This book is the first of its kind about healthcare reform efforts in Kazakhstan since its independence within the context of the public sector reform movement. The book provides a brief background of Kazakhstan and its Soviet legacy and the country’s efforts to modernize the health system, before creating an overview of the existing system, the reforms since independence, and the future of healthcare in Kazakhstan. This book will be of interest to policymakers, analysts, and development economists.
This report assesses how Kazakhstan measures up in the development and application of its national health accounts, delivering a set of recommendations to improve the health spending information necessary to support health system performance.
- Foreword - Acronyms and abbreviations - Executive Summary - Assessment and recommendations - Introduction and overview - The health financing system in Kazakhstan - National health accounts of Kazakhstan - Reporting and data sources - Methodology - Adjusting NHA of RK to improve comparability with OECD countries - Productivity and efficiency indicators - Conclusions - Classifications currently used in nha of rk - OECD adjusted NHA of RK tables
Kazakhstan has made significant economic progress over recent decades. Health has risen on the policy agenda with a number of sector reforms introduced. This review uses globally recognised frameworks and indicators to evaluate Kazakhstan’s overall health system.
The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. When Kazakhstan became independent in 1991, it faced many of the same challenges as other countries from the former Soviet Union, including an oversized and inpatient-oriented system of health facilities and a drop in health financing in the early transition years. Although the country embarked on several major health reforms in the second half of the 1990s, these often lacked consistency and clear direction. In the wake of the economic upswing fuelled by oil revenues in recent years, in 2004 Kazakhstan initiated a comprehensive National Programme of Health Care Reform and Development for the period 2005 ̃2010. One of the key challenges addressed by the reform programme is the considerable inequities in terms of health financing per capita between the countryŸs oblasts (regions) and between urban and rural areas. Another major challenge is out-of-pocket payments for health services and pharmaceuticals, although the magnitude of these payments remains unknown. Despite an increased emphasis on primary care, the inpatient sector continues to consume the bulk of health funding, and the question of specialized and parallel health services has so far not been addressed by the reform programme. Overall, more attention will need to be paid to the quality and efficiency of health services. A system of monitoring and evaluation, as well as the establishment of clinical practice guidelines, could play an important role in achieving these aims. Many rural areas are lacking sufficient numbers of health care workers, while an oversupply exists in the major cities. A comprehensive system of human resources planning and the introduction of incentives for health care workers in rural areas might present an avenue for addressing this challenge. [Ed.]
Central Asia remains one of the least known parts of the former Soviet Union. The five central Asian republics gained their unexpected independence in 1991. They have faced enormous challenges over the last decade in reforming their health care systems, including adverse macro-economic conditions and political instability. To varying extents, each country is diverging from a hierarchical and unsustainable Soviet model health care system. Common strategies have involved devolving the ownership of health services, seeking sources of revenue additional to shrinking state taxes, 'down-sizing' their excessive hospital systems, introducing general practitioners into primary care services, and enhancing the training of health professionals. This book draws on a decade of experience of what has worked and what has not. It is an invaluable source for those working in the region and for others interested in the experiences of countries in political and economic transition.
While the need for effective action toward a greener and socially inclusive economy has long been evident, health promotion in the context of sustainable development has faltered. Arguing that human health is the key factor to sustainable development, Development and Sustainability promotes a fresh, transdisciplinary approach to the eradication of extreme poverty. This ground-breaking book calls for new forms of cooperation which cross the traditional boundaries between social activism and science, and which are capable of harnessing the complex knowledge that such radical change requires. The contributions bridge the gap between those working for health and those working for sustainability science and the green economy, through developing the methodological and scientific means to deal with some of the most critical issues faced by humanity in the twenty-first century.
Finalist, PEN Center USA Literary Awards, Research NonfictionRich in oil and strategically located between Russia and China, Kazakhstan is one of the most economically and geopolitically important of the so-called Newly Independent States that emerged after the USSR's collapse. Yet little is known in the West about the region's turbulent history under Soviet rule, particularly how the regime asserted colonial dominion over the Kazakhs and other ethnic minorities.Grappling directly with the issue of Soviet colonialism, Curative Powers offers an in-depth exploration of this dramatic, bloody, and transformative era in Kazakhstan's history. Paula Michaels reconstructs the Soviet government's use of medical and public health policies to change the society, politics, and culture of its outlying regions. At first glance the Soviets' drive to modernize medicine in Kazakhstan seems an altruistic effort to improve quality of life. Yet, as Michaels reveals, beneath the surface lies a story of power, legitimacy, and control. The Communist regime used biomedicine to reshape the function, self-perception, and practices of both doctors and patients, just as it did through education, the arts, the military, the family, and other institutions.Paying particular attention to the Kazakhs' ethnomedical customs, Soviet authorities designed public health initiatives to teach the local populace that their traditional medical practices were backward, even dangerous, and that they themselves were dirty and diseased. Through poster art, newsreels, public speeches, and other forms of propaganda, Communist authorities used the power of language to demonstrate Soviet might and undermine the power of local ethnomedical practitioners, while moving the region toward what the Soviet state defined as civilization and political enlightenment.As Michaels demonstrates, Kazakhs responded in unexpected ways to the institutionalization of this new pan-Soviet culture. Ethnomedical customs surreptitiously lived on, despite direct, sometimes violent, attacks by state authorities. While Communist officials hoped to exterminate all remnants of traditional healing practices, Michaels points to evidence that suggests the Kazakhs continued to rely on ethnomedicine even as they were utilizing the services of biomedical doctors, nurses, and midwives. The picture that ultimately emerges is much different from what the Soviets must have imagined. The disparate medical systems were not in open conflict, but instead both indigenous and alien practices worked side by side, becoming integrated into daily life.Combining colonial and postcolonial theory with intensive archival and ethnographic research, Curative Powers offers a detailed view of Soviet medical initiatives and their underlying political and social implications and impact on Kazakh society. Michaels also endeavors to link biomedical policies and practices to broader questions of pan-Soviet identity formation and colonial control in the non-Russian periphery.
