Availability and Quality of Medical Services in Kazakhstan: the Urban-Rural Context
https://doi.org/10.47703/ejebs.v68i2.376
Abstract
Despite the policy pursued by the Head of State and the government to improve the current healthcare system and certain successes achieved, the quality and availability of services provided by medical organizations to the Kazakhstan population remain low. This is evidenced by statements by officials, as well as a survey of the population. This article examines the primary trends in healthcare development with a particular focus on the urban-rural divide and proposes strategies to enhance service quality and accessibility in rural areas. Given the complexity of the tasks, both theoretical and empirical research methods were used in the research process, in particular economic and statistical methods and structural and institutional analysis. A special role in the study belongs to a sociological survey, which made it possible to obtain information about the quality and availability of medical services for various groups of the population, depending on their place of residence. Based on a comprehensive study, the main trends in the development of healthcare in the republic in recent years have been identified. It has been determined that in the context of the availability of medical services, the main gap lies along the rural-urban line. Based on the identified problems, recommendations were developed to eliminate them and improve the quality of medical services. Further, the study explores the attitudes towards medical treatment based on the place of residence, leading to targeted proposals to enhance the quality and accessibility of medical care in rural areas.
Keywords
Economy,
Socio-Economic Potential,
Healthcare,
Medical Services,
Availability,
Quality,
Population,
Village,
City
Supporting agencies: This research article has been supported by the Ministry of Science and Higher Education of the Republic of Kazakhstan within the project “Development of a methodology for assessing the impact of income inequality on the level of use of medical services” (IRN AP14869863).
About the Authors
Lazat Spankulova
Al-Farabi Kazakh National University, Almaty, Kazakhstan
Kazakhstan
Kazakhstan
Doc. Sc. (Econ.), Professor Email: lyazzat.spankulova@kaznu.kz
Zaure Chulanova
Institute of Economics CS MSHE, Almaty, Kazakhstan
Kazakhstan
Kazakhstan
Cand. Sc. (Econ.), Leading Researcher, Email: chulanova.zaure@ieconom.kz
Adilet Konyrbay
Al-Farabi Kazakh National University, Almaty, Al-Farabi Kazakhstan.
Kazakhstan
Kazakhstan
PhD student, Email: adilet.kongyrbay@marsh.com
References
1. Adilet (2022). The concept for the development of healthcare in the Republic of Kazakhstan until 2026. Available online: https://adilet.zan.kz/rus/docs/P2200000945 (accessed on 25 March 2024)
2. Akorda (2021). Message from the Head of State Kassym-Jomart Tokayev to the people of Kazakhstan on September 1, 2021. The unity of the people and systemic reforms are a solid foundation for the country’s prosperity. Available online: https://www.akorda.kz/ru/poslanie-glavy-gosudarstva-kasym-zhomarta-tokaeva-narodu-kazahstana-183048 (accessed on 25 March 2024)
3. Akorda (2021). Speech by President Kassym Jomart Tokayev at an expanded meeting of the Government on January 26, 2021. Avaliable online: https://www.akorda.kz/ru/speeches/internal_political_affairs/in_speeches_and_addresses/vystuplenie-prezidenta-kasym-zhomarta-tokaeva-na-rasshirennom-zasedanii-pravitelstva (accessed on 25 March 2024)
4. Akorda (2022). Message from the Head of State Kassym-Jomart Tokayev to the people of Kazakhstan on September 1, 2022. A fair state, a united nation, a prosperous society. Available online: https://www.akorda.kz/ru/poslanie-glavy-gosudarstva-kasym-zhomarta-tokaeva-narodu-kazahstana-181130 (accessed on 25 March 2024)
5. Akorda (2024). Message from the Head of State Kasym Zhomart Tokayev to the people of Kazakhstan on September 1, 2024. “Economic course of a Fair Kazakhstan”. Available online: https://www.akorda.kz/ru/poslanie-glavy-gosudarstva-kasym-zhomarta-tokaeva-narodu-kazahstana-ekonomicheskiy-kurs-spravedlivogo-kazahstana-18588 (accessed on 25 March 2024)
6. Asante, A.D., Zwi, A.B., & Ho, M.T. (2006) Equity in resource allocation for health: A comparative study of the Ashanty and Northern Regions of Ghana. Health Policy, 78, 135–148. https://doi.org/10.1016/j.healthpol.2006.03.013
7. Baygenzhin, A.K., Ismailov, Zh.K., Akhmetniyazova, L.M., & Isataeva, N.M. (2015). Prospects for the development of the healthcare system of the Republic of Kazakhstan. Healthcare Manager, 4(17), 12-16.
8. Central communications service under the President of the Republic of Kazakhstan. The Ministry of Health of the Republic of Kazakhstan discussed the progress in implementing the instructions of the Head of State. August 24, 2022. Available online: https://ortcom.kz/ru/novosti/1661314844 (accessed on 25 March 2024)
9. Gavrilov, E.L., Khomanov, K.E., & Shevchenko E.A. (2016) Sociological surveys of the population as a mechanism for assessing the availability and quality of medical care in the Russian Federation. Bulletin of the National Medical and Surgical Center named after N.I. Pirogova, 11(3), 126–129.
10. Gaysina, S.N., Chulanova, Z.K., & Dzhumashev, N.M. (2023). Socio-Economic Risks of Internal Migration Processes and Their Impact on the Socio-Territorial Mobility of the Population of Kazakhstan. Economics: the strategy and practice, 18(3), 174-188, https://doi.org/10.51176/1997-9967-2023-3-174-188
11. Gwatkin, D.R., & Ergo, A. (2011) Universal health coverage: friend or foe of health equity? Lancet, 377(9784), 2160–2161. https://doi.org/10.1016/S0140-6736(10)62058-2
12. Hagen, J. (2018) The effects of increasing the normal retirement age on health care utilization and mortality. Journal of Population Economics, 31(1), 193–234. https://doi.org/10.1007/s00148-017-0664-x
13. Hartman, C. (2016) Post neoliberal Public Health Care Reforms: Neoliberalism, Social Medicine, and Persistent Health Inequalities in Latin America. American Journal of Public Health, 106(12), 2145–2151. https://doi.org/10.2105/AJPH.2016.303470
14. Health Ministry of RK (2022). The development of rural medicine was discussed at the government hour in the Mazhilis on October 10, 2022. Available online: https://www.gov.kz/memleket/entities/dsm/press/news/details/437958?lang=ru (accessed on 25 March 2024)
15. Jones, A.M., Roemer, J.E., & Rosa, Dias P. (2014). Equalizing opportunities in health through educational policy. Social Choice and Welfare, 43(3), 521–545. https://doi.org/10.1007/s00355-014-0793-z
16. Jui-fen, R.L., & Tung-liang, Ch. (2018). Developing an adequate supply of health services: Taiwan’s path to Universal Health Coverage. Social Science and Medicine, 198, 7–13.
17. Kalmataeva, Zh.A., & Kalieva, D.A. (2016). On the issue of increasing the competitiveness of government healthcare organizations. Central Asian Scientific and Practical Journal of Public Health, 1, 33-36.
18. Kochkina, N.N., Krasilnikova, M.D., & Shishkin, S.V. (2015) Availability and quality of medical care in population estimates. Higher School of Economics. State and municipal management. Мoscow: Izd. dom VShE. 1-56. (In Russ)
19. Li, C., Yu, X., & Butler, J.R. (2011). Moving towards universal health insurance in China: performance, issues, and lessons from Thailand. Social Science & Medicine, 73(3), 359–366. https://doi.org/10.1016/j.socscimed.2011.06.002
20. Long, Q., Xu, L., & Bekedam, H. (2013). Changes in health expenditures in China in the 2000s: has the health system reform improved affordability? International Journal for Equity in Health, 12(40), 1-8. https://doi.org/10.1186/1475-9276-12-40
21. Mitra, A. (2021). Age, Inequality and the Public Provision of Healthcare. Studies in Economics. School of Economics, University of Kent. Available online: https://hdl.handle.net/10419/246690 (accessed on 25 March 2024)
22. Morris, S., Sutton, M., & Gravelle, H. (2005). Inequity and inequality in the use of health care in England: An empirical investigation. Social Science and Medicine, 60, 1251–1266.
23. Nguyen, K. T., Khuat, O.T.H., & Ma, S. (2012). Impact of health insurance on health care treatment and cost in Vietnam: a health capability approach to financial protection. American Journal of Public Health, 102(8), 1450–1461. https://doi.org/10.2105/AJPH.2011.300618
24. OECD (2020). Rural Well-being: Geography of Opportunities”, OECD Rural Studies, OECD Publishing, Paris. Available online: https://doi.org/10.1787/d25cef80-en
25. O’Donnell, O., van Doorslaer, E., & van Ourti, T. (2015). Health and Inequality. Handbook of Income Distribution, 2B, 1419–1533. https://doi.org/10.1016/B978-0-444-59429-7.00018-2
26. Official information resource of the Prime Minister of the Republic of Kazakhstan. Modernizing rural healthcare will increase the life expectancy and social well-being of the population. November 22, 2022. Available online: https://primeminister.kz/ru/news/modernizaciya-selskogo-zdravoohraneniya-pozvolit-uvelichit-prodolzhitelnost-zhizni-i-socialnoe-blagopoluchie-naseleniya-22102515 (accessed on 25 March 2024)
27. Palmer, M.G. (2014). Inequalities in universal health coverage: Evidence from Vietnam. World Development, 64, 384–394.
28. Pasqualini, M., Lanari, D., & Minelli, L. (2017). Health and income inequalities in Europe: What is the role of circumstances? Economics & Human Biology, 26, 164–173. https://doi.org/10.1016/j.ehb.2017.04.002
29. Rosa, Dias P. (2010) Modelling opportunity in health under partial observability of circumstances. Health Economics, 19(3), 252–264. https://doi.org/10.1002/hec.1584
30. Roemer, J.E., & Trannoy, A. (2016). Equality of Opportunity: Theory and Measurement. Journal of Economic Literature, 54 (4), 1288–1332. https://doi.org/10.1257/jel.20151206
31. Sutton, M. (2002). Vertical and horizontal aspects of socio-economic inequity in general practitioner contacts in Scotland. Health Economics, 11, 537–549. https://doi.org/10.1002/hec.752
32. Schmidt, H., Gostin, L.O., & Emanuel, E.J. (2015). Public health, universal health coverage, and Sustainable Development Goals: can they coexist? Lancet, 386 (9996), 928–930. https://doi.org/10.1016/S0140-6736(15)60244-6
33. Spankulova, L.S., Chulanova, Z.K., Nuruly, E., & Isaeva, Zh.S. (2022). Methodological approaches to assessing the implementation of drug insurance. Bulletin of National Academy of Sciences of the Republic of Kazakhstan, 3 (397), 379-396. https://doi.org/10.32014/2022.2518-1467.32
34. Tokayev, K-J. (2022). Qasym-Jomart Toqayev. Available online: https://twitter.com/TokayevKZ
35. Trannoy, A., Tubeuf, S., Jusot, F. (2010). Inequality of opportunities in health in France: A first pass. Health Economics, 19(8), 921–938.
36. Turgambayeva, A., Imanova, Z., & Tulegenova, A. (2021). Rural Healthcare in Kazakhstan: Problems and Trends (Literature Review). Journal of Health Development, 3(43), 13-18. (In Russ)
37. Utegenova, G.I. (2014). On improving the quality and availability of pharmaceutical care for the rural population in the Republic of Kazakhstan). Meditsina, 1, 2-3. (In Russ)
38. van Doorslaer, E., Koolman, X., & Jones, A.M. (2004). Explaining income-related inequalities in doctor utilization in Europe. Health Economics, 13, 629–647. https://doi.org/10.1002/hec.919
39. Vyalykh, N.A. (2015). Factors of reproduction of social inequality in the sphere of consumption of medical services. Sociological studies, 11(379), 126–132. (In Russ)
40. World Bank (2023). Statistics indicators. Available online: https://data.worldbank.org/indicator/SP.RUR.TOTL.ZS (accessed on 25 March 2024)
41. World Health Organization (2022). Constitution of the World Health Organization. Available online: https://www.who.int/about/accountability/governance/constitution (accessed on 25 March 2024)
42. World Health Organization (2022). Quality of care. Available online: https://www.who.int/health-topics/quality-of-care#tab=tab_1 (accessed on 25 March 2024)
43. Yu, H. (2015). Universal health insurance coverage for 1.3 billion people: What accounts for China’s success? Health Policy, 119(9), 1145–1152 https://doi.org/10.1016/j.healthpol.2015.07.008
Review
For citations:
Spankulova L., Chulanova Z., Konyrbay A. Availability and Quality of Medical Services in Kazakhstan: the Urban-Rural Context. Eurasian Journal of Economic and Business Studies. 2024;68(2):5–19. https://doi.org/10.47703/ejebs.v68i2.376
Views:
58
JATS XML
Email this article 