EPIDEMIOLOGY AND HEALTH DATA INSIGHTS
Review Article
Sep 08, 2025 19 12

Towards Universal Health Coverage in Kazakhstan from the Alma-Ata Declaration in 1978 to Astana Declaration in 2018: Challenges, Successes and Future Outlook

Naanlep Matthew Tanko 1 * ,
Kuanysh Yergaliyev 2,
Ulzhan Khassen 2,
Antonio Sarria-Santemera 2
1 Department of Medicine, School of Medicine, Nazarbayev University, Astana, Republic of Kazakhstan2 Department of Biomedical Sciences, School of Medicine, Nazarbayev University, Astana, Republic of Kazakhstan * Corresponding Author
Epidemiology and Health Data Insights, 1(3), 2025, ehdi012, https://doi.org/10.63946/ehdi/16892
Publication date: Sep 08, 2025
Full Text (PDF)

ABSTRACT

For centuries, health was viewed from the lens of biomedicine as the core. This view considered medical professionals and hospitals as the sole agents and venues where health could be obtained, with only passive mentions of the impact of social determinants of health. In a paradigm shift from this view in 1978, at the Alma-Ata Declaration in Kazakhstan, 134 member countries of the WHO formalized the recognition of the social determinants of health into a global policy. Factors such as accessibility, affordability, availability, social and economic status, and education about health services are crucial for population health. The Alma-Ata Declaration required the governments of member countries to include deliberate policies that strengthen and promote population health, by ensuring that social measures are included in their national development plans while recognizing the rights of collective and individual participation of their populations. The phrase “Primary Health Care” (PHC) was then adopted. It was defined as “essential health care based on practical, scientifically sound and socially acceptable methods which are of relevant technology, made accessible and affordable to families and communities through their participation”. Health became a human right underpinned by equity and population participation principles. The aftermath of the Declaration was an immediate implementation challenge. It was soon to be realized that PHC interventions are not linear and generalizable like biomedical interventions which have specific measures and predictable outcomes. To date, there is no blueprint for universal intervention measures because economic disparities, social and situational contexts differ and determine the success of any intervention measure. Our review explores the challenges and successes of the implementation of PHC in Kazakhstan, the birthplace of the global health policy on PHC.

KEYWORDS

PHC Universal Health Coverage Kazakhstan

CITATION (Vancouver)

Tanko NM, Yergaliyev K, Khassen U, Sarria-Santemera A. Towards Universal Health Coverage in Kazakhstan from the Alma-Ata Declaration in 1978 to Astana Declaration in 2018: Challenges, Successes and Future Outlook. Epidemiology and Health Data Insights. 2025;1(3):ehdi012. https://doi.org/10.63946/ehdi/16892
APA
Tanko, N. M., Yergaliyev, K., Khassen, U., & Sarria-Santemera, A. (2025). Towards Universal Health Coverage in Kazakhstan from the Alma-Ata Declaration in 1978 to Astana Declaration in 2018: Challenges, Successes and Future Outlook. Epidemiology and Health Data Insights, 1(3), ehdi012. https://doi.org/10.63946/ehdi/16892
Harvard
Tanko, N. M., Yergaliyev, K., Khassen, U., and Sarria-Santemera, A. (2025). Towards Universal Health Coverage in Kazakhstan from the Alma-Ata Declaration in 1978 to Astana Declaration in 2018: Challenges, Successes and Future Outlook. Epidemiology and Health Data Insights, 1(3), ehdi012. https://doi.org/10.63946/ehdi/16892
AMA
Tanko NM, Yergaliyev K, Khassen U, Sarria-Santemera A. Towards Universal Health Coverage in Kazakhstan from the Alma-Ata Declaration in 1978 to Astana Declaration in 2018: Challenges, Successes and Future Outlook. Epidemiology and Health Data Insights. 2025;1(3), ehdi012. https://doi.org/10.63946/ehdi/16892
Chicago
Tanko, Naanlep Matthew, Kuanysh Yergaliyev, Ulzhan Khassen, and Antonio Sarria-Santemera. "Towards Universal Health Coverage in Kazakhstan from the Alma-Ata Declaration in 1978 to Astana Declaration in 2018: Challenges, Successes and Future Outlook". Epidemiology and Health Data Insights 2025 1 no. 3 (2025): ehdi012. https://doi.org/10.63946/ehdi/16892
MLA
Tanko, Naanlep Matthew et al. "Towards Universal Health Coverage in Kazakhstan from the Alma-Ata Declaration in 1978 to Astana Declaration in 2018: Challenges, Successes and Future Outlook". Epidemiology and Health Data Insights, vol. 1, no. 3, 2025, ehdi012. https://doi.org/10.63946/ehdi/16892

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