Internet Association of Kazakhstan
Home » Publications » Three whales that sink healthcare system in Kazakhstan

Three whales that sink healthcare system in Kazakhstan



A thermometer that has been purposefully held close to the heater shows 42°C, miserable facial expression and a nose protruding from under the blankets – all this makes up a picture of t typical schoolchild who is trying to skive off the lessons. Children see this as a kind of game, and think that they are the smartest and the most quick-witted. Adults, on the other hand, can just smile in response to this “wittiness”. However, the real illness is unlikely to make anyone smile. Worry for the loved one is a typical response in this case.


Unfortunately, in Kazakhstan the widespread mistrust of the health care system is added to the common worry. Almost everyone in the country can tell about either personal negative experience or share a relative’s or a friend’s adverse story about the local hospitals and health centers.



Complaints about unqualified doctors, neglect and indifference of medical personnel and bureaucracy do not seem to surprise anyone any more. Many people know only too well about waiting in the queues and that it does not always guarantee a meeting with a doctor, as they can suddenly leave for lunch or a meeting, or for some other “urgent” business. As a result, the road to recovery and sometimes not to recovery at all looks more like an obstacle course.

However, all these problems are secondary; they are the ones people generally use to assess the quality of medical service. In reality there are problems that are more serious than queuing and arguments with the local doctor.

The audit made by the General Prosecutor's Office of the Republic of Kazakhstan revealed ubiquitous violation of citizens' right for health care guaranteed by the law of our country. Problematic health system in Kazakhstan seems to stand on three whales: low quality of medical services, ineffective planning and spending of budget money, and finally improper performance of duties by the health care system workers. Each of those whales has to be discussed separately.


So the first whale is low quality of medical services. This one is responsible for all the “medical errors” as well as unjustified refusal of hospitalization and charging for procedures and operations which are supposed to be free of charge. 40% of citizens believe that in the past year they encountered some serious malpractices, while 4% tell about serous negative consequences.Overall in the last five years 352 criminal cases have been initiated in regards to poor medical treatment and 134 of them have been initiated in 2012.  


From one year to the next the cases when patients are illegally charged for medical services are repeated. For example, in Kostanay region one of the patients was demanded to pay 30,000 KZT for the operation that is supposed to be done free of charge. At the same time patient of one of the hospitals in Aktobe regions had to pay for using hospital beds.


The second whale of the problematic health care system carries the weight of responsibility of ineffective budgeting and spending of budget money and as a consequence for lack and irrational usage of medicines and violation of purchasing formalities.  


A vivid example would be the case of Almaty children’s hospital, where the overall sum of medical prescriptions was more than 8.1 million KZT. The Head Prosecutor Office’s inspection revealed that in reality the prescriptions were drawn out for 6-8 months ahead. Looks like the doctors were too concerned for the health of their patients.


In addition the rules of procurement of medicines as well as their highest purchasing price are being violated. In addition the medicines whose certificate of registration has been suspended are being purchased.


The last whale holds on its back illegal actions of healthcare system officials. In a great number of cases this results into medical equipment standing idle and in purchasing of unregistered equipment. For example, due to incompleteness two continuous positive airway pressure machines for the newborns which cost 8.2 million KZT have been standing idle in the district hospital of Western Kazakhstan region since 2010. Moreover no real action has been taken to supply the missing components, whereas the warranty period has already finished.


These three whales no just negatively affect the overall state of healthcare system and people’s opinion about it, but also obstruct with their mass all the attempts made by the government to improve the quality of medical services in the Republic of Kazakhstan. For instance very few citizens know that funding of the healthcare system has increased by more than ten times since 1999. They are unaware that the patients who suffer from such illness as acromegalia are fully supplied by the medicaments and this costs more than 20 thousand USD a year for each patient. Moreover, medicaments for more than 3 billion KZT are bought every year for the patients who suffer from cancerous diseases. There are other achievements as well, but they are not visible for the citizen of our country.


Despite the general negative attitude of the population, we should not forget that public health service remains free and accessible to each citizen of our country no matter what. We should also remember that regulatory authorities, including the General Prosecutor’s Office actively monitor the addressing of negative aspects of this particular area. In the end, we just have to remember that even the smallest success on the way to a decent health care system – it is someone’s restored health or saved life.