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Community Health Assessment Maternal and Child Health Republic of Kazakhstan Meruert Rakhimova Kanat Shaken

Community Health Assessment Maternal and Child Health Republic of Kazakhstan Meruert Rakhimova Kanat Shakenov Faina Linkov. Kazakhstan: Introduction. Location: North of Central Asia Population: 14.9 million (53% women) (1999) Religion: Islam Ethnicity:

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Community Health Assessment Maternal and Child Health Republic of Kazakhstan Meruert Rakhimova Kanat Shaken

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  1. Community Health Assessment Maternal and Child Health Republic of KazakhstanMeruert RakhimovaKanat ShakenovFaina Linkov

  2. Kazakhstan: Introduction Location:North of Central Asia Population:14.9 million (53% women) (1999) Religion:Islam Ethnicity: Kazakh 53.4%, Russian 30%, others 16.6 Political status: former Soviet Republic, independent state since 1991

  3. Objective:To analyze factors influencing maternal and child health in Kazakhstan. To identify major health deficiencies in these areas and to propose interventions strategies for improving the current situation.

  4. Conceptual Framework MANDALA of Health. We looked at multiple factors influencing maternal and child health in Kazakhstan: • Maternal education • Women’s role • Economics • Environment And other factors…..

  5. Culture Community Lifestyle Personal Behaviour Psycho-Socio Economic Environment Family Spirit Sick Care System Work Mind Body Human Biology Physical Environment Human-Made Environment Biosphere

  6. DECLINE IN: Birth rate per 1000: • 1994 – 18.2 • 1999 – 14.0 Fertility rate (No of children per woman): • 1989 – 2.9 • 1995 – 2.5 • 1999 – 2.1

  7. Maternal and Child health indicators in Kazakhstan • Infant mortality rate 61.9 / 1,000 • Under-five mortality rate 71.4 / 1,000 • Maternal mortality 62.5 per 100,000

  8. Comparison Communities

  9. Major causes of infant mortality per 10,000

  10. Access to healthcare (1999) • Obstetricians and gynecologists supply – 14.4 per 1,000 newborns • Pediatricians supply (incl.neonatologists)- 1.32 per 1,000 children aged 1-14 • Antenatal care received – 94% • No of births delivered at health facilities – 98%

  11. Vaccination coverage among children 12-23 months (1999): • BCG and first dose of polio and DPT/DP – 99% • All WHO-recommended vaccinations – 81%

  12. Personal Behavior • Changes in values • Substance abuse • Lowered average age at first sexual intercourse • Unsafe sexual practices

  13. Incidence of syphilis in KZ per 100,000 (years 1991 thru 1999)

  14. Human biology • DALE - 56.4 years (122 rank) • Average life expectancy is decreasing for the past decade: 1988 – male – 64.8; female – 74.1 2000 – male – 58.8; female – 70.1

  15. Physical Environment • Proper housing • Fresh water – 59% piped water (1999), 1/3 (30%) use water from an open well, urban – 90% piped water, rural – 35 % • Sanitation Urban – 81% flush toilets, Rural – 5% flush toilets (94 % pit toilets)

  16. Psycho-Social-Economic Status • Female Literacy - over 99% • Muslim society-the role of women is undermined • Women are underrepresented in the government • Women have little decision making power

  17. Major Deficiencies • Financial difficulties due to economic crisis (approx. 2 - 2.5% of GDP goes to healthcare; GDP itself decreased by 50% after collapse of Soviet Union) • Access to quality healthcare-disproportionate allocation of health facilities-all rural areas are underserved • Absence of health insurance • Access to fresh water supply • Sanitation problems

  18. Proposed interventions Elaboration and implementation of reproductive health programs ( raise health awareness among women, family planning) Increase access to quality health care for indigent women and children Legal restrictions on alcohol and cigarette sales and consumption Provision of information to population via Mass Media on available health resources

  19. Useful Links Related to Maternal and Child Health in Kazakhstan Official web site of Kazakhstan (Background) Republic of Kazakhstan Social Protection Project, supported by World Bank (targeting kindergarten age children) Maternal Health Around the WorldMaternal Mortality in Asia

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