Assessment of primary healthcare accessibility and inequality in north-eastern Kazakhstan

Out of the many aspects of health care, the concept of physical accessibility is a priority that not only encompasses availability of health care resources, but also requires that they are easily accessible for all. To assess this factor as expressed in terms of the number of available physicians in the north-eastern part of Kazakhstan, we used the enhanced two-step float catchment area in a geographic information system approach. The Gini index and the Lorentz curve were used to evaluate the economic inequality within this region. Based on the data obtained, we developed models to increase the availability of health care considering allocation of additional primary health care resources. A low to zero index was found to be typical for most rural settlements, which currently make up less than 15% of the total population. We also identified a correlation between the index of accessibility and that of inequality, which indicates that areas with high accessibility show a more equitable distribution of resources. The developed location/ allocation models of additional primary health care resources can be useful in implementing government initiatives to improve the availability of primary health care in rural areas.info:eu-repo/semantics/publishedVersio

Health-care Accessibility Assessment in Kazakhstan

BACKGROUND: Global health initiatives such as health for all and universal health coverage aim to improve access to health care. These goals require constant comprehensive monitoring to eliminate inequalities in the availability of health care. AIM: The purpose of our study was to assess the physical availability of medical care in Kazakhstan. METHODS: A descriptive study based on a Service Availability and Readiness Assessment (SARA) general availability index calculation that used secondary data as a source of information. RESULTS: The general availability index calculated for the regions of Kazakhstan ranged from 95% to 100%. When considering individual indicators of the index, decrease trends of the volume of inpatient care were identified. Outpatient care had fluctuations with values better than benchmark after 2009. Stable upward trend illustrates positive picture of core health personnel. CONCLUSION: According to the SARA availability index, it can be concluded that health care in Kazakhstan exceeds the threshold values and is available in all regions. Trends for individual indicators of the index should be studied in more detail, taking into account the influence of health policy and other factors

The Association between Parental Child Vaccination Refusal Rate and the Impact of Mass Vaccination against COVID-19 in Kazakhstan: An Interrupted Time Series Analysis with Predictive Modelling of Nationwide Data Sources from 2013 to 2022

Despite well-established evidence supporting vaccination efficacy in reducing morbidity and mortality among infants and children, there is a global challenge with an increasing number of childhood vaccination refusals. This issue has intensified, especially during the COVID-19 pandemic. Our study aims to forecast mandatory childhood vaccination refusal trends in Kazakhstan until 2030, assessing the impact of mass COVID-19 vaccination on these rates. Utilizing annual official statistical data from 2013 to 2022 provided by the Ministry of Health of Kazakhstan, the study reveals a significant surge in refusals during the pandemic and post-pandemic periods, reaching record levels of 42,282 cases in 2021 and 44,180 cases in 2022. Notably, refusal rates sharply rose in specific regions, like Aktobe (13.9 times increase) and Atyrau (4.29 times increase), emphasizing the need for increased public healthcare attention in these areas. However, despite a decade of data, our forecasting analysis indicates a lack of volatility in childhood vaccine refusal trends for all vaccine types up to 2030, highlighting the statistical significance of the obtained results. The increasing trend in vaccine refusals underscores the necessity to enhance crisis response and support health initiatives, particularly in regions where a substantial rise in refusals has been observed in recent years

Prevalence of postpartum depression and its associated factors within a year after birth in Semey, Kazakhstan: a cross sectional study

Background: Postpartum depression (PPD) is a depressive disorder that occurs after childbirth and can last until a year after delivery. The global prevalence of PPD among mothers is between 0.5% and 63.3%. The aim of the study is to determine the prevalence of postpartum depression within a year after birth among mothers in Semey (Kazakhstan) and identify the factors associated with it. Methods: A cross-sectional study covering 251 women within one year after delivery was conducted in five Primary Healthcare Centers in Semey. The Edinburgh Postnatal Depression Scale (EPDS) for assessing PPD was used. Data was analysed using the Statistical Package for Social Sciences (SPSS), version 25. The statistical significance and magnitude of the relationships between dependent and independent variables were conducted using chi-square and bivariate and multivariate logistic regression analyses. A p-value of less than 0.05 was considered to be significant. Results: The prevalence of PPD within a year after delivery was estimated as 59.4%. Factors including accommodation type (p = 0.021), satisfaction with living conditions (p = 0.001), relationship with mother-in-law (p = 0.013), the interest of the patronage service about the psychological state of a woman after childbirth (p = 0.001) and husband employment status (p = 0.04) showed significant positive association with PPD. Conclusion: The high prevalence rate of PPD and associated risk factors imply the need for strengthening and improving of postpartum care program in country. Further research on the experiences and the level of antenatal depression among women will be needed to understand and prevent any possible depressions in prenatal and postpartum periods