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

Boerma, W., Wiegers, T.A., Kringos, D.S., Baltag, V., Zhylkaidarova, A. Evaluation of the organization and provision of primary care in Kazakhstan: a survey-based project in the regions of Almaty and Zhambyl. Kopenhagen: WHO Regional Office for Europe, 2011. 119 p.
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Although the strengthening of primary care services is a health reform priority in many countries of the WHO European Region, the background for such reform varies. In western Europe, primary care is emphasized to help address rising costs and changing demand that result from demographic and epidemiological trends. In the central and eastern part of the Region, however, countries that were once part of or closely allied with the Soviet Union are struggling to improve the performance of their entire health systems drastically. These countries are now developing or reorganizing primary care to bring adequate, responsive health services closer to their populations. In many countries in socioeconomic and political transition, health reforms are part of profound, comprehensive changes in essential societal functions and values. Primary care reforms are not always based on evidence, and progress is often driven by political arguments or professional interests rather than sober assessment. However, policy-makers and programme managers increasingly demand evidence for the progress of reforms and the responsiveness of services. This report evaluates primary care developments in Kazakhstan, using an approach that assumes the importance of providing accessible, continuous, coordinated and comprehensive health services to the population. This approach recognizes that to improve a health system as whole, it is also critical to consider all four functions in the WHO performance framework for health systems equally: stewardship, resource generation, financing and service delivery. (aut. ref.)