Background: Cardiovascular diseases (CVD) occupy leading positions in the mortality of the Republic of Kazakhstan (RK). In RK CVD screening is performed with 40-years of age. Objectives: to evaluate the effectiveness of screening over time. Methods: We conducted a survey of 121 patients with CVD, identified on screening. Results: The average age patients in survey-54.3 [95% CI: 52.64;55.96], of which 38% are men and 62%-women. Fact smoking mark 64 persons (52±8), alcohol-(37.2±11.6), family history-66 (54.5±8.1) daily physical activity-34 person (28.1±14.3). Middle systolic blood pressure (BP) is 144.3 [95% CI: 141.61;146.99] and diastolic BP 90.2 [95% CI: 89.02;91.38] mm.Hg. Most of the respondents have different degrees of obesity. The average BMI is 31.8 [95% CI: 30.93;32.67]. The average waist size is 89.1 [95% CI: 86.88;91.52], with the waist size of women over 80 cm (91.9 [89.03;94.77] and the waist size of men 86.1 [82.31; 89.89]. Mean values for total cholesterol of 5.9 [95% CI: 5.85;5.95]. To evaluate the effect of various factors on the increase in BP, we calculated the analysis of variance. According to our calculations, gender does not affect BP, however, age, BMI and waist size affect. We interviewed patients for complaints, analyzed outpatient cards, a check-up journal: chest pains or interruptions in the heart during exercise are noted by 25 people (20.7±17.5), improvement of the subjective state-29 (24±15.9), regularly receive basic therapy-59 (48.8±9.1), call the ambulance team-43 (35.5±12), are urgently hospitalized for a year-31 (25.6±15.2) and 7 person participate in the school of CVD. There is a statistically significant relationship between gender and smoking, gender and alcohol, gender and regular intake of basic therapy at a significance level of p < 0.05. Conclusions: Identifying the low effectiveness of CVD screening over time requires the revision of a comprehensive training program for doctors-nurses and the public. Key messages: Patients in Kazakhstan generally do not change their lifestyle after screening for a disease. The effectiveness of the screening depends on the teamwork of the doctor, nurse and patient.

Background: Employment of graduates of medical universities is one of the traditional problems of health care in the Republic of Kazakhstan (RK). The annual graduation of medical universities of RK exceeds 4500 young specialists. Despite this, as well as the positive dynamics of employment, the health care industry continues to experience a shortage of medical personnel. Methods: To take effective measures to improve the employment performance of graduates of medical education organizations, to cover the shortage of medical personnel, an analysis was made of the employment of graduates of internship programs at 8 medical universities for the period from 2014-15 to 2016-17 school years Results: For three years, medical schools of RK prepared 12019 people, of whom 8921 people studied under the state and 1343 under the rural grant. The total number of employed was slightly more than half of the graduates-6533, which amounted to 54.4%. At the same time, the number of those employed in urban hospitals is 1.5 times higher than the number of those employed in rural medical organizations. High percentages are persons who have continued their studies in residency/magistracy, and this figure tends to increase every year. The trend towards an increase is maintained by the free distribution index for pregnant women and people caring for children under the age of 3 years, for a total of three years it was 1,452 (12.1%) of a person. At the same time, those employed in rural health facilities are only 19.1% of those who studied under the grant and 31.5% of those who studied according to the rural quota. Conclusions: Thus, the percentage of employed graduates, as well as graduates who studied under the state and rural grant, barely exceeds 50%. Even the employment of persons trained in rural quotas in rural health care facilities is only 31.5%. Universities do not fully monitor the employment of graduates, especially those who studied under a state or a rural grant. Key messages: To create and implement an electronic platform with a complete database of students and graduates. To monitor employment and track the graduate’s work route; to organize employment services at universities.

Background: When interviewing nursing specialists of the Republic of Kazakhstan (RK) about the level of satisfaction with the prospects of the profession with the participation of 9039 nurses, 71% of whom believe that nurses should be given special status. To study the satisfaction of the new competencies and roles of nurses in the framework of the reform of the nursing service conducted a survey of employers Methods: The cross-sectional study in 1417 of employers participated, of which 11% were senior doctors, 26% deputy chief physicians, 50% of heads of departments, 13% others. Results: Analysis of the survey results showed the following: more than 70% of employers have a positive attitude towards nursing service reforms. According to 48% of employers, the functionality of nurses is expanded. 54% of nurses fully cope with new functional responsibilities. 44% of respondents say that with the expansion of the functionality of nurses, doctors have more time to perform more complex skilled work. According to 44% of employers, nurses should delegate the primary reception and examination of the patient, 42% setting the primary diagnosis, 33% deciphering the results of laboratory and instrumental studies, 21% independent visiting the patient at home, 8% active prenatal and postnatal patronage, 17% rendering pre-medical and emergency medical care. 62% of employers consider it appropriate to introduce the practice of joint training of doctors and nurses and fully support the increase in the independence of the nursing service. Conclusions: In general, employers support the reform of nursing, are satisfied with the new competencies of nurses and have a positive attitude towards increasing their independence. Key messages: It is necessary to improve basic training programs in medical colleges and to implement effective advanced training programs for working nurses. It is advisable to practice the introduction of co-education for doctors and nurses - the practice of inter-professional teams specialists.

Issue/problem: Nurses play a key role in the system of public health. The total number of nurses in Kazakhstan is 105,441 people (January 1, 2019), which is over 40% of all health workers in the health system of Kazakhstan. The continuing problem of insufficiently effective nursing service (NS) in the country prompted us to develop policy options to increase the NS effectiveness. Description of the problem: Key problems of the NS in Kazakhstan include the ineffective management of NS in health organizations, which is associated with an underestimation of the role of nurses in the therapeutic and diagnostic process. There is also a discrepancy in the functioning of the system of nursing education, research and practice with European directives. There are inadequate regulatory acts governing the activities of nurses (including the lack of national guidelines, nursing standards, etc.). Results: As a result of analyzing the current situation in the country and summarizing the data from systematic reviews, we were developed the Policy Brief on the issues of implementation of a new model of the NS management. As the key policy options, we proposed: 1. Improving the NS management in health organizations based on a revision of the role of nursing staff in the treatment and diagnostic process; 2. Improving the sectoral qualifications system of nursing specialists in accordance with European directives; 3. Ensuring the development of evidence-based nursing practices with the implementation of generally accepted international standards and models, the development of national guidelines and standards for NS. Lessons: The proposed measures found support from the Ministry of Health and were included in the action plans. Each of these policy options contributes to increasing the effectiveness of NS in the health system of Kazakhstan, but these options provide more substantial achievement of the goal of enhancing the role and status of a nurse with their combined implementation. Key messages: Implementation of a new model of the NS management in which nurses and physicions work on an equal footing and independently can significantly improve the efficiency of NS. Implementation of evidence-based approaches to the formation of a policy in the field of the NS development gives possibility to increase the effectiveness of the reforms in this field.