Evaluation of the organization and provision of primary care in Kazakhstan: a survey-based project in the regions of Almaty and Zhambyl

Abstract

For many countries in political and economic transition, health reforms are part of profound, comprehensive changes in essential societal functions and values. However, primary care reforms are not always based on evidence, often being driven instead by political arguments or the interests of specific professional groups. Yet health policy-makers and managers are increasingly demanding evidence of the progress of these reforms and the responsiveness of services. The WHO Primary Care Evaluation Tool (‎PCET)‎ seeks to provide a structured approach to this process by drawing on health systems functions such as governance, financing and resource generation and the characteristics of a good primary care service delivery system: accessibility, comprehensiveness, coordination and continuity. This report summarizes PCET findings for Kazakhstan. The project was undertaken there in the framework of the 2008–2009 Biennial Collaborative Agreement between the WHO Regional Office for Europe and the Ministry of Health of Kazakhstan. Additional partners have included the Netherlands Institute for Health Services Research (‎NIVEL, a WHO collaborating centre for primary care)‎, the National Center of Healthy Lifestyle Development and other stakeholders in the health system of Kazakhstan, including national policy experts, managers, academics, primary care physicians and patients.