Reforms on medical personnel training in the Nakhchivan Autonomous Republic

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Institute of History after A. Bakikhanov of Azerbaijan National Academy of Sciences

Reforms on medical personnel training in the Nakhchivan Autonomous Republic

A.A. Suleymanov

Институт истории им. А.А. Бакыханова НАН Азербайджана

Реформы в области подготовки кадров для здравоохранения в Нахчыванской Автономной Республике

Сулейманов Азер Абдул оглу, соискатель

Like other countries that at present practice transition period Azerbaijan has also faced some social problems. Our steps forward in the direction of health guard's population and health service improvement and our achievements under present conditions rejoice us.

Azerbaijan has made big achievements in the rapid increase of health field, in the creation and extension of multy-profile health network and in the preparation of health-service specialists. Nowadays Azerbaijan that moves confidently forward to build independent, democratic and legal power has high skilled medical specialists.

It must be mentioned that health specialists training has a direct impact on people's sound development. Hence, an intensive work is being carried out in the fields- training of modern medical specialists, organization of educational establishments with an eye to develop competency level of present cadre reserve, solidity of material and technical basis.

Our national leader Heydar Aliyev said: “There are people with high knowledge, high specialty, high science in Azerbaijan and they reflect a great part of the society which makes us witness how valuable our educational system is. If not for these, all the scientific fields and economy of Azerbaijan could hardly develop in this way. If not for these, the science of Azerbaijan could hardly grow. We must appreciate them and never forget achievements gained within ten years”, while talking about the role of educational and medical cadre reforms in our national increase. (7, S.34)

Azerbaijan State Medical University after N.Narimanov was the educational establishment that used to train erudite medical specialists for Nakhchivan Autonomous Republic.

From 1993 the number of qualified doctors in Nakhchivan AR began to decrease. The main reason of it is being grounded on day-by-day stray intensifying political, economic and social situation, the substitution of high skilled doctors working in Nakhchivan AR for Baku, the blockade situation of the autonomous republic, etc.

Notwithstanding between 1993-1994 AMU after N.Narimanov sent graduates of therapeutics (17), pediatry (10), stomatology(4), pharmaceutics(2) to Nakhchivan AR on appointment, over 50% of them substituted it for Baku owing to their marital status. [4]

Therefore medical indices of population in Nakhchivan for 1994 in comparison with 1993 dropped from 25, 3% to 24, 9%.

The secondary medical personnel play an exceptional part in the development of medical service quality and its rationality in Nakhchivan AR. The positive results of the health institutions occupations depend on professional level as well of secondary medical personnel as of doctors, on their workmanship, also on providing the health institutions with sufficient secondary medical personnel

Provision of the health institutions in Nakhchivan AR also with secondary medical personnel in the period under investigation was unsatisfying. If in 1993 the number of secondary medical personnel in Nakhchivan was 2970, in 1994 and 1995 this number fell to 2933. [13, S.25] Of course provision of every ten thousand men of population is getting decreased. If in 1993 the number of secondary medical personnel for every ten thousand was 94, in 1995 this number was 85 men. [13, S.16] These indicies is much under medical cadres providing indicies. According to statistics in 1994-1995 though there were 1638 vacancies for middle skilled cadres by the republic 492 of them fell to Nakhchivan AR's share.

Decrease of the level to provide health institutions with secondary medical personnel, inequality of the settlement in different regions and institutions in Nakhchivan AR was related to the then processes in the republic, the hard blockade situation of the province and to the abrupt changes in demographic processes, also to transforming a part of professionals to military-medical patterns. One of the most important factors that bear negative impact on staffing duties was the drawbacks in preparation and settlement of secondary medical personnel. Because the planning of admittance to medical schools, the efficient arrangement of the process of admittance, the proper appointment supplies of young cadres is of great importance. Except for these, the number of students from Nakhchivan AR at Baku medical educational establishments was getting decreased in the period under investigation.

For material and technical basis of Nakhchivan medical school didn't afford the cadre preparation didn't meet standard needs. Admittance plan being poor and corresponding graduation didn't fill even annual loss of secondary medical personnel. Moreover, the intensifying migration process, expansion of health net and increase in population, opening new military-medical patterns has already resulted in vacancies for secondary medical personnel. In 1993-1994 necessity for secondary medical personnel was not only in Nakhchivan AR but even in the whole republic in grave condition.

It should be noted that preparation of middle skilled medical cadres with new bias in Nakhchivan AR began in 1994.

A small medical educational establishment called “Shafgat” founded in Nakhchivan attached to International Charity and Health fond started working according to October 30, 1994, order numbered 396 by Prime Minister of Nakhchivan AR.[15] The very year 94 students were admitted attached to “the nurse business” after whose successful graduation the educational establishment became inactive.

Owing to corresponding needs of the “Regulations on Education” the International Charity and Health Fund sent documents to Azerbaijan Ministry of Education and Azerbaijan Ministry of Health to register “Shafgat” junior educational health establishment which train secondary medical personnel, with the bias of medicine, status of medical school. As the existence of “Shafgat” junior educational health establishment in the structure of the Charity and Health Fond didn't meet the needs of the “Regulations on Education” it was decided admissible to stop its work.

Hence, we want to note that to consider the present wide care for national medicine, existence of all medicinal plants in the Nakhchivan AR flora, in order to employ it thoroughly, in this case the renewal and starting educational activity of “Shafgat” junior educational establishment, which is the only establishment training secondary medical personnel on national medicine. Since there will be more need for these personnel almost in everywhere, in all health organizations, in health sanitary wings, in military hospitals.

Nakhchivan AR set a board to attestate secondary medical personnel according to its 15.02.1994, issue of order 28. [16] As it ran in the issue, into the board, there were included medical organizer, surgeon, therapist, pediator and medical personnel on different fields. After the commission got its maintenance by Azerbaijan Ministry of Health, from June in 1994 it got power to activate.

The commission started its work for attestation by taking special training measures as shown in existing regulations. Head doctors of health establishments were the first informed about the rules to hold attestation and also in large institutions, for instance, in the Republican hospital after N.Narimanov there was held a heating discussion on this point. Lay-out samples of necessary documents for attestation, as well the inquests considered in the direction, were copied and sent together to the institutions. Hence, a result can be arrived at that in Nakhchivan AR there has a lot been done concerning the attestations of secondary medical personnel and proper preparatory measures have been taken .

But it becomes apparent from the results of the reference on the work of the secondary medical personnel attestation commission attached to Nakhchivan AR Ministry of Health that the attestation enlisting factors of personnel was very poor. Results of the attestation held in 2000 were visual proof of that. The attestation taking indices of average secondary medical workers in Nakhchivan AR held in 1994 and 2000 shown in the table below:

As obvious from the table, the enlisting factors of secondary medical personnel is too below the standard indices.

Investigations yielded that in 1993-1995 in Nakhchivan AR health institutions requirements for secondary medical personnel comparatively rose. Having considered it, Minister of Health of the Republic of Azerbaijan authorized the admittance of graduates of the Nakhchivan “Tekis” college after R.Budagov to fill the secondary medical personnel posts according to his order dated 14.08.1995.[5] It was particularly mentioned in the order that there was great need for sercondary medical cadres in Nakhchivan AR living in the blockade conditions for a long period and that the youth faced many difficulties to study in other cities of the republic.

The calendar plans and syllabus, teaching stuff, material and technical basis of “Tekis” college in Nakhchivan correspond to that of the state institutions and hence the Supreme Experts Commission gave it an affirmative review.

One of the issues calling attention in the period under investigation was that there grew great need for nurses in remote villages of Nakhchivan AR in health establishments with shift labor routine. Notwithstanding the point was always under the check of Nakhchivan AR Ministry of Health, it was left unsolved for a good deal of time.

The situation was discussed in Nakhchivan AR Ministry of Health Board, it was taken into account to admit graduate nurses of paying co-operative medical colleges to posts at institutions in need of them, by way of exception, according to April 27, 2001 dated 11/7 Order.[101] On June 6, 2000 Azerbaijan Ministry of Health issues an order “On Ministry of Health medical schools' activities in 1998-1999 academic years” and the order was considered as a new phase of reforms performed to improve the training of secondary medical and pharmaceutical cadres in medical schools.

It was particularly pointed out that material and technical basis of some medical schools was insufficient, especially at Nakhchivan medical school after Heyran khanum the academic space for a student was much tinier than standards, the laboratories, classes were poorly provided with utensils and visual aids. The number of the teachers on staff at Nakhchivan medical schools is equal to 13,9%. The superiority of teachers of hour-work results in deranging the training level of students. The subject calendar plans are poorly worked out, even in some cases one can witness the teachers give classes without calendar plans.

Ministry of Health Board accepted an order to discuss the drawbacks and gaps existing at Nakhchivan medical school at masters' meeting, the working-out of prompt measures plan to lift them. The order had also reflected to develop educative-cultivating issues, provision of laboratories and rooms with equipments, staffing of teachers on staff and Nakhchivan AR Ministry of Health and The Cadres, Science and Education Central Board of Ministry of Health of Azerbaijan Republic was charged with regular supervision over the school.

Under Azerbaijan Republic President Heydar Aliyev's order “On State Committee for reforms in the field of Education of Azerbaijan Republic”, dated March 30, 1998, there was founded State Committee to ensure The World Bank for capital invests to make reforms in independent Azerbaijan educational system to meet the international standards, to develop education and develop its material and technical basis, to prepare the reforms Program on education. [2, P.80-81] Hence there was established a new phase of reforms in the educational branch of the republic. “Program of Reforms on Education of Azerbaijan Republic” worked out in a short period of time was asserted by President Heydar Aliyev after large considerations on June 15, 1999 [11, P.187], on a historical day-National Liberty, by a particular order. So there was written a valiant page to our modern educational history. medical personnel nakhchivan

In the very program reflecting the basis of state policy in educational field of Azerbaijan Republic and legible strategy, prior lines of the XXI century national educational establishment the national personnel training was pointed out as one fo the main issues to solve. Acceleration of reforming and construction in Nakhchivan science and education branches widely scoped at the beginning of XXI century. So that it steadily holds the issues- the development of education to meet modern standards, training of secondary medical cadres in the focus of attention. Nakhchivan AR governing body succeeded in solving the radical problems within short period of time.

According to Vasif Talibov's order, the chairman of Nakhchivan AR National Assembly, regarding Nakhchivan medical school's 70 year jubilee, it has been evicted to a three-storeyed building in Nizami street in Nakhchivan to improve its material and technical basis, to develop the educational and training efficiency and has been represented to students' and teaching-staff's utilization after capital repairs. [7] The aggregate area of the school is 5183 square meters and 3816 square meters of it is the share of the school building.

There are 10 discipline studies, 1 computer study, a large and rich designed H.Aliyev lecture hall, 18 classrooms, a gymnasium, an assembly hall to hold popular-cultural acts, a library with large book stock and other subsidiary rooms. The building has also been provided with the heating system and an attached electric transformer. In order to improve the material and technical basis of the school the studies have been supplied with modern visual aids, medical appliances, new computers have been bought, and lessons are conducted by computers in “Anatomy”, “Pediatric”, “Therapy”, “Surgery” studies.

In order to minimize the secondary medical personnel requirements in Nakhchivan AR the student admittance plan has been increased to 210 persons in 2001-2003.[15] According to the results of test exams the admittance plan was carried out in the following way under student admittance state committee's 14.09.2001 dated order.

As is seen from the table, the admittance was carried out with deficiency in 2001 and the planned 33 person lack. In 2002-2003, 27-31 persons were lacking in accordance with the admittance plan that all belonged to paying groups. A significant part of the extensive building measures taken in Nakhchivan comprises the ones done on educational system. With regard to improving the quality, efficiency of education in Nakhchivan there are taken measures to open new faculties to meet proper needs.

A faculty laid under our national leader Heydar Aliyev's particular instructions, attached to Nakhchivan State University, served as a background for training high level doctors-pediators. In 2000 a new building was delivered for utilization of 150 students and teachers consisting of a clinic, a chemist's, laboratories on clinical anatomy, biology, microbiology, a library and wide auditoria. [1]

But in early 2003-2004 the faculty building was repaired on modern lines, being supplied with experimental laboratories, computer and other utensils to improve educational level and provide the use of visual aids.

Academic basis of the medical faculty consists of the chairs “Principal medical subjects”, “General medicine”, “Pediatric”, and University Clinic and oter health institutions in Nakhchivan. There have been offered all facilities for students to make use of Nakhchivan Central Hospital, Children's Hospital, Mother-and-child Rehabilitation Center, Cardio logical Clinic, Venereal Clinic, and other health institutions.

The basic question for present-day sanitation is to meet needs for high-level medical personnel in the transition period to market economy, to form sound life-style in every public member. The duties to fulfill the above mentioned are the followings:

1. To strive for to increase the admittance quantity of students and staffing of teachers;

2. To intensify teaching-cultivating point at medical school and to increase the supervision over students' achievement indices;

3. To take proper measures for the supply of laboratories and medical studies with necessary equipments and aids;

4. To discuss at joint-discipline commissions the topics on syllabus every year;

5. To intensify supervision over teachers' and students' use of modern medical literature to adapt theoretical and practical lessons to modern methodology;

6. To organize doctors' and secondary medical personnel's dispatch to professional courses to improve their skills in a planned and consecutive order;

7. To intensify systematic supervision over doctor-interns training process and over graduates to practice internment;

8. To set a task before Ministry of Health to draw young personnel to doctors' posts that Nakhchivan AR is in much need of;

9. To enlarge international ties to corporate with foreign countries in order to profit from their educational and personnel training probations;

10. To hold steady scientific-practical conferences and seminars to increase professional knowledge and proficiency of doctors and secondary medical personnel.

It should be noted that as a result of reforms held in 1993-2003 in Nakhchivan AR city and regional hospitals, at medical units, dispensary and polyclinics attention grew to develop the professional personnel staff, to hold professional and qualification improving courses. There was paid more attention not only to quantity, but also to quality in training high and secondary medical personnel, which impressed high and secondary schools of Nakhchivan training medical personnel to build their work in two directions, to increase quality and quantity. As a result, Nakhchivan AR's needs for high skilled personnel was met more profoundly in comparison with early 90-s.

Our great leader was on particular terms with doctors, high appreciated their public role. He said: “Profession of a doctor is the one that requires great loyalty to his nation and profession.” [12]

H Aliyev bore particular attention together with the quantity to also the quality of doctors. To his mind, people who work on the health of people had no rights to err. This idea by our great leader remains as the professional responsibility and motto of every doctor.

The list of literature

1. Aghayev Z. Doctors-pediators are trained in Nakhchivan// “Sharg gapisi”-2005, 2 June.

2. Orders and directions of Azerbaijan President (January-March), 1998,B: 1998.

3. The jubilee conference materials dedicated to the 60 year of High Pharmacological education.

4. The record office of Azerbaijan Ministry of Health, fund 2, list 2, issue 19, papers 53-58.

5. The record office of Azerbaijan Ministry of Health, fund 2, list 2,issue 14, papers 76-81.

6. The record office of Azerbaijan Ministry of Health, fond 2, list 24, pages 83-87.

7. A joint board Of Azerbaijan Ministry of Health.

8. Aliyev.N. Education is the future of our nation. B.: 2002, 207 pages.

9. Problems on labor market and training personnel. [The problems of scientific-practical conference] B.:2002-303 pages.

10. Jafarov T. Development of medicine in Nakhchivan AR. B.-”Sada”.1999-313.

11. Huseynov I. Independent Azerbaijan founder.B-:”Tehsil”, 2004-472 pages.

12. Gadirov A. The role of Heydar Aliyev's policy in the development of Azerbaijan// Historic Persons.-2006,N 1.S.36.

13. Nakhchivan AR in the statistic indicies.-B”(Sada), 1998-127 pages.

14. Reports on 1993-2003 of Nakhchivan AR Ministry of Health.

15. In Nakhchivan AR, fond 17, list 2, issue 256.

16. In Nakhchivan AR, fond 17, list 2, issue 257.

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