ORDER OF THE MINISTER OF HEALTH OF THE REPUBLIC OF KAZAKHSTAN

of May 4, 2019 No. KR DSM-62

About modification and amendments in some orders of the Ministry of health and social development of the Republic of Kazakhstan

According to the subitem 99) of Item 1 of Article 7, of Item 5 of Article 88, Item 4-1 of Article 45, Item 1 of Article 115, Items 7 and 8 of Article 167, Item 12 of article 169 of the Code of the Republic of Kazakhstan of September 18, 2009 "About health of the people and health care system", I ORDER:

1. Approve the list of some orders of the Ministry of health and social development of the Republic of Kazakhstan to which changes and additions according to appendix to this order are made.

2. To provide to department of the organization of medical care of the Ministry of Health of the Republic of Kazakhstan in the procedure established by the legislation of the Republic of Kazakhstan:

1) state registration of this order in the Ministry of Justice of the Republic of Kazakhstan;

2) within ten calendar days from the date of state registration of this order the direction it the copy in electronic form in the Kazakh and Russian languages in the Republican state company on the right of economic maintaining "Institute of the legislation and legal information of the Republic of Kazakhstan" for official publication and inclusion in Reference control bank of regulatory legal acts of the Republic of Kazakhstan;

3) placement of this order on Internet resource of the Ministry of Health of the Republic of Kazakhstan after its official publication;

4) within ten working days after state registration of this order in the Ministry of Justice of the Republic of Kazakhstan provision in Department of legal service of the Ministry of Health of the Republic of Kazakhstan of data on execution of the actions provided by subitems 1), 2) and 3) of this Item.

3. To impose control of execution of this order on the vice-Minister of Health of the Republic of Kazakhstan Aktayeva L. M.

4. This order becomes effective after ten calendar days after day of its first official publication.

Appendix

to the Order of the Minister of Health of the Republic of Kazakhstan of May 4, 2019 No. KR DSM - 62

The list of some orders of the Ministry of Health of the Republic of Kazakhstan to which changes and additions are made

1. In the order of the Minister of health and social development of the Republic of Kazakhstan of March 27, 2015 No. 168 "About approval of Rules of rendering palliative care and sisterly leaving" (it is registered in the Register of state registration of regulatory legal acts at No. 10803, it is published in information system of law of Ad_let on May 15, 2015):

Rules of rendering palliative care and sisterly leaving to be reworded as follows according to appendix 1 to this list.

2. In the order of the Minister of health and social development of the Republic of Kazakhstan of April 1, 2015 No. 194 "About approval of the list of the sharp diseases constituting danger to people around in case of which the foreigners and stateless persons which are temporarily staying in the Republic of Kazakhstan have the right to the guaranteed amount of free medical care" (it is registered in the Register of state registration of regulatory legal acts at No. 11317, it is published in information system of law of Ad_let on June 23, 2015):

to state heading of the specified order in the following edition:

"About approval of the list of the sharp diseases constituting danger to people around in case of which oralmans, the foreigners and stateless persons which are temporarily staying in the Republic of Kazakhstan have the right to the guaranteed amount of free medical care";

state Item 1 in the following edition:

"1. Approve the enclosed list of the sharp diseases constituting danger to people around in case of which oralmans, the foreigners and stateless persons which are temporarily staying in the Republic of Kazakhstan have the right to the guaranteed amount of free medical care.";

in the list of the sharp diseases constituting danger to people around in case of which the foreigners and stateless persons which are temporarily staying in the Republic of Kazakhstan have the right to the guaranteed amount of free medical care, approved by the specified order:

state heading in the following edition:

"The list of the sharp diseases constituting danger to people around in case of which oralmans, the foreigners and stateless persons which are temporarily staying in the Republic of Kazakhstan have the right to the guaranteed amount of free medical care".

3. In the order of the Minister of health and social development of the Republic of Kazakhstan of April 22, 2015 No. 246 "About approval of Rules of voluntary anonymous and (or) confidential physical examination and consultation of citizens of the Republic of Kazakhstan concerning HIV infection on free basis" (it is registered in the Register of state registration of regulatory legal acts at No. 11145, it is published in information system of law of Ad_let on July 2, 2015):

to state heading of the specified order in the following edition:

"About approval of Rules of voluntary anonymous and (or) confidential physical examination and consultation of citizens of the Republic of Kazakhstan, the oralmans, foreigners and persons without citizenship who are constantly living in the territory of the Republic of Kazakhstan concerning HIV infection on free basis";

state Item 1 in the following edition:

"1. Approve the enclosed Rules of voluntary anonymous and (or) confidential physical examination and consultation of citizens of the Republic of Kazakhstan, the oralmans, foreigners and persons without citizenship who are constantly living in the territory of the Republic of Kazakhstan concerning HIV infection on free basis.";

in Rules of voluntary anonymous and (or) confidential physical examination and consultation of citizens of the Republic of Kazakhstan and the oralmans concerning HIV infection on free basis approved by the specified order:

state heading in the following edition:

"Rules of voluntary anonymous and (or) confidential physical examination and consultation of citizens of the Republic of Kazakhstan, the oralmans, foreigners and persons without citizenship who are constantly living in the territory of the Republic of Kazakhstan concerning HIV infection on free basis";

to state heading of Chapter 1 in the following edition:

"Chapter 1. General provisions";

state Items 1 and 2 in the following edition:

"1. These rules of voluntary anonymous and (or) confidential physical examination and consultation of citizens of the Republic of Kazakhstan, the oralmans, foreigners and persons without citizenship who are constantly living in the territory of the Republic of Kazakhstan concerning HIV infection on free basis (further - Rules) determine procedure for carrying out voluntary anonymous and (or) confidential physical examination and consultation of citizens of the Republic of Kazakhstan, the oralmans, foreigners and persons without citizenship who are constantly living in the territory of the Republic of Kazakhstan concerning HIV infection on free basis.

2. In these rules the following concepts are used:

1) HIV - human immunodeficiency virus;

2) anonymous inspection - voluntary physical examination of person without identification of the personality;

3) confidential physical examination - the inspection based on preserving medical secret and information on the identity of the inspected person.";

to state heading of Chapter 2 in the following edition:

"Chapter 2. Procedure for carrying out physical examination concerning HIV infection";

3, of 4, of 5, of 6, 7 and 8 to state Items in the following edition:

"3. The citizens of the Republic of Kazakhstan, oralmans, foreigners and persons without citizenship who are constantly living in the territory of the Republic of Kazakhstan, showed willingness to undergo voluntary physical examination on HIV infection are inspected at their choice:

1) anonymously (documents are not required);

2) confidentially (the identity document, the home address is provided).

4. Anonymous examination on HIV infection is conducted with use of the rapid tests revealing antibodies to VICh-1,2 and virus antigen r24.

Anonymous examination on HIV infection is conducted by the organizations of health care performing activities in the field of prevention of HIV infection and the non-governmental organizations working with core groups of the population according to algorithm of testing for HIV of anonymously addressed persons with use of rapid tests according to appendix 1 to these rules. Persons with the increased risk of infection with HIV infection treat core groups of the population: people the using injecting drugs, the workers of sex, men having sex with men.

In case of anonymous inspection the unique identification code is assigned for inspected.

5. By results of rapid test with inspected posttest consultation with oral informing on result of testing is carried out.

In case of negative result of rapid test to inspected recommend to pass test in three months in the presence of infection factors.

In case of positive result of rapid test to inspected recommend to undergo inspection on HIV infection according to algorithm of laboratory diagnosis of HIV infection at adults and children 18 months according to appendix 2 to these rules are more senior (further - appendix 2).

The conclusion about availability or absence of HIV infection by results of rapid test is not issued.

6. Confidential examination on availability of markers of HIV infection is conducted by laboratories city, regional and republican the organizations of health care performing activities in the field of prevention of HIV infection (further - laboratories) according to appendix 2.

In case of laboratory diagnosis of HIV infection antibodies to VICh-1,2 and antigen r24 by method of the immunoenzymatic analysis (further - IFA), the immunokhemilyuministsentny analysis (further - IHLA) or the elektrokhemilyuministsentny analysis are at the same time determined (further - EHLA).

Confirmation of primary and positive results is carried out by confirmatory test: immunoblot (further - IB) or the immunokhromatografichesky test with profile of proteins of HIV: 2 ENV, GAG, POL.

Criteria of quality of test systems for IFA, IHLA or EHLA are: diagnostic sensitivity - 100% (lower limit of 95% of confidential interval - at least 99%); diagnostic specificity - at least 99% (lower limit of 95% of confidential interval - at least 98%); analytical sensitivity - no more than 2 ME/ml. (minimum quantity of VICh-1 of antigen р 24).

7. Blood sampling for confidential inspection is carried out in the medical organizations, irrespective of pattern of ownership and departmental accessory, in case of presentation of the identity document.

Blood samples for research to markers of HIV infection go to laboratory. The direction in the form No. 201/at approved by the order of the acting minister of health care of the Republic of Kazakhstan of November 23, 2010 No. 907 "About approval of forms of primary medical documentation of the organizations of health care" is applied to sample of blood (it is registered in the Register of state registration of regulatory legal acts at No. 6697): individual - in one copy, list - in duplicate.

In the presence of medical information system the form is conducted in electronic form.

8. The negative result on HIV infection is issued by the laboratory conducting examination (the I stage).

Blood samples with initially positive results go to laboratory of the republican organization of health care performing activities in the field of prevention of HIV infection for carrying out additional researches according to appendix 2 (the II stage).

The republican organization of health care performing activities in the field of prevention of HIV infection sends results of the II stage of inspection to laboratories where the I stage of inspection was carried out.

exclude Item 10;

state Item 11 in the following edition:

"11. The certificate certificate of research on HIV infection markers in form according to appendix 3 to these rules is issued by the organization of health care performing activities in the field of prevention of HIV infection upon the demand of the inspected person in case of presentation of the identity document. The reference is valid within 3 (three) months.

For persons directed to surgery, donors of bodies/fabrics, sexual and stem cells, recipients before hemotransfusion/transplantation and also persons which are to be surveyed according to clinical and/or epidemiological indications, results of inspection are valid for markers of HIV within 10 days.";

to state heading of Chapter 3 in the following edition:

"Chapter 3. Procedure for carrying out consultation on HIV infection questions";

state Items 12 and 13 in the following edition:

"12. In case of inspection on HIV infection to the tested persons, information relating to dotestovy and posttest consultation is provided.

13. Dotestovy consultation is provided through means of evident propaganda: posters, brochures, websites and video clips which show in rooms of expectation.";

add with Items 14, of 15, of 16, of 17, 18 and 19 following contents:

"14. Dotestovy consultation includes:

1) information on advantage of testing for HIV and value of the HIV-positive and HIV-negative diagnosis;

2) explanation about the available services in case of the HIV-positive diagnosis, including explanation about receipt of anti-retrovirus therapy;

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