Josh Imhof | staff writer

Kazakhstan citizens Abdrakhmanova Zinat, Aizhan Raushanova and Aigerim Aliakparova are part of an exclusive club. All three are recipients of scholarships from the Bolashak program, a Kazakh government initiative that sends its citizens to universities around the world to further their education. In 2024, 11,293 people applied and only 550 were accepted.

This scholarship led the three to Duquesne, where Zinat and Raushanova currently serve as research interns and Aliakparova is pursuing her doctorate at the Center for Global Health Ethics.

On March 11, these scholars presented “Health and Education Systems in Kazakhstan: Opportunities and Challenges.” The discussion focused on the ups and downs of Kazakhstan’s healthcare and educational journey since the fall of the Soviet Union.

The Center for African Studies hosted the program as part of their Global Public Health Speaker Series, which aimed to get students to collaborate with professionals and develop relevant skills to the global health field, according to their website.

As a former member of the Soviet Union, Kazakhstan relied on a centralized healthcare system controlled by Moscow. However, after its fall, the country and the rest of the newly freed Soviet Republics had to find ways to adapt.

“Lack of experience in leading their own healthcare system was one of the challenges, because you’re facing a situation when you have to make a decision yourself. You have to utilize your own money to do that,” Aliakparova said.

This also left Kazakhstan with outdated infrastructure. Combined with a rapidly aging population, it created many challenges for the Kazakh health system, according to the Central Asian Journal of Global Health. Many of its educated citizens also relocated during this time, leading to a collective brain drain that made it difficult for the country to progress.

“They had to give some time to raise their own expertise,” Aliakparova said.

During this time, Kazakhstan looked both westward and inward to figure out how to establish a new system going forward. One of these was through the development of the aforementioned Bolashak program, which exposed students to western nations and their healthcare networks. The government also began creating new programs, like the Social Health Insurance Fund.

The fund started in 2016 and aimed at increasing accessibility to healthcare and reducing costs for patients. All Kazakhs must enroll in Compulsory Social Health Insurance and contribute based on their income, allowing every citizen access to medical care, regardless of their economic status.

Almost 10 years since its inception, the program has grown and evolved, now paying for 66% of health care expenditures in the country. Despite this, the country still fell under the international average in terms of state contributions to healthcare.

“This emphasizes the need for Kazakhstan to increase state support, provide expenses and improve financial protection,” said Raushanova, who is also a doctor of Philosophy at Al-Farabi Kazakh National University.

Most medical funding — both private and public — goes to outpatient care, inpatient care and pharmaceutical provisions. The rest goes to services like rehabilitation, long-term care and other day to day expenses.

Digital healthcare is also rapidly advancing, with Kazakh doctors integrating telehealth services into their practices. This will allow for easier access to treatment for people with unreliable transportation or those who are too sick to make it into the office.

Other features include a doctor rating system, digital access to test results and a digital vaccination system that allows users to report side effects and doctors to monitor the two-stage vaccination process required by some vaccines. All of this data is then combined and put into a patient’s Electronic Health Passport.

This allows Kazakhs easy access to their records and more accurate data reporting, something that has been a problem for the country in the past.

Some officials hid and released misleading medical data that skewed and inflated certain numbers, like life-expectancy within the country. Over a 20-year period, overall life expectancy went up by 10 years, however, the country only spent 2% of its budget on preventative healthcare, which are practices such as screenings, immunizations and check-ups.

“Initially, there was a big disconnect between the real data and the one presented. That’s why that progress is so high. It will be more visible when we compare the next year to what we have now so we can see a clear difference,” Aliakparova said.

During the COVID-19 pandemic, authorities in Kazakhstan also downplayed the significance of the disease by neglecting to report asymptomatic and suspected cases, according to a 2020 Human Rights Watch report. In addition to this, former Deputy Minister of Health Olzhas Abishev was arrested in 2020 after being suspected of embezzling funds through another digital medical database.

More accurate data will allow for a better distribution of funds and resources, something that is crucial for development of the healthcare system. Government officials also analyze feedback from doctors, scientific organizations and the public.

“Both categories of information complement each other, helping to determine priority areas for funding,” said Zinat, who has a doctorate in public health.

This internal analysis combined with education gained from the Bolashak program will continue to strengthen both the Kazakh and American healthcare systems.

“There is always room to learn from each other,” Aliakparova said.