Cervical cancer (CC) continues to be a significant global health issue, which in part can be attributed to disparities in access to CC screening services. This study aims to conduct a trend of CC in Kazakhstan and to compare attitudes towards the screening program between women living in urban and rural areas. In the first stage, we conducted a trend study of CC indicators in Kazakhstan using official statistics. In the second stage, a cross-sectional study was conducted using a structured questionnaire to assess adherence to screening. The trend study reveals a decline in cervical cancer mortality rates (from 7.15 to 5.93 per 100,000 female inhabitants) over the period studied, while the incidence remains stable (from 18.51 to 19.38 per 100,000 female inhabitants). Regional variations in Period Prevalence rates were observed. Significant differences were found in screening participation rates between urban n = 41 (74%) and rural n = 23 (38%) women, p < 0.001, as well as awareness of the screening program (urban: n = 15 (27%), rural: n = 35 (58%), p < 0.001). The trend study highlights a decrease in cervical cancer mortality rates over the specified period, accompanied by a consistent incidence rate. Additionally, regional disparities in period prevalence rates of cervical cancer were observed. The primary factor contributing to the low adherence of rural women to screening was found to be a lack of awareness regarding the screening program. Therefore, increasing awareness about the importance of screening is crucial for improving adherence rates among rural women in Kazakhstan.

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.

Введение: литературный обзор посвящен вопросу внедрения в образовательные программы интернатуры профессиональных стажировок на будущем рабочем месте. Данный вопрос освещается в контексте актуальной для системы высшего образования Казахстана проблемы, реализации дуального обучения. Цель: обоснование необходимости внедрения в образовательные программы интернатуры профессиональных стажировок на основе результатов литературного обзора. Материалы и методы: в статье представлены результаты аналитического обзора. Поиск литературы был осуществлен по тегу «профессиональная стажировка интерна» в электронных базах данных «Pabmed.gov», «eLIBRARY.RU», Республиканская межвузовская электронная библиотека (РМЭБ), официальные сайты Министерства здравоохранения и социального развития Республики Казахстан, Управлений здравоохранения Восточно-Казахстанской и Павлодарской областей. В ходе поиска было обнаружено 3053 литературных источника, 59 из которых были выбраны в качестве аналитического материала статьи. Кроме того была изучена нормативно-правовая база Республики Казахстан глубиной 27 лет. Выводы: профессиональная стажировка способствует комплексной адаптации интерна на будущем рабочем месте. Достоинствами внедрения в образовательный процесс интернатуры профессиональных стажировок являются: сокращение сроков адаптации интерна к условиям работы на будущем месте трудоустройства; возможность работодателя оценить личность и качество подготовки будущего работника; возможность получения интерном конструктивной обратной связи от будущих коллег и работодателя; повышение мотивации интернов к обучению; овладение требуемыми профессиональными навыками и умениями, их закрепление в условиях конкретной клиники, приобретение знаний, позволяющих быстро ориентироваться в различных клинических ситуациях; сокращение рисков врачебных ошибок и жалоб от пациентов; возможность замещения на период ежегодного отпуска основного сотрудника клиники стажером-интерном. Introduction: the literary review is devoted to a question of introduction in educational programs of intership of professional training on the future workplace. The given question is shined in a context actual for system of higher education of Kazakhstan of a problem, realization of dual training. Objective: a background of an indispensability of introduction in educational programs of intership of professional training on the basis of results of the literary review. Materials and methods: in article results of the state-of-the-art review are presented. Search of the literature has been carried out on description «professional training of the intern» in electronic databases «Pabmed.gov», «eLIBRARY.RU», republican interuniversity electronic library (РМЭБ), official sites of Ministry of Health and social development of Republic Kazakhstan, Managements of healthcare of the East Kazakhstan and Pavlodar areas. During search 3053 literary sources were revealed, 59 from which have been chosen as an analytical material of article. Except for that the legal base of Republic Kazakhstan has been studied by depth of 27 years. Conclusions: professional training assists complex adaptation of the intern on the future workplace. Dignity of introduction in educational process of intership of professional training are: reduction of timeframes of adaptation of the intern to operating conditions on the future seat of employment; a possibility of the employer to estimate the person and quality of preparation of the future worker; a possibility of reception by the intern of a constructive feedback from the future colleagues and the employer; increase of motivation of interns to training; mastering by required professional skills and skills, their fastening in conditions of specific clinic, purchase of the knowledge allowing quickly to be guided in various clinical situations; reduction of risks of medical mistakes and complaints from patients; a possibility of replacement with the period of annual vacation of the basic employee of clinic the trainee-intern. Кіріспе: әдеби шолу болашақ жұмыс орнында кәсіптік оқу тағылымдамадан білім беру бағдарламаларын жүзеге асыру мәселесіне баса назар аударылды. Бұл...

Background: Depressive symptoms, anxiety symptoms, and low subjective well-being are highly prevalent among older adults, but they are typically assessed separately, and their co-occurrence remains insufficiently explored, particularly in Central Asia. Objectives: This study aimed to assess the prevalence and co-occurrence of depressive symptoms, anxiety symptoms, and low subjective well-being among older adults in northeastern Kazakhstan and to identify associated factors. Methods: A cross-sectional study was conducted among 387 individuals aged 60 years and older. Depressive symptoms, anxiety symptoms, and well-being were screened using the Geriatric Depression Scale (GDS-15), the Short Anxiety Screening Test (SAST), and the World Health Organization Five Well-Being Index (WHO-5), respectively. Analyses included Spearman’s rank correlation and multivariable binary logistic regression. Results: The prevalence of clinically significant depressive symptoms, elevated anxiety symptoms, and low subjective well-being was 22.7%, 20.7%, and 25.3%, respectively; at least one screening-positive indicator was identified in 36.4% of participants. Simultaneous screening positivity on all three indicators (10.3%) was the most common single pattern, exceeding the prevalence of any isolated indicator. Depressive and anxiety symptom scores were strongly positively correlated (r = 0.695, p < 0.001), and both were inversely correlated with well-being. Functional limitations in self-care and income level were independently associated with all three outcomes, with the strongest association observed for functional limitations (adjusted odds ratio (aOR) = 6.40; 95% confidence interval (CI): 3.05–13.86). Conclusions: Depressive symptoms, anxiety symptoms, and low subjective well-being co-occurred more frequently than expected under statistical independence, indicating a co-occurring pattern of psycho-emotional vulnerability rather than entirely independent indicators. Screening focused on a single outcome may miss a substantial share of vulnerable older adults, underscoring the need for integrated detection and management at the primary health care level.

Introduction. Emergency hospitals in single-payer insurance systems face structural tariff gaps that chronically depress reported margins. Evidence on supply-side financial dynamics under mandatory insurance in post-Soviet health systems remains limited. Aim. To assess the dynamics of financial-economic efficiency of a public emergency hospital in Kazakhstan (2020–2024) using a standardised 19-ratio framework against HFMA and WHO benchmarks, and to characterise the financial impact of the 2022 full implementation of Mandatory Social Health Insurance (MSHI). Materials and methods. Longitudinal single-organisation case study. Data: audited IFRS financial statements of the Emergency Medical Hospital (EMH), Semey, Abai Region (n = 5 annual observations). Nineteen ratios across five analytical blocks were benchmarked against HFMA and WHO thresholds. The 2022 MSHI full launch was used as a conceptual Interrupted Time Series (ITS) intervention point. Analysis: R 4.4. Results. In 2024, 12 of 14 benchmarked ratios met HFMA/WHO thresholds. Key improvements: Absolute Liquidity Ratio rose 23-fold (0.04 to 0.94); Fixed Asset Turnover exceeded WHO ≥ 1.0 from 2022 (2024: 1.22); Operating Cash Flow Margin reached HFMA ≥ 3% for the first time (3.61%); CapEx/Revenue exceeded 5% (7.22%). Operating margin improved from −19.55% (2023) to −3.17% (2024). Days Cash on Hand (25.5 days) remained the sole persistent deficit below the ≥ 30-day benchmark. Conclusions. The EMH demonstrated measurable efficiency improvement across four of five analytical blocks under MSHI. The persistent operating loss reflects structural tariff underfunding – not managerial failure. Policy responses should address tariff recalculation, emergency cost premiums, and contractual liquidity buffers. Введение. Больницы скорой медицинской помощи в системах с единым плательщиком сталкиваются со структурным тарифным разрывом, хронически занижающим показатели рентабельности. Данные о финансовой динамике на стороне поставщиков в условиях обязательного страхования в постсоветских системах здравоохранения практически отсутствуют. Цель. Оценить динамику финансово-экономической эффективности государственной БСМП в Казахстане за 2020–2024 годы с использованием стандартизированной системы из 19 коэффициентов, сопоставленных с нормативами HFMA и ВОЗ, и охарактеризовать финансовое воздействие полного запуска ОСМС в 2022 году. Материалы и методы. Продольное исследование единственной организации. Данные: аудированная финансовая отчётность по МСФО БСМП г. Семей, область Абай (n = 5 годовых наблюдений). Девятнадцать коэффициентов по пяти аналитическим блокам сопоставлены с нормативами HFMA и ВОЗ. 2022 год использован как точка вмешательства в концептуальной модели прерванных временных рядов. Анализ: R 4.4. Результаты. В 2024 году 12 из 14 нормируемых показателей соответствовали нормативам HFMA/ВОЗ. Ключевые улучшения: коэффициент абсолютной ликвидности вырос в 23 раза (0,04 to 0,94); фондоотдача превысила норматив ВОЗ ≥ 1,0 с 2022 года (2024: 1,22); операционный CF/Выручка впервые достиг норматива HFMA ≥ 3% (3,61%); капвложения/выручка превысили 5% (7,22%). Операционная маржа улучшилась с −19,55% (2023) до −3,17% (2024). Days Cash on Hand (25,5 дней) остался единственным устойчиво дефицитным показателем. Выводы. БСМП продемонстрировала измеримое улучшение эффективности по четырём из пяти аналитических блоков в условиях ОСМС. Сохраняющийся операционный убыток отражает структурное тарифное недофинансирование, а не управленческие просчёты. Необходимы: пересчёт тарифов, надбавка за экстренные услуги, создание контрактных буферов ликвидности. Кіріспе. Жалғыз төлеуші жүйелеріндегі жедел медициналық жәрдем ауруханалары рентабельділік көрсеткіштерін тұрақты төмендететін тарифтік алшақтыққа тап болады. Постсоветтік денсаулық сақтау жүйелерінде міндетті сақтандыру жағдайында жеткізушілер тарапынан қаржылық динамика туралы деректер іс жүзінде жоқ. Мақсаты. HFMA және ДДҰ нормативтерімен салыстырылатын 19 коэффициенттен тұратын стандартталған жүйені пайдалана отырып, Қазақстандағы мемлекеттік жедел медициналық жәрдем...