Factors associated with maternal mortality in Kazakhstan: a pre- and during-pandemic comparison.

Introduction: The maternal mortality indicator serves as a crucial reflection of a nation's overall healthcare, economic, and social standing. It is necessary to identify the variations in its impacts across diverse populations, especially those at higher risk, to effectively reduce maternal mortality and enhance maternal health. The global healthcare landscape has been significantly reshaped by the COVID-19 pandemic, pressing disparities and stalling progress toward achieving Sustainable Development Goals, particularly in maternal mortality reduction. Methods: This study investigates the determinants of maternal mortality in Kazakhstan from 2019 to 2020 and maternal mortality trends in 17 regions from 2000 to 2020, employing data extracted from national statistical reports. Stepwise linear regression analysis is utilized to explore trends in maternal mortality ratios in relation to socioeconomic factors and healthcare service indicators. Results: The national maternal mortality ratio in Kazakhstan nearly tripled from 13.7 in 2019 to 36.5 per 100,000 live births in 2020. A remarkable decrease was observed from 2000 until around 2015 with rates spiked by 2020. Significant factors associated with maternal mortality include antenatal care coverage and the number of primary healthcare units. Additionally, socioeconomic factors such as secondary education enrollment and cases of domestic violence against women emerged as predictors of MMR. Moreover, the impact of the pandemic was evident in the shift of coefficients for certain predictors, such as antenatal care coverage in our case. In 2020, predictors of MMR continued to include secondary education enrollment and reported cases of domestic violence. Conclusion: Despite Kazakhstan's efforts and commitment toward achieving Sustainable Development Goals, particularly in maternal mortality reduction, the impact of the COVID-19 pandemic poses alarming challenges. Addressing these challenges and strengthening efforts to mitigate maternal mortality remains imperative for advancing maternal health outcomes in Kazakhstan.

General, Vaccination, Navigational and Digital Health Literacy of Students Enrolled in Different Medical and Health Educational Programs.

Evaluating prospective graduates' health literacy profiles before they enter the job market is crucial. Our research aimed to explore the health literacy levels of medical and health students by assessing their ability to obtain health-related information, understand healthcare systems, use e-health, and be informed about vaccination as well as to explore the factors associated with health literacy. Short versions of the HLS19-Q12 were used for a cross-sectional survey that was carried out among 1042 students enrolled in various medical and health educational programs at three medical universities in Kazakhstan between September and November of 2023. Additionally, instruments such as Digital Health Literacy (HLS19-DIGI), Navigational Health Literacy (HLS19-NAV), and Vaccination Health Literacy (HLS19-VAC) were employed. The score of General Health Literacy was 88.26 ± 17.5. One in eight students encountered difficulties in Vaccination Health Literacy. Despite overall high health literacy, Navigational Health Literacy posed challenges for all students. The Public Health students exhibited the highest General Health Literacy (91.53 ± 13.22), followed by students in Nursing, General Medicine, other educational programs (Dentistry and Biomedicine) and Pharmacy. Financial constraints for medication and medical examinations significantly influenced health literacy across all types of individuals. Since comprehensive health literacy instruction or interventions are still uncommon in the curricula, it seems reasonable to develop and incorporate appropriate courses for medical and health educational programs.

Infant Mortality Trends and Determinants in Kazakhstan.

Infant mortality rate (IMR) is a crucial indicator of healthcare performance and a reflection of a country's socioeconomic development. We analyzed the trends of IMR in Central Asia (CA) countries and its determinants in Kazakhstan, which is a middle-income country. Linear regression was used for IMR trend analysis in CA countries from 2000 to 2020 and for exploring associations between IMR and socioeconomic factors, health service-related factors, and population health indicators-related factors. A gamma generalized linear model was applied to define associations with various determinants. Our analysis revealed that IMR has decreased in all CA countries, with Kazakhstan having the lowest rate in 2000 and 2020. Our results suggest that socioeconomic indicators, such as total unemployment, Gini index, current health expenditure, gross domestic product (GDP), proportion of people living in poverty, and births by 15-19-year-old mothers, were associated with increased infant mortality rates. Improving socioeconomic conditions, investing in healthcare systems, reducing poverty and income inequality, and improving access to education, are all potential issues for further development. Addressing these factors may be critical for improving maternal and child health outcomes in the region.

COVID-19 Pandemic Impact on the Maternal Mortality in Kazakhstan and Comparison with the Countries in Central Asia.

Maternal mortality ratio is one of the sensitive indicators that can characterize the performance of healthcare systems. In our study we aimed to compare the maternal mortality ratio in the Central Asia region from 2000 to 2020, determine its trends and evaluate the association between the maternal mortality ratio and Central Asia countries' total health expenditures. We also compared the maternal mortality causes before and during the pandemic in Kazakhstan. The data were derived from the public statistical collections of each Central Asian country. During the pre-pandemic period, Central Asian nations had a downward trend of maternal mortality. Maternal mortality ratio in Central Asian countries decreased by 38% from 47.3 per 100,000 live births in 2000 to 29.5 per 100,000 live births in 2020. Except for Uzbekistan, where this indicator decreased, all Central Asian countries experienced a sharp increase in maternal mortality ratio in 2020. The proportion of indirect causes of maternal deaths in Kazakhstan reached 76.3% in 2020. There is an association between the maternal mortality ratio in Central Asian countries and their total health expenditures expressed in national currency units (r max = -0.89 and min = -0.66, p < 0.01). The study revealed an issue in the health data availability and accessibility for research in the region. The findings suggest that there must be additional efforts from the local authorities to enhance the preparedness of Central Asian healthcare systems for the new public health challenges and to improve health data accessibility.

Industrial traumatism and occupational morbidity in mining industry of Kazakhstan.

This article presents data in the dynamics on industrial injuries and occupational morbidity in the mining industry of the Republic of Kazakhstan. The aim of this study is to analyze occupational injuries and occupational diseases between 2008 and 2018. An analysis of the number of victims of accidents, including those who died from accidents at work during the period, shows indicators of occupational injuries in the gender aspect, the outcome of accidents by degrees of severity and the material consequences of accidents. During the analyzed period, the overall level of occupational injuries and occupational morbidity in the country remains high. The material consequences of accidents, in addition to social damage, bring great material losses to the state.