HEALTH PASSPORT

From now on, every child in Azerbaijan aged from birth to 18 will undergo free of charge and compulsory prophylactic medical examinations once a year. President Ilham Aliyev approved a programme to this effect last week. The programme will be implemented for the early identification of children's diseases and their risk factors, to improve the quality of medical services provided to children, to enhance desease prevention, diagnostics and treatment and to raise children's and parents' awareness of diseases.

This programme, so important and necessary, was adopted in the light of the implementation of the UN Convention on the Rights of the Child, the  Millennium Development Goals programme and the national concept: "Azerbaijan 2020: A Look into the Future". It should be noted that parliament adopted the law "On mandatory medical examination of children" early this year. This means that the legal framework for implementing the state programme on prophylactic examination of children is already in place. But now the executive bodies must do the most difficult thing: draw up principles and mechanisms for implementing this programme. In other words, we are now awaiting real actions and they will come after the Health Ministry presents the public with information on the number of children having undergone this procedure and on its results.

To minimize risks

What precisely is prophylactic medical examination and how it differs from routine medical inspection of a newborn by a pediatrician at a polyclinic? The thing is that routine inspection does not include prevention counselling, risk estimation and questionnaires. That is, a routine medical inspection detects a disease the child already carries in the body.  In prophylactic examination, the physicians must identify and assess preconditions for a disease in order to prevent it. The prophylactic examination procedure includes not only the application of relevant examination methods but also subsequent follow-up examination, determination of health status groups, preventive counselling and, if necessary, therapeutic measures and case follow-up.

Incidentally, after the adoption of the law "On mandatory medical examination of children," the country's Health Ministry identified the types of surveys that children should undergo in the first place. First of all, the child will be checked for weight, height, arterial blood pressure, eyesight, complete blood count, bowel condition for the presence of adverse factors (worms). If necessary, children will undergo x-ray screening. In addition, children will be checked for pathologies in their musculoskeletal system. For example, the proper development of the feet is very important for the development of the musculoskeletal system. If flat foot is identified at an early stage, it is possible to correct and prevent its further development. As the child grows older and their bones are shaped, it will becomes very difficult to align them.

What kinds of doctors will take part in prophylactic examinations? Above all paediatricians and family doctors. The involvement in this process of a neurologist, an ophthalmologist, a surgeon and an ear-nose-throat specialist is a must. If any pathology is encountered during a preventive medical examination, follow-up examination and inspection will be carried out by medical specialists on the basis of the preventive examination report. That will be done regardless of whether the child was healthy or sick during a compulsory medical examination - every child must undergo preventive examination once a year. In case an acute disease arises, the follow-up period will last until the baby's complete recovery. In chronic forms of pathology, active case follow-up will be carried out in order to prevent acute conditions and improve the little patient's health.

According to the law

Implementation of the state programme on compulsory medical examination of children is to cover about 3 million children in Azerbaijan.

The approved programme also determines the state's responsibilities in the implementation of mandatory medical examination including efforts to improve the technical equipment of medical institutions, the use of automated preventive health care systems, early-stage disease detection and to educate the population on prophylactic examination.

The state undertakes to ensure the annual medical examination of children; create and maintain a register of children to be examined; take efforts to improve the physical infrastructure of state-run medical institutions involved; identify causes of diseases among children; implement social, sanitary, epidemiological and therapeutic measures for the treatment of diseases; provide medical diagnostic examinations of children who are at risk of various diseases.

Prophylactic examination of children deprived of parental care, children with disabilities and children who are serving sentences in correctional facilities will be carried out in accordance with specific rules defined by relevant executive authorities. Relevant executive authorities must also specify expenditure rates for the medical examination of each individual child. Mandatory medical examination of children should be conducted with the consent of their legal representatives. Expediency of prophylactic examination of children with disabilities, orphaned children and children in difficult social circumstances or in correctional facilities will be determined by relevant executive authorities.

Mandatory medical examination will be financed by the state budget; it can also be funded by municipalities, compulsory health insurance, contributions from legal entities and individuals as well as other methods determined by the legislation. In the future, a similar programme will be adopted for the adult population.

In neighboring Russia, nationwide mandatory prophylactic examination was introduced in 2013. Now in that country's residents aged over 21 visit doctors once in every three years. Children, students and veterans are examined annually.