1
|
Jobalayeva B, Khismetova Z, Glushkova N, Kozhekenova Z, Abzaliyeva A, Berikuly D, Semenova Y. The impact of incentive scheme on rural healthcare workforce availability: a case study of Kazakhstan. Hum Resour Health 2024; 22:23. [PMID: 38605387 PMCID: PMC11010400 DOI: 10.1186/s12960-024-00905-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 04/02/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND During the 1990-2000, Kazakhstan experienced a decline in the number of healthcare professionals working in rural areas. Since 2009, the national government has been implementing financial incentives to encourage healthcare professionals to relocate to rural areas. This study aims to investigate the temporal and spatial patterns in the distribution of the rural healthcare workforce and evaluate the impact of this incentive scheme. METHODS Interrupted Time Series Analysis using ARIMA models and Difference in Differences analyzes were conducted to examine the impact of the incentive scheme on the density of different categories of the healthcare workforce in rural Kazakhstan in the period from 2009 to 2020. RESULTS There was a significant increase in the number of rural healthcare professionals from 2009 to 2020 in comparison to the period from 1998 to 2008. However, this increase was less pronounced in per capita terms. Moreover, a decline in the density of internists and pediatricians was observed. There is substantial variation in the density of rural nurses and physicians across different regions of Kazakhstan. The incentive scheme introduced in 2009 by the government of Kazakhstan included a one-time allowance and housing incentive. This scheme was found to have contributed insignificantly to the observed increase in the number of rural healthcare professionals. CONCLUSION Future research should be undertaken to examine the impact made by the incentive scheme on other medical subspecialties, particularly primary practitioners. Addressing the shortage of healthcare workers in rural areas is a complex issue that requires a multifaceted approach. Aside from financial incentives, other policies could be considered to increase relocation and improve the retention of healthcare professionals in rural areas.
Collapse
Affiliation(s)
- Bagym Jobalayeva
- Department of Public Health, JSC "Semey Medical University", Semey, Republic of Kazakhstan
| | - Zaituna Khismetova
- Department of Public Health, JSC "Semey Medical University", Semey, Republic of Kazakhstan
| | - Natalya Glushkova
- Department of Epidemiology, Biostatistics & Evidence Based Medicine, Al-Farabi Kazakh National University, Almaty, Republic of Kazakhstan
| | - Zhanat Kozhekenova
- Department of Public Health, JSC "Asfendiyarov Kazakh National Medical University", Almaty, Republic of Kazakhstan
| | - Akerke Abzaliyeva
- Department of Public Health and Social Sciences, "Kazakhstan School of Public Health", Kazakhstan's Medical University, Almaty, Republic of Kazakhstan
| | - Duman Berikuly
- Deputy Chairperson of the Board for Clinic and Postgraduate Education, JSC "Semey Medical University", Semey, Republic of Kazakhstan
| | - Yuliya Semenova
- Nazarbayev University School of Medicine, Astana, Republic of Kazakhstan.
| |
Collapse
|
2
|
Glushkova N, Turdaliyeva B, Kulzhanov M, Karibayeva IK, Kamaliev M, Smailova D, Zhamakurova A, Namazbayeva Z, Mukasheva G, Kuanyshkalieva A, Otyzbayeva N, Semenova Y, Jobalayeva B. Examining disparities in cardiovascular disease prevention strategies and incidence rates between urban and rural populations: insights from Kazakhstan. Sci Rep 2023; 13:20917. [PMID: 38017260 PMCID: PMC10684854 DOI: 10.1038/s41598-023-47899-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 11/20/2023] [Indexed: 11/30/2023] Open
Abstract
Kazakhstan is experiencing a high burden of cardiovascular disease (CVD), and the country has implemented a range of strategies aimed at controlling CVD. The study aims to conduct a content analysis of the policies implemented in the country and augment it with an analysis of official statistics over a 15-year period, from 2006 to 2020. The study also includes comparisons of incidence rates between urban and rural areas. A comprehensive search was conducted to identify policy documents that regulate the provision of primary, secondary, and tertiary prevention of cardiovascular diseases. Additionally, official data on the incidence of arterial hypertension, ischemic heart disease, acute myocardial infarction, and cerebrovascular disease were extracted from official statistics, disaggregated by urban and rural areas. Forecast modeling was utilized to project disease incidences up to 2030. The study reveals that Kazakhstan primarily focuses on tertiary prevention of cardiovascular diseases, with less attention given to secondary prevention, and primary prevention is virtually non-existent. In general, screening for arterial hypertension appears to be more successful than for ischemic heart disease. The incidence of arterial hypertension has increased threefold for urban residents and 1.7-fold for rural residents. In urban areas, residents saw a twofold increase in ischemic heart disease incidence, while it remained the same in rural areas. The findings of this study have practical implications for decision-makers, who can use the results to enhance the effectiveness of existing CVD prevention strategies.
Collapse
Affiliation(s)
- Natalya Glushkova
- Department of Epidemiology, Evidence-Based Medicine and Biostatistics, Kazakhstan's Medical University "Kazakhstan School of Public Health", Almaty, 050060, Kazakhstan
| | - Botagoz Turdaliyeva
- Kazakh Scientific Center of Dermatology and Infectious Diseases, Almaty, 050002, Kazakhstan
| | - Maksut Kulzhanov
- Department of Management in Healthcare and Pharmacy, Kazakhstan's Medical University "Kazakhstan School of Public Health", Almaty, 050060, Kazakhstan
| | - Indira K Karibayeva
- Department of Science and Consulting, Kazakhstan's Medical University "Kazakhstan School of Public Health", Almaty, 050060, Kazakhstan
| | - Maksut Kamaliev
- Department of Health Management, Kazakhstan's Medical University "Kazakhstan School of Public Health", Almaty, 050060, Kazakhstan
| | - Dariga Smailova
- Research Department, Asfendiyarov Kazakh National Medical University, Almaty, 050040, Kazakhstan
| | - Ayaulym Zhamakurova
- Department of Postgraduate Education, Kazakhstan's Medical University "Kazakhstan School of Public Health", Almaty, 050060, Kazakhstan
| | - Zhanar Namazbayeva
- Department of Postgraduate Education, Kazakhstan's Medical University "Kazakhstan School of Public Health", Almaty, 050060, Kazakhstan
| | - Gulmira Mukasheva
- Department of Postgraduate Education, Kazakhstan's Medical University "Kazakhstan School of Public Health", Almaty, 050060, Kazakhstan
| | - Asylzhan Kuanyshkalieva
- Department of Postgraduate Education, Kazakhstan's Medical University "Kazakhstan School of Public Health", Almaty, 050060, Kazakhstan
| | - Nurzhamal Otyzbayeva
- Department of Postgraduate Education, Kazakhstan's Medical University "Kazakhstan School of Public Health", Almaty, 050060, Kazakhstan
| | - Yuliya Semenova
- School of Medicine, Nazarbayev University, Astana, 010000, Kazakhstan
| | - Bagym Jobalayeva
- Department of Public Health, JSC "Semey Medical University", Semey, 071400, Kazakhstan.
| |
Collapse
|
3
|
Glushkova N, Semenova Y, Jobalayeva B, Davletov K, Sarría-Santamera A. Geospatial characteristics of medical workforce and infrastructure to combat COVID-19 in Kazakhstan. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac130.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
After cessation of initial quarantine in Kazakhstan, the COVID-19 outbreak peaked in July 2020, imposing dramatic stress on the country's healthcare system. This study was focused on calculation of updated epidemiological characteristics, on evaluation of available medical workforce and infrastructure and the impact of workforce density on infected and dead individuals via ArcGIS platform.
Methods
The national and local incidence rate (IR), mortality (M) and case-fatality rates (CFR) were calculated along with the population-weighted densities of beds, physicians, general practitioners, resuscitators, nurses and healthcare budget. Associations between the density of different health workers, infected and dead individuals were investigated using Poisson regression. Finally, we constructed vector maps of country regions clustered by IR and CFR to depict the density of beds and those health workers that were significantly associated with infection and death rates.
Results
There is much heterogeneity between the country regions in terms of CFR (range from 0.28 to 2.57) and IR (range from 1.62 to 12.04), while density of beds was characterized by a relatively greater stability (range from 3.47 to 6.66) and so did density of physicians (range from 0.79 to 2.76) and density of nurses (range from 5.73 to 8.26). Densities of beds, physicians, general practitioners, resuscitators, and nurses have been linked significantly with infection and death rates.
Conclusions
As COVID-19 epidemic is still far from ending, findings of this study could be of interest for policy makers to formulate an appropriate action plan in the view of possible repeated outbreaks.
Key messages
Collapse
Affiliation(s)
- N Glushkova
- Department of Epidemiology and Biostatistics, Al-Farabi Kazakh National University , Almaty, Kazakhstan
| | - Y Semenova
- School of Medicine, Nazarbayev University, Nur- Sultan, Kazakhstan
| | - B Jobalayeva
- Department of Public Health, Semey Medical University , Semey, Kazakhstan
| | - K Davletov
- Health Research Institute, Al-Farabi Kazakh National University , Almaty, Kazakhstan
| | | |
Collapse
|