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 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 is guaranteed to each pregnant woman. Therefore 100% of births in the country are attended by the skilled health personnel.
During the period 1991-2010 the infant mortality rate has decreased 3.1-fold (up to 4.0 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 - 3.0 in 2010.
There has been a positive tendency to an increase in life expectancy at birth (70.5 years in 2010).
Since 2000 the process of health care reforming in Belarus has become a systemic one. The introduction of the state social standards, ensuring 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, motor transports and sanitation facilities.
The goal-oriented programme planning in health care as a key mechanism for increasing the efficiency of the branch has been introduced. The following state programmes are aimed at health promotion, reducing morbidity and mortality: the Presidential Programme “Children of Belarus”, the National Programme of Demographic Security of Belarus, the State Programme "Tuberculosis", the State Integrated Programme on Cancer Prevention, Diagnosis and Treatment for 2010–2014, the State Programme of HIV-Infection Prevention, the State Programme of National Actions on the Prevention and Overcoming Heavy Drinking and Alcoholism, etc.
Restructuring of the branch is being carried out. Unused hospital beds (about one sixth of the total hospital beds) have been cut. A 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, staffing 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 were 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 immunization of the population is carried out. The level of the preventive vaccination coverage has reached 97-98%. Consequently, the diphtheria incidence has decreased 20-fold, mumps - 120-fold, viral hepatitis B - 26-fold.
In the country the coverage of preventive vaccination against tuberculosis (98.4%) is higher than the indicator recommended by WHO, and therefore for the past 10 years there has been a moderate downward trend in TB incidence by an average of 0.7% annually.
The high-tech medical care is rendered not only at the national level, but also in the regions on the basis of the regional hospitals.
Cardiosurgery
Diagnostic coronary angiographies, pacemaker implantation, coronary (peripheral) arteries stenting, coronary artery bypass grafting are performed. For the past 5 years about 32 000 cardiosurgical interventions have been done.
At the Children's Cardiosurgery 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 cardiosurgery service.
Oncology
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; methods on treatment of patients with superficial cancer of urinary bladder; methods on complex treatment of patients with mesothelioma of pleura of I-III stage using thermochemotherapy ; methods of complex treatment of patients with prostate cancer 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 a five-year survival rate of cancer patients has increased up to 53.7% in 2010. A total long-term survival rate of children with hematologic cancers makes up 75%, and as regards this indicator Belarus ranks second among European countries.
Traumatology
High-tech and composite operations on the musculoskeletal system are performed A total of 11000 hip joint replacements and a total of 1811 knee joint replacements were performed. This type of the high-tech surgical interventions is implemented in large cities and at the inter-district level. In case of vital indication a total or hemialloplastic hip replacement is performed in fractures of the femoral neck.
Neurosurgery
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 of brain tumors, stereotactic interventions in Parkinson’s disease, stereotactic biopsy of brain tumors were introduced in practice of the neurosurgical service. Thrombolytic therapy (thrombolysis) for cerebral infarction as well as extracorporeal methods of homeostasis correction (plasmapheresis and cryoprecipitation) was applied. Annually the Belarusian neurosurgeons perform over 85 endovascular neurosurgical interventions in aneurism of brain and arteriovenous malformations; a total of 25 stereotactic interventions in Parkinson's disease and brain tumors as well as 16 rhizotomies.
Maternity and childhood protection
With the help of modern technology, newborns, barely overweighing 500 gr., are nursed at the perinatal centers. As a result of the infertility treatment with the methods of reproductive technologies more than 600 children were born. The effectiveness of this technology is more than 40%, that corresponds to the world average standards.
Otolarhinolaryngology
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.
Ophthalmology
At present, the most modern methods on diagnosis and treatment of patients with pathology of the organ of vision are introduced. The number of surgical interventions as regards cataract (phacoemulsification) has enlarged. Cornea transplantations have increased twofold.
Transplantology
Transplantology develops successfully. A total of 89 liver transplants, 443 kidney transplants, 48 heart transplants were performed. Transplantation of a kidney-pancreas complex has been performed.
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 the 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 Education. 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 created a harmonious system of continuous post-graduate training of specialists with medical education, including self-training, professional skills improvement, probation period, 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 the 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), 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 the 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 were 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.
