Universal health coverage relies on providing essential medical services and shielding individuals from financial risks. Our study assesses the progressivity of out-of-pocket (OOP) payments, identifies factors contributing to healthcare expenditure inequality, and examines catastrophic health expenditures (CHE) prevalence in Kazakhstan from 2018 to 2021. Using retrospective analysis of National Statistics Bureau data, we employed STATA 13 version for calculations CHE incidence, progressivity, Lorenz and concentration curves. In 2020–2021, OOP expenditures in Kazakhstan decreased, reflecting a nearly twofold reduction in the CHE incidence to 1.32% and 1.24%, respectively. However, during these years, we observe a transition towards a positive trend in the Kakwani index to 0.003 and 0.005, respectively, which may be explained by household size and education level factors. Increased state financing and quarantine measures contributed to reduced OOP payments. Despite a low healthcare expenditure share in gross domestic product, Kazakhstan exhibits a relatively high private healthcare spending proportion. The low CHE incidence and proportional expenditure system suggest private payments do not significantly impact financial resilience, prompting considerations about the role of government funding and social health insurance in the financing structure.

Global progress toward achieving universal health coverage (UHC) by 2030 remains insufficient, as significant regional disparities in access to healthcare persist. In Kazakhstan, the uneven distribution of healthcare resources continues despite reforms aimed at improving equity. This retrospective study analyzed inequalities in the distribution of medical infrastructure, healthcare personnel, and service utilization across 14 regions and 2 cities of republican significance from 2002 to 2023. Data were obtained from national statistical reports on healthcare and population income. The analysis included the following indicators: the number of primary care facilities, hospital beds, healthcare personnel, outpatient visits, and hospitalizations per population. Inequality was assessed using the Gini coefficient and the concentration index, and spatiotemporal trends were visualized through cluster analysis in ArcGIS PRO. Results revealed that southern and western regions exhibit lower availability of hospital beds and healthcare personnel, with moderate levels of inequality particularly evident in outpatient care. Despite Kazakhstan’s commitment to UHC, these disparities underscore the need for further measures to ensure equitable access to healthcare services.

Background: Environmental problems can significantly influence population health. Cardiovascular diseases (CVDs) are the most common cause of death in developed countries including in Kazakhstan. The aim of our study was to assess the relationship between exposure to ionizing radiation and mortality risks from major CVDs for the population of Kazakhstan living in areas adjacent to the Semipalatinsk nuclear test site (SNTS). Materials and Methods: The study of the structure and dynamics of cardiovascular mortality was based on the State Scientific Automated Medical Registry (SSAMR) database. Among members of the exposed group, the median equivalent radiation dose was 864.0 mSv, compared to 64.4 mSv in the control group. It should be noted that almost the entire population of the Semipalatinsk region was exposed to some degree of radiation; however, the Kokpekti district received the lowest radiation doses. Results: Mortality rates from CVD were statistically significantly higher in the radiation-exposed population from 1960 to 1994, with RR fluctuating from 1.118 to 8.7. The predominant mortality events were chronic coronary heart disease, chronic cerebrovascular disease, and hemorrhagic stroke throughout the study period, and acute myocardial infarction within 20 years of the start of nuclear testing. In the exposed group, RR = 10.35 for chronic cerebrovascular disease, RR = 3.56 for hemorrhagic stroke, and RR = 5.77 for peripheral arterial atherosclerosis. A dose of 100–500 mSv increased the risk of mortality from CVD by 3.14 times, and a dose of >600 mSv increased it by 7.05 times. Conclusions: A link has been established between long-term exposure to ionizing radiation and increased risks of mortality from CVD in the population of areas contaminated with radiation as a result of nuclear testing.

Aim: The present study aimed to perform validation and assessment of psychometric indicators of the Kazakh version of the Brief Index of Affective Job Satisfaction on the academic faculty staff. Material and methods: The translation of the Brief Index of Affective Job Satisfaction was performed following the World Health Organization guidelines on the translation and adaptation of research instruments. 715 medical educators of Kazakhstani medical universities represented the study population. Preliminary statistical analysis included Cronbach’s alpha calculation. The psychometric properties of the instrument were examined using exploratory and confirmatory factor analysis. Results: Cronbach’s alpha obtained 0.83. The Kaiser-Meyer-Olkin index reached 0.830, which indicated meritorious sample adequacy. CFA identified good factorial validity of the scale: all model fit indices exceeded the threshold values. The inter-item correlation index varied between r=0.616 and r=0.716, designating an acceptable correlation between variables. The total job satisfaction level was moderate (3.15±0.78). Women reported lower rates of job satisfaction, although the difference was not statistically significant (p<0.284). Conclusion: Our findings provide support to the psychometric properties of the Kazakh version of the BIAJS as an instrument for the assessment of job satisfaction. The major advantages of the BIAJS are that it is optimally brief, highly affective, and has good internal validity.

Background/Objectives: Effective management represents a real opportunity to reduce the economic burden of focal epilepsy, which leads to the withdrawal of at least 0.7% of the working-age population from the labor force. The aim of this retrospective observational cross-sectional study is to identify barriers that limit access to surgical treatment for epilepsy among patients with focal epilepsy in Kazakh population. Methods: Medical reports from epileptologists on 3112 patients of the Epilepsy Center (Astana) in 2024 were reviewed. The study included original information on 1361 patients with a confirmed diagnosis of focal epilepsy, in accordance with ICD-10 codes G40.0–G40.2. Results: Timely detection of focal epilepsy was not associated with socio-demographic or regional factors in our sample. Logistic regression analysis showed that sex and social status did not affect whether patients underwent surgery. However, marital status, employment, and region were significant factors. Married and employed patients had higher odds of remaining non-operated. Among candidates for surgical treatment, 38.68% underwent surgery. Conclusions: The markedly higher odds of remaining non-operated outside Astana point to gaps in referral pathways and service availability, emphasizing the need for a comprehensive approach to managing focal epilepsy in countries undergoing rapid technological development.

Background: Depression is a major global health burden, requiring culturally appropriate assessment instruments, but no validated Kazakh-language version of the Patient Health Questionnaire-9 (PHQ-9) is available. This study aimed to translate, culturally adapt, and evaluate the psychometric properties of the Kazakh PHQ-9 in a community-based, non-clinical sample. Methods: This cross-sectional study included 503 Kazakh-speaking adults (mean age = 24.0 years, SD = 10.1; 51.3% women and 48.7% men) who completed the Kazakh PHQ-9 and Generalized Anxiety Disorder-7 (GAD-7) questionnaires. Internal consistency, structural validity, measurement invariance across genders, and convergent validity were assessed. Results: Internal consistency was excellent (Cronbach’s α = 0.91), and both one-factor and correlated two-factor models showed excellent fit (CFI = 0.998; TLI = 0.997–0.998; RMSEA = 0.046–0.048; SRMR = 0.050–0.052), with a slightly better fit for the latter. Measurement invariance across genders was supported, and PHQ-9 and GAD-7 scores were strongly correlated (r = 0.68, p < 0.001). Conclusions: The Kazakh PHQ-9 demonstrated excellent internal consistency and structural validity, measurement invariance across genders, and strong convergent validity in this non-clinical sample. These findings support its use for assessing depressive symptoms in Kazakh-speaking adults. Clinical validation is needed to establish diagnostic validity and screening performance.