health matters each with its own programme geared to the particular health conditions of the countries it serves. Member States Albania Andorra Ministry of Health of the Republic of Kazakhstan Armenia Austria Azerbaijan Belarus Belgium Bosnia and Herzegovina Self-assessment of essential public Bulgaria Croatia Cyprus health operations in Kazakhstan Czechia Denmark Estonia Finland France Georgia Germany April-September 2016 Greece Astana 2018 Hungary Iceland Ireland Israel Italy Kazakhstan Kyrgyzstan Latvia Lithuania Luxembourg Malta Monaco Montenegro Netherlands North Macedonia Norway Poland Portugal Republic of Moldova Romania Russian Federation San Marino Serbia Slovakia Slovenia Spain Sweden Switzerland Tajikistan Turkey Turkmenistan Ukraine United Kingdom Uzbekistan UN City, Marmorvej 51, DK-2100 Copenhagen Ø, Denmark Tel.: +45 45 33 70 00 Fax: +45 45 33 70 01 E-mail: [email protected] ABSTRACT This technical report presents the results of Kazakhstan’s self-assessment of the essential public health operations (EPHOs). The EPHO self-assessment was initiated by the Ministry of Health of Kazakhstan and conducted under the biennial collaborative agreement between the WHO Regional Office for Europe and the Government of Kazakhstan for 2016–2017. In addition to describing the self-assessment process, this report presents the key recommendations put forth by the Steering Committee and specialized teams. KEYWORDS ESSENTIAL PUBLIC HEALTH OPERATIONS HEALTH POLICY PUBLIC HEALTH HEALTH PROMOTION DISEASE PREVENTION HEALTH SYSTEM REFORM HEALTH SYSTEM ASSESSMENT HEALTH SYSTEM STRENGTHENING PUBLIC HEALTH STRATEGY PUBLIC HEALTH RESEARCH PUBLIC HEALTH SERVICES PUBLIC HEALTH WORKFORCE SELF-ASSESSMENT © World Health Organization 2019 All rights reserved. The Regional Office for Europe of the World Health Address requests about publications of the Organization welcomes requests for permission to reproduce or WHO Regional Office for Europe to: translate its publications, in part or in full. 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Contents Foreword from the Minister of Health of Kazakhstan ..................................................................... v Foreword from the WHO Regional Director for Europe .................................................................. vi Acknowledgements ......................................................................................................................................... vii Abbreviations ..................................................................................................................................................... viii Executive summary .......................................................................................................................................... ix Introduction ........................................................................................................................................................ 1 Background and overview ................................................................................................................................... 1 Rationale and scope ................................................................................................................................................ 2 Organizational structure and methodology ............................................................................................... 3 Key findings of the self-assessment ...................................................................................................... 5 EPHO 1: Surveillance of population health and well-being ................................................................. 5 EPHO 2: Monitoring and response to health hazards and emergencies....................................... 12 EPHO 3: Health protection, including environmental, occupational and food safety ............ 20 EPHO 4: Health promotion, including action to address social determinants and health inequity ................................................................................................................................................. 28 EPHO 5: Disease prevention, including early detection of illness .................................................... 36 EPHO 6: Assuring governance for health and well-being .................................................................... 41 EPHO 7: Assuring a competent and sufficient public health workforce ....................................... 46 EPHO 8: Assuring organizational structures and financing .............................................................. 51 EPHO 9: Information, communication and social mobilization for health ................................... 54 EPHO 10: Advancing public health research to inform policy and practice ................................. 57 Outcomes and recommendations ............................................................................................................ 62 Key findings of the EPHO self-assessment ................................................................................................. 62 Challenges faced during the EPHO self-assessment ........................................................................... 62 Existing resources ................................................................................................................................................... 62 Areas for improvement .......................................................................................................................................... 63 Recommendations ................................................................................................................................................... 63 Annex 1. Supportive and guidance materials ..................................................................................... 65 Annex 2. Participating experts and institutions ............................................................................... 68 Annex 3. Self-assessment scores ............................................................................................................. 75 iv Self-assessment of essential public health operations Foreword from the Minister of Health of Kazakhstan Health is the key resource for social, economic and individual development, as well as an important aspect of the quality of life of the entire population. While we enjoy longer lives globally, challenges such as the growing burden of noncommunicable diseases and mental health needs; cross-border threats such as antimicrobial resistance, infectious diseases and low-quality medicines; the socioeconomic divide among societies; and ever-growing health-care costs are all undoubted arguments for appreciating public health systems and understanding how much we could gain from proper implementation of public health functions. Taking into account that public health efforts, health promotion and health maintenance go beyond the provision of medical care, I consider it important to draw the attention of all stakeholders to the prioritization of health issues in the agendas of leaders of all sectors and at all levels, as first proclaimed in the legendary Declaration of Alma-Ata on primary health care in 1978. Forty years after the Declaration of Alma-Ata was signed, Kazakhstan again became the birthplace of global leaders’ renewed commitment to advancing health for all. The Declaration of Astana on primary health care reinstates these leaders’ role in health: it urges governments to make bold political commitments to health in their decision-making and to design primary health care around essential public health functions. Kazakhstan made its clear commitment to public health at the highest political level