Dr. Anatoly Belonog , First Vice-Minister of the Health Republic of Kazakhstan

1. Achievements of the Republic of Kazakhstan on recommendations of the VI CARK MCH Forum Dr. Anatoly Belonog , First Vice-Minister of the Health Republic of Kazakhstan

2. Priority Actions for Reduction of Infant and Child Mortality • A New Post of a Deputy Health Minister was established that would be primarily responsible for MCH • A National Project on Improvement of Perinatal Care for 2004-2010 is developed • Continue activities on certification of maternal health facilities as Baby Friendly Hospitals and 19 hospitals were certified

3. Priority Actions for Reduction of Infant and Child Mortality • Main activities as per International Code on Marketing of Breastmilk Substitutes were developed according to the Decree of the President of Kazakhstan • Adoption and Introduction of WHO PHC guidelines on Health Care for Children have been initiated

4. Priority Actions for Reduction of Infant and Child Mortality • Integrated Management of Child Illnesses (IMCI) strategy is being implemented in pilot regions • The IMCI training modules were translated into Kazakh and distributed in pilot regions • IEC materials as per third IMCI component were developed • The Better Parenting KAP/B Study conducted and currently the results are being analyzed

5. Priority Actions for Reduction of Infant and Child Mortality • Safe immunization programme is successfully implemented – 95% immunization coverage • Republic of Kazakhstan certified by WHO as polio free country • Initiated activities on liquidation of rubella and measles by 2007

6. Priority Actions for Reduction of Infant and Child Mortality • 14 cold rooms were purchased • The surveys on Access to and Quality of PHC services and Public Expenditures Review were conducted • Preliminary results will be used for policy and management decisions aimed at reduction of maternal, infant and child mortality

7. Priority Actions on Life Birth Definition (LBD) Implementation • Use of International LBD is introduced in pilot regions of Republic of Kazakhstan • Under the Ministry of Health a Coordination Board was established and legislative regulatory base for WHO recommended LBDs were developed • A meeting on introduction of LBDs in pilot regions was held and the results were thoroughly discussed

8. Priority Actions on Safe Motherhood • Plan of Actions on Mother and Child Health specified in a President Decree of Republic of Kazakhstan • Initiated development of a National Programme and Strategy on Prevention of Mother To Child Transmission • Drugs for preventive treatment of pregnant women and newborns are being purchased from local budgets

9. Priority Actions on Prevention of Vitamin a Deficiency • The survey on vitamin A deficiency conducted in two regions of Republic of Kazakhstan • Development of a National Programme on prevention of vitamin A deficiency is initiated

10. Priority Actions on Prevention of Iodide Deficiency Disorders (IDD) • The National Coordination Committee on food fortification was established • Conduct National IDD prevention Communication campaign aimed at decision-makers, mass media and population • The law «On Iodine Deficiency Disorders Prevention», of Republic of Kazakhstan from October 14, 2003 # 489 adopted

11. Priority Actions on Prevention of Iodine Deficiency Disorders (IDD) • The mechanisms and legislation regulations to ensure the law’s implementation and follow up are to be developed • The training of SES staff on ensuring quality control of salt iodization would be conduct at oblast level until the end 2003

12. Priority Actions on Prevention of Iron Deficiency Anemia • Within the framework of the project on “Improving nutrition for poor mothers and children in Asian Countries in transition” the following activities were conducted: • A premix formula, which consist of iron, vitamin B group, zinc and folic acid is developed • Flour Fortification Equipment was purchased and set at 15 mills. Also premix was provided to the same flour producers. • A Communication campaign on prevention of Iodine deficiency disorders and Iron deficiency anemia at pilot level are conducted

13. Priority actions on prevention of Iron deficiency anemia • The Communication campaign have been transferred now up to the National level • Cost efficiency and cost benefit analysis of achievement of the universal flour fortification was conducted. Results of the analysis submitted to the Government of Kazakhstan