COVID-19 has affected all aspects of human life so far. From the outset of the pandemic, preventing the spread of COVID-19 through the observance of health protocols, especially the use of sanitizers and disinfectants was given more attention. Despite the effectiveness of disinfection chemicals in controlling and preventing COVID-19, there are critical concerns about their adverse effects on human health. This study aims to assess the health effects of sanitizers and disinfectants on a global scale. A total of 91,056 participants from 154 countries participated in this cross-sectional study. Information on the use of sanitizers and disinfectants and health was collected using an electronic questionnaire, which was translated into 26 languages via web-based platforms. The findings of this study suggest that detergents, alcohol-based substances, and chlorinated compounds emerged as the most prevalent chemical agents compared to other sanitizers and disinfectants examined. Most frequently reported health issues include skin effects and respiratory effects. The Chi-square test showed a significant association between chlorinated compounds (sodium hypochlorite and per-chlorine) with all possible health effects under investigation (p-value <0.001). Examination of risk factors based on multivariate logistic regression analysis showed that alcohols and alcohols-based materials were associated with skin effects (OR, 1.98; 95%CI, 1.87–2.09), per-chlorine was associated with eye effects (OR, 1.83; 95%CI, 1.74–1.93), and highly likely with itching and throat irritation (OR, 2.00; 95%CI, 1.90–2.11). Furthermore, formaldehyde was associated with a higher prevalence of neurological effects (OR, 2.17; 95%CI, 1.92–2.44). Furthermore, formaldehyde was associated with a higher prevalence of neurological effects (OR, 2.17; 95%CI, 1.92–2.44). The use of sodium hypochlorite and per-chlorine also had a high chance of having respiratory effects. The findings of the current study suggest that health authorities need to implement more awareness programs about the side effects of using sanitizers and disinfectants during viral epidemics especially when they are used or overused.

Background: Patient satisfaction is a key indicator of healthcare quality. Although crucial, limited research has explored factors contributing to satisfaction disparities in outpatient obstetric-gynecological care, particularly in Kazakhstan. The objective of the study is to explore disparities in satisfaction with obstetric-gynecological care between insured and uninsured women in Almaty, Kazakhstan, and to identify the key determinants of patient satisfaction.Methods: A cross-sectional survey was conducted among 107 insured and uninsured patients over three months in early 2024 at a hospital in the Almaty region, Kazakhstan. Using a five-point Likert scale, a structured questionnaire assessed socio-demographics, patient-reported experiences with the care process, and overall satisfaction across 16 dimensions. The survey instrument was pilot-tested and demonstrated strong internal consistency (Cronbach's alpha = 0.83). Chi-square tests examined associations, and multivariable logistic regression identified key predictors of patient satisfaction.Results: A multivariable analysis revealed a “satisfaction paradox”: insured patients had lower odds of being satisfied compared to uninsured patients (AOR = 0.15, 95% CI: 0.03–0.81). Specifically, a lack of insurance was associated with higher reported satisfaction in doctor-patient communication (OR = 1.8) and nursing care (OR = 2.1). Other significant predictors of satisfaction included having kidney disease and a shorter hospital stay.Conclusions: Our findings suggest that expanding insurance coverage is necessary for access but insufficient for ensuring patient satisfaction. The observed “satisfaction paradox” highlights that policy must adopt a dual focus: promoting enrolment while simultaneously improving the quality of patient-provider interactions to meet the higher expectations of insured patients.

Disclosure of near-miss medical error (ME) and how to disclose ME to patients remain controversial. Furthermore, available guidelines on the disclosure of ME have primarily emerged in developing co...

Background: Timely prehospital management is critical for survival after traumatic injury. In rapidly growing metropolises, emergency medical service (EMS) systems often struggle to provide equitable care amid urban sprawl and traffic congestion. This study investigated spatiotemporal inequalities in trauma-related EMS response in a rapidly expanding capital city (Astana, Kazakhstan) to inform healthcare optimization and urban health equity. Methods: We analyzed a five-year population-based dataset of 26,073 trauma-related EMS calls recorded between 2020 and 2024. Spatial patterns were examined using Kernel Density Estimation (KDE) and Getis–Ord Gi* hotspot analysis. Road-network modeling assessed accessibility at 3, 5, and 10 min thresholds using a GIS-based network analyst framework. Results: Males accounted for 60.1% of utilization and had higher clinical severity (hospitalization rate: 45.5% vs. 40.3%, p < 0.001). Demand peaked at 20:00, coinciding with peak traffic. The mean total response time was 21.63 min, and only 16.9% of calls met the 10 min benchmark. Significant accessibility gaps were found in the Baikonur district (61.4% delay rate). Conclusions: The findings demonstrate that while the EMS system provides broad geographic coverage, it suffers from systemic spatiotemporal bottlenecks. Targeted infrastructure expansion in underserved peripheral districts and the implementation of dynamic deployment models are necessary to enhance urban health equity and reduce preventable mortality in expanding metropolitan areas.

Background: Management of inguinal hernia repair (IHR) in transition economies remains a challenge where clinical adoption of international guidelines, such as HerniaSurge 2023, is often hindered by legacy funding models. This study evaluates the impact of surgical technique transition on clinical outcomes, cost-utility, and institutional resource turnover in Almaty, Kazakhstan. Methods: A prospective-retrospective analysis of 505 patients was conducted (January 2021 to December 2023). For clinical comparison, a matched subgroup (n=138) was analyzed, comparing Open Lichtenstein (n=56), Laparoscopic Totally Extraperitoneal (TEP, n=42), and Open Transinguinal Preperitoneal (TIPP, n=40) repairs. Clinical outcomes were quantified via the EuraHS-QoL scale. Economic efficiency was modeled using Quality-Adjusted Life Years (QALY). We introduced the System Burden Index (SBI) — calculated as the ratio of category mean length of stay (LOS) to population average — to identify productivity bottlenecks across financing channels (Commercial, Government Quotas, and City Budget). Results: Posterior approach techniques (TEP and TIPP) significantly reduced postoperative pain frequency compared to the Lichtenstein group (26.2% and 32.5% vs. 51.8%, p=0.013). TEP was identified as the dominant strategy for cost-utility. Management analysis revealed a significant “Efficiency Gap” across funding sectors: government quota cases showed a mean LOS of 8.31 days (SBI 1.28) compared to 5.37 days (SBI 0.83) in the commercial sector. Our predictive model suggests that transitioning state-funded sectors to rapid-recovery protocols could potentially reclaim 4.7 bed-days per patient. Conclusion: Transitioning to TEP/TIPP protocols is a key factor for enhancing healthcare capacity in Kazakhstan. Shifting reimbursement logic from bed-day occupancy to value-based outcome packages is essential to align regional practice with global surgical standards and optimize institutional throughput.

Background: Healthcare professionals, public committees and leaders, as well as and people in positions of responsibility, deeply apprehensive with improving patient safety in Kazakhstan. Patient attitude towards of medical error is relatively well studied in developed countries of the world, but little is known about Central Asian countries, especially post-soviet space. This study aimed to analyze the attitude towards medical errors, depending on whether the respondents themselves or their relatives had this experience in the Republic of Kazakhstan from 2019 to 2021. Methods: The study included two hundred sixty-seven participants. The statistical analysis of data on medical error was performed for the whole country. Data on medical error from public were retrieved for the period 2019-2020. Respondents were asked about the causes of and solutions to the challenge of preventable medical errors and what the consequences of medical error should be. Results: A total of 40.8% (109/267) of respondents confirmed that they had experienced problems regarding medical errors while 59.2% (158/267) had not encountered any medical errors in their life experience. Nearly one in three Kazakhstan's adults agree that cause of medical errors is lack of professional qualifications of health professionals 36.3% (97/267). The respondents noted that hospital administration 47.6% (127/267) should be held accountable for medical errors, followed by the health professionals 25.5% (68/267). Conclusions: There were significant differences between the regions of the country in the causes of medical errors in the opinion of public, as well as in indicators of the degree of responsibility for and response to medical errors. There is a need for further study of the causes and attitudes of public, which may have helped to better understand the challenge of medical errors in Kazakhstan. Key messages: There is a need to performing regular analysis and evaluation to find out the cause of the problem and taken into account in deciding regarding the medical error. We recommend raising awareness about medical errors and the need for incident reporting, introducing training and learning workshops, and improving medical error reporting.