Since independence in 1991, the organizational structure of the health care system of the Republic of Belarus has not changed drastically. The heath care system of the Republic of Belarus is regulated by the state. The private health care sector within the volume of the provided medical services amounts to about 7.0 %. The primary aim of the state health care policy of the Republic of Belarus is to create conditions for every person to exercise his right to health on the basis of the state guarantees.
Special attention is paid to the maternity and childhood protection. Free medical observation at the health care institutions, inpatient treatment during and after childbirth, as well as medical care and observation of the newborns are guaranteed to each pregnant woman. Therefore 100% of births in the country are attended by the skilled health personnel.
During the period 1991-2011 the infant mortality rate decreased more then 3-fold (up to 3.9 per 1000 live births) and it is the lowest one in the CIS countries.
In 2002 the natural population loss reached its maximum level (- 5.9) and it decreased to - 2.8 in 2011.
There is a positive tendency to an increase in life expectancy at birth (70.6 years in 2011).
Since 2000, the process of health care reforming in Belarus has become systemic. The introduction of the state social standards which ensure the realization of the citizens’ social rights stipulated in the Constitution of the Republic of Belarus, is a distinctive feature of the national health care system. At present the following seven state social health care standards are implemented in health care: standards on budgetary provision of expenditure on health per capita, availability of primary care physicians, beds, drugstores, ambulance teams, transport and sanitation facilities.
The programme-oriented planning in health care as a key mechanism to increase the efficiency of the branch has been introduced. The following state programmes are aimed at health promotion, reduction of morbidity and mortality: National Programme of Demographic Security of the Republic of Belarus for 2011 – 2015, State Integrated Programme on Cancer Prevention, Diagnosis and Treatment for 2010–2014, State Programme "Tuberculosis" for 2010–2014, State Programme of National Actions on the Prevention and Overcoming Heavy Drinking and Alcoholism for 2011 – 2015, State Programme of HIV-Infection Prevention for 2011-2015, State Program on Overcoming the Consequences of the Chernobyl Accident for 2011-2015 and the Period to 2020 , State Programme “Cardiology” for 2011 – 2015, State Programme on the Creation of a Barrier-Free Environment for Physically Disabled Persons for 2011-2015, etc.
Restructuring of the branch is carried out. Unused hospital beds have been cut. The priority has been given to primary health care including an increase in its funding, development of hospital-substituting technologies, improvement of the material and technical basis, staff and introduction of the general practitioner’s practice. The republican technological level on the provision of the population with medical care has been formed. A total of 16 republican scientific and practical centers have been established.
The system of the quality control over medical health care has been improved. A compulsory licensing of medical and pharmaceutical activities has been introduced. More than 1000 clinical protocols on diagnosis and treatment of 24 disease groups, grounded on evidence-based medicine and cost-effectiveness analysis of medical care, have been elaborated and introduced.
Disabled persons, patients with tuberculosis, AIDS, systemic diseases of connective tissue, cancer and hematologic diseases, diabetes mellitus, epilepsy and some other serious diseases are provided with free medicines. Children and pregnant women with phenylketonuria are provided with free medicinal nutrition mixtures.
The country ensures sanitary-epidemic well-being of the population. In accordance with the National Immunization Schedule, the vaccination of the population is carried out. The level of the preventive vaccination coverage has reached 97-98%. In 2011, viral hepatitis incidence rate was 3.0 per 100 000 population (in 2002 – 750.0 per 100 000 population). No diphtheria cases were registered in 2011 (1 case – in 2010).
In the country the coverage of preventive vaccination against tuberculosis (98.4%) is higher than the indicator recommended by WHO. Since 2004 a tendency to the decrease of tuberculosis incidence rate has been observed. In 2011 this indicator was 42.8 per 100 000 population (in 2004 – 55.4 per 100 000 population).
High-tech medical services are rendered not only at the national level, but also in the regions on the basis of the regional hospitals.
Diagnostic coronary angiographies, pacemaker implantation, coronary (peripheral) arteries stenting, coronary artery bypass grafting are performed. For the past 5 years about 33 325 cardiosurgery interventions have been done.
At the Children's Cardiac Surgery Center operations in about 1000 children including 100 newborns are performed annually. At present a full spectrum of the world-class operations is performed by the children's cardiac surgery service.
The algorithm of early detection of the background and pre-cancer diseases of the female reproductive system in patients with hormone-dependent neoplasms has been developed. Methods on treatment of patients with primary and metastatic cancer of the liver using chemoembolization of hepatic artery, the method on treatment of patients with superficial cancer of urinary bladder, methods on complex treatment of patients with mesothelioma of pleura of I-IIIA stage using thermochemotherapy, methods of complex treatment of patients with prostate cancer of III-IV stage without remote metastases and local cervical carcinoma, etc. have been introduced.
Thanks to the purposeful work of the cancer health care institutions the European standard in a 5-year survival rate among cancer children and teenagers has been achieved.
High-tech and composite operations on the musculoskeletal system are performed. In 2001-2011 a total of 22108 hip joint replacements and in 2005-2011 a total of 3218 knee joint replacements were performed. This type of high-tech surgical interventions is implemented in large cities and at the inter-district level. In case of vital indication hemialloplastic hip replacement is performed in fractures of the femoral neck.
Such high-tech methods of surgical treatment as endovascular techniques of interventions in vascular pathology of the brain and spinal cord, non-traumatic methods of microsurgical ablation and stereotactic biopsy of brain tumors, stereotactic interventions for Parkinson’s disease have been introduced in practice of the neurosurgical service.
Thrombolytic therapy (thrombolysis) for cerebral infarction as well as extracorporeal methods of homeostasis correction (plasmapheresis and cryoprecipitation) have been applied. In 2011 the Belarusian neurosurgeons performed over 134 endovascular neurosurgical interventions in aneurisms of brain and arteriovenous malformations, as well as 61 stereotactic interventions.
Maternity and childhood protection
With the help of modern technology, newborns, barely overweighting 500 gr., are nursed at the perinatal centers. In 2011 a total of 609 ECF cycles and 187 inseminations were performed. Pregnancy made up 42% out of the complete ECF cycles. The effectiveness of this technology is more than 40% that corresponds to the world average standards.
Operations with regard to cochlear implantation with preservation of residual hearing, implantation of bone conduction aids for children with congenital malformations of external and middle ear as well as with neurosensory hearing impairments are performed in the Republic.
At present the most modern methods on diagnosis and treatment of patients with pathology of the organ of vision have been introduced. The number of surgical interventions regarding cataract (phacoemulsification) has enlarged. Cornea transplantations have increased twofold.
Transplantology develops successfully. In 2008-2011 a total of 109 liver transplants, in 2006-2011 a total of 520 kidney transplants and in 2009-2011 a total of 54 heart transplants were performed. Transplantation of a kidney-pancreas complex was done, too.
Consumables and components, produced in Belarus, are widely used while performing the high-tech operations.
High-tech methods and technology for rendering medical care, as well as medicinal products, applied in our country, are in line with international standards.
Today the health care of the Republic of Belarus has virtually a full range of medical services that makes it possible to exclude the referral of our citizens for treatment abroad. We welcome warmly foreign citizens to our country for rehabilitation and recovery rendering high-tech medical services to them.
The telemedicine system has been created in the Republic of Belarus. Now it includes 11 health care institutions of the district level, 9 health care institutions of the regional level and 10 health care institutions of the republican level.
This system makes it possible to carry out the remote consultation on X-ray, ultrasound and cytological investigations as well as on the diagnosis of patients in complicated cases.
A research medical activity is carried out at 21 institutions, including 16 republican scientific and practical centers which provide practical health care with up-to-date technologies and methods on prevention, diagnosis, treatment of the diseases and rehabilitation.
Training of specialists with higher medical education is carried out at the following four higher educational institutions: the Belarusian State Medical University, Vitebsk State Order of Peoples’ Friendship Medical University, Grodno State Medical University and Gomel State Medical University. They train students in 8 medical specialties: general medicine, pediatrics, dentistry, medical prophylaxis, medical diagnostics, medical psychology, pharmacy and nursing. More than 2000 foreign students are trained annually.
The country has created a harmonious system of continuous post-graduate training of specialists with medical education, including self-training, professional skills improvement, training courses, retraining and clinical residency.
The Belarusian Medical Academy of Post-Graduate Education is a leading higher educational institution engaged in post-graduate specialists` training for health care. Post-graduate training of medical and pharmaceutical staff is also carried out at Vitebsk State Order of Peoples’ Friendship Medical University and post-graduate training of specialists with secondary medical and pharmaceutical education is conducted by the medical colleges of the country.
The Ministry of Health is deeply involved in cooperation with such international organizations as the United Nations Organization (UNO), including the World Health Organization (WHO), the United Nations Children's Fund (UNICEF) and the United Nations Population Fund (UNFPA).
Together with the Global Fund to Fight AIDS, Tuberculosis and Malaria a purposeful work, aimed at combating HIV/AIDS and tuberculosis prevalence in Belarus, is under way. In cooperation with the International Atomic Energy Agency (IAEA) the work on the improvement of qualification of specialists in radiation medicine is organized. The quality control and application of new radiotherapy methods is ensured. Cooperation within the framework of the Commonwealth of Independent States (CIS), the Eurasian Economic Community (EAEC) and the Union State aimed at the elaboration of the coordinated policy in the field of health care, develops.
Achievements of the health care system of Belarus have been recognized by the World Health Organization as the highest ones among the CIS countries.
The main purpose of the health care system for the future is to stabilize and to further improve the medical and demographic situation in the country, as stipulated in the Directions of the Strategic Development of Health Care of the Republic of Belarus for 2011-2015.