EPIDEMIOLOGY AND HEALTH DATA INSIGHTS
Original Article
Feb 04, 2026 29 10

Kazakhstan’s Healthcare System Through the Harvard Control Knobs: Analysis of Performance and Future Strategic Directions

Kuanysh Yergaliyev 1,
Ulzhan Khassen 1,
Claire Chaumont 2,
Adel Stoyanova 3 *
1 Department of Biomedical Sciences, School of Medicine, Nazarbayev University, Astana, Kazakhstan2 Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America3 Department of Medicine, School of Medicine, Nazarbayev University, Astana, Kazakhstan* Corresponding Author
Epidemiology and Health Data Insights, 2(1), 2026, ehdi028, https://doi.org/10.63946/ehdi/17861
Publication date: Feb 04, 2026
Full Text (PDF)

ABSTRACT

This article presents a comprehensive analysis of the health system of the Republic of Kazakhstan, its current state, key achievements and remaining challenges. Using the Harvard “Five Control Knobs” analytical framework (financing, payment, organization, regulation and behavior), as well as analysis of the dynamics of the main medical and demographic indicators and human resources for 2017-2023, the article seeks to fill the gap in the systemic understanding of the effectiveness of the ongoing reforms and their impact on the health of the population. Particular attention is paid to the relationship between the various components of the system and the identification of priority areas for further improvement.
Our findings indicate a moderate improvement in population health, with average life expectancy increasing from 72.9 to 75.1 years and overall mortality returning to pre-pandemic levels. However, noncommunicable diseases continue to account for approximately 84% of all deaths. Total health expenditure remained low at 3.8% of GDP in 2023, while out-of-pocket spending accounted for 27.7% of current health expenditure, reflecting persistent gaps in financial protection. Although the introduction of mandatory social health insurance has expanded pooled financing, significant weaknesses persist in provider incentive structures, workforce distribution, and regulatory enforcement.
Overall, the results suggest that while gradual progress has been achieved, chronic underfunding, system fragmentation, and governance challenges continue to constrain equity and efficiency, underscoring the need for coordinated, evidence-based reforms.

KEYWORDS

Healthcare System Kazakhstan Harvard Five Knobs Healthcare Reforms Mandatory Social Health Insurance (MSHI)

CITATION (Vancouver)

Yergaliyev K, Khassen U, Chaumont C, Stoyanova A. Kazakhstan’s Healthcare System Through the Harvard Control Knobs: Analysis of Performance and Future Strategic Directions. Epidemiology and Health Data Insights. 2026;2(1):ehdi028. https://doi.org/10.63946/ehdi/17861
APA
Yergaliyev, K., Khassen, U., Chaumont, C., & Stoyanova, A. (2026). Kazakhstan’s Healthcare System Through the Harvard Control Knobs: Analysis of Performance and Future Strategic Directions. Epidemiology and Health Data Insights, 2(1), ehdi028. https://doi.org/10.63946/ehdi/17861
Harvard
Yergaliyev, K., Khassen, U., Chaumont, C., and Stoyanova, A. (2026). Kazakhstan’s Healthcare System Through the Harvard Control Knobs: Analysis of Performance and Future Strategic Directions. Epidemiology and Health Data Insights, 2(1), ehdi028. https://doi.org/10.63946/ehdi/17861
AMA
Yergaliyev K, Khassen U, Chaumont C, Stoyanova A. Kazakhstan’s Healthcare System Through the Harvard Control Knobs: Analysis of Performance and Future Strategic Directions. Epidemiology and Health Data Insights. 2026;2(1), ehdi028. https://doi.org/10.63946/ehdi/17861
Chicago
Yergaliyev, Kuanysh, Ulzhan Khassen, Claire Chaumont, and Adel Stoyanova. "Kazakhstan’s Healthcare System Through the Harvard Control Knobs: Analysis of Performance and Future Strategic Directions". Epidemiology and Health Data Insights 2026 2 no. 1 (2026): ehdi028. https://doi.org/10.63946/ehdi/17861
MLA
Yergaliyev, Kuanysh et al. "Kazakhstan’s Healthcare System Through the Harvard Control Knobs: Analysis of Performance and Future Strategic Directions". Epidemiology and Health Data Insights, vol. 2, no. 1, 2026, ehdi028. https://doi.org/10.63946/ehdi/17861

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