Tengrinews.kz — Kazakhstan has changed the rules for preventive medical examinations of children. Here is what will be checked at different ages, who may be exempted from physical education classes, and what parents need to know.
What examinations children will undergo and at what age
The updated rules for children’s preventive medical examinations came into effect on August 30. We asked Assel Yegimbayeva, a practitioner and expert in medical service reimbursement who studies and analyzes changes in the regulatory framework, to compare the previous and new versions of the document.
She notes that, first of all, the age at which some examinations are conducted has changed.
- blood pressure: previously measured from age seven, now from age six;
- ECG: previously performed at ages 14 and 17, now at 10, 14, 15 and 16;
- complete blood count and urinalysis: now scheduled at age one, two years and six months, five, 10, 14 and 16. Before the order was updated, they were conducted before age one, and at ages two, five, 14 and 17;
- referrals for preventive dental examinations have also been formally introduced: at age two, two years and six months, and then annually from age three to 17;
- head circumference was previously measured in children up to age three, and will now be measured up to age five. At the same time, chest circumference measurement has been removed from the list of mandatory anthropometric measurements at the pre-medical stage of preventive examinations.
In addition, children from one month to 18 years old will undergo pulse oximetry during preventive examinations. This measures the level of oxygen saturation in the blood.
How a child’s health will be assessed during examinations
Another important change, according to Yegimbayeva, is the introduction of special assessment sheets. Medical workers will use them to evaluate various health indicators, including hearing, visual acuity, the condition of the nervous and endocrine systems, dental health and other parameters.
"Patients under the age of six will be examined by pediatric specialists. After age six, the initial health assessment will partly be carried out by a pediatrician or general practitioner, a dentist, and nurses from ophthalmology or surgery offices. If nurses detect any abnormalities, the child will be referred to a pediatrician or general practitioner,” the expert explained.
The changes also affected voluntary informed consent for medical intervention. It existed before, but the requirement to formalize it has now been explicitly included in the rules for preventive medical examinations.
“Until the age of 16, consent is given by a parent or another legal representative. From age 16, a minor can provide it independently — this is stipulated by the Code ‘On Public Health and the Healthcare System,’” Yegimbayeva clarified.
The rules also specify that examination results must be available to parents through a digital medical system or mobile application.
Who will be exempt from physical education
The rules now set out four groups for physical education classes in detail: main, preparatory, special and exempt. Previously, there were only two — main and special.
The groups are now defined as follows:
- Group 1, main — children in health groups 1 and 2. They take physical education classes under the standard curriculum without restrictions.
- Group 2, preparatory — children in health group 3. Physical activity is limited based on medical contraindications.
- Group 3, special — children in health group 4. Physical activity is restricted.
- Group 4, exempt — children in health group 5. Instead of regular physical education classes, they should receive therapeutic exercise.
What happens after a child’s preventive checkup
The expert considers the child’s follow-up pathway to be the most important change. Referrals for additional examinations existed before, but the process has now been described in greater detail.
“If signs of a disease are detected during the examination but a diagnosis cannot be made immediately, the child is referred to a specialist through a pediatrician or general practitioner at the clinic where they are registered. A care pathway should then be generated automatically in the digital system, including consultations, necessary tests and further monitoring,” the expert explained.
The rules also introduce a separate health improvement algorithm for schoolchildren. It specifies who refers the child for additional examinations, who informs the parents and who monitors treatment and compliance with recommendations.
Assel Yegimbayeva says follow-up monitoring of children is also being expanded. Previously, it was explicitly provided for children in health groups 3, 4 and 5 — those with chronic conditions of varying severity.
“Now the second group has also been included, meaning children who may not yet have a chronic disease but have already been found to have functional abnormalities or risk factors,” she said.
The expert explained that the purpose of the changes is to ensure that parents do not simply receive the results of a preventive examination, but also understand what problems were identified, what additional examinations the child was referred for, and whether further monitoring is needed.
“In other words, a preventive checkup should become the starting point of a clear care pathway for a child if any problems are identified,” the expert concluded.
Yegimbayeva stressed that preventive examinations were carried out before as well — clinics compiled lists of children and organized visits by specialists to schools and kindergartens. However, some procedures have now been changed and clarified, which parents should be aware of.
