Orynbassarova Dilara
KIMEP University, MPA, Almaty, Kazakhstan.
Cent Asian J Glob Health. 2015 Apr 8;4(1):209. doi: 10.5195/cajgh.2015.209. eCollection 2015.
Advanced models of delivering primary health care are being implemented in various countries of the world. This is especially true for countries undergoing a healthcare transition in Central Asia, such as Kazakhstan, which obtained independence from Soviet Union in 1991. The Kazakhstan National Program of Health Reform, implemented between 2005-2010, aimed to create an effective system of primary care. One of the key directions of healthcare reform implemented in Kazakhstan included the development of family medicine, which has become cutting-edge agenda for Kazakhstan Health Ministry over the past 10 years. While many papers have been published about the importance of family medicine and primary healthcare models, few have focused on analyzing family medicine effectiveness in Kazakhstan and its impact on access to family doctor services and patient satisfaction. The key aims of this pilot investigation were 1) to assess the model's impact on access to primary care and patients' satisfaction, and 2) to explore the model's effectiveness in some Central Asian and transitional countries in the literature.
This pilot study was based on semi-structured interviews and questionnaires about the perception and impact of the primary care model to 86 respondents aged 19-51 (54% females, 46% males). The majority of respondents were Almaty city residents (71%), while the rest were Almaty Province rural residents (22%) and residents of other Kazakhstan regions (7%).
Respondents from rural areas associated general practitioners, or family doctors, with community clinics (also referred to as feldsher posts). Even though urban area respondents use family doctor services, they were more likely to get those services in private rather than public clinics. Rural residents appear to have better access to primary care providers than urban residents participating in our study. Also, respondents from rural areas were more satisfied with services provided by family doctors than respondents from urban areas.
This pilot study helped to improve our understanding of primary health care reforms implemented in Kazakhstan, a topic that is not traditionally covered in international literature. This pilot study suggests that primary care is more effectively implemented in rural areas of Kazakhstan (Almaty Province); however, future full-scale research in this area is needed to fully understand the complexity of primary healthcare access in Kazakhstan.
世界各国都在推行先进的初级卫生保健模式。中亚地区正在经历医疗体系转型的国家尤其如此，比如1991年从苏联独立出来的哈萨克斯坦。2005年至2010年实施的哈萨克斯坦国家卫生改革计划旨在建立一个有效的初级保健体系。哈萨克斯坦实施的医疗改革的一个关键方向包括发展家庭医学，在过去十年里，这已成为哈萨克斯坦卫生部的前沿议程。虽然已经发表了许多关于家庭医学和初级卫生保健模式重要性的论文，但很少有研究聚焦于分析哈萨克斯坦家庭医学的有效性及其对获得家庭医生服务和患者满意度的影响。这项试点调查的主要目的是：1）评估该模式对获得初级保健服务和患者满意度的影响；2）在文献中探讨该模式在一些中亚和转型国家的有效性。
这项试点研究基于对86名年龄在19至51岁之间的受访者（54%为女性，46%为男性）进行的半结构化访谈和关于初级保健模式认知与影响的问卷调查。大多数受访者是阿拉木图市居民（71%），其余为阿拉木图省农村居民（22%）和哈萨克斯坦其他地区居民（7%）。
农村地区受访者将全科医生或家庭医生与社区诊所（也称为乡村医生岗位）联系起来。尽管城市地区受访者使用家庭医生服务，但他们更倾向于在私立而非公立诊所获得这些服务。农村居民似乎比参与我们研究的城市居民更容易获得初级保健提供者的服务。此外，农村地区的受访者对家庭医生提供的服务比城市地区的受访者更满意。
这项试点研究有助于增进我们对哈萨克斯坦实施的初级卫生保健改革的理解，这一主题在国际文献中传统上并未涉及。这项试点研究表明，初级保健在哈萨克斯坦（阿拉木图省）农村地区实施得更为有效；然而，需要在该领域开展未来的全面研究，以充分了解哈萨克斯坦初级卫生保健获取的复杂性。
