Keyword: health systems

ABSTRACT: Background: Leadership effectiveness is a key determinant of organizational performance in healthcare systems. Although leadership styles and emotional intelligence have been widely studied in high-income countries, limited empirical evidence exists within transitional healthcare systems such as Kazakhstan. This study assessed leadership effectiveness among healthcare managers in Kazakhstan and examined associations between leadership effectiveness, leadership styles, and emotional intelligence.
Methods: A cross-sectional study was conducted between November 2024 and March 2025 among 77 healthcare managers from medical organizations in Astana and Almaty. Participants were selected using stratified random sampling across managerial levels. Leadership styles were measured using the Multifactor Leadership Questionnaire, emotional intelligence using the Emotional Competency Profiler, and leadership effectiveness using the Management Research Group framework. Reliability and content validity were confirmed. Descriptive statistics and Pearson correlation analysis were performed to examine associations between leadership effectiveness and independent variables.
Results: Among the 63 respondents who completed the survey, most reported moderate levels of effectiveness across all dimensions (creating vision, implementing vision, developing followership). Around 62-68% of participants rated their effectiveness as moderate, while approximately 22-33% reported as high. Implementing vision showed the lowest mean score (2.13). Correlation analysis showed that leadership effectiveness was positively associated with transformational (r = 0.45, p = 0.038) and transactional leadership (r = 0.54, p < 0.001), as well as emotional intelligence (r = 0.57, p < 0.001), with emotional intelligence suggesting the strongest relationship. In contrast, no significant association was observed for laissez- faire leadership (r = 0.2617, p = 0.1076).
Conclusion: Leadership effectiveness among healthcare managers in Kazakhstan is positively associated with active leadership styles and emotional intelligence. Strengthening competencies related to vision implementation and emotional intelligence may support leadership development within ongoing healthcare reforms. Further research using larger and more diverse samples is warranted.

ABSTRACT: In March 2026, Kazakhstan approved a new national Healthcare Development Concept for 2026–2029. This editorial provides a rapid critical analysis of the document, comparing it with its 2022–2026 predecessor. We identify genuine advances, including expanded indicator architecture, health technology assessment tools, digital health ambitions, and an explicit adolescent health agenda alongside persistent structural weaknesses: the absence of a theory of change, limited economic evaluation, no comprehensive human resources for health strategy, and a thin monitoring and evaluation framework. We also raise a chronic governance concern: the Concept was adopted without meaningful consultation with the professional and academic health community, in tension with President of Kazakhstan Tokayev's stated commitment to a hearing state.

ABSTRACT: Antimicrobial resistance (AMR) poses an escalating threat to global public health, undermining the effectiveness of infectious disease prevention and treatment and placing sustained pressure on health systems worldwide. Advances in genomic technologies, including whole-genome sequencing and metagenomic analyses, have substantially enhanced the resolution and scope of AMR surveillance. However, despite growing investments in genomic surveillance, the routine translation of genomic data into public health policy and action remains limited. This review examines the persistent data-to-decision (D2D) gap that constrains the public health impact of genomic AMR surveillance. Using a narrative review approach, the literature on genomic AMR surveillance, public health surveillance systems, and decision-making frameworks was synthesized to assess how genomic data are generated, interpreted, and operationalized within public health systems. The review integrates evidence from international and national surveillance initiatives, policy analyses, and implementation studies, with particular attention to organizational, analytical, and governance factors influencing data use. Findings indicate that while genomic surveillance offers high potential for early detection of resistance, transmission tracking, and proactive intervention, its public health utility is frequently limited by insufficient integration with decision-making structures, lack of standardized reporting and interpretation frameworks, and unclear action thresholds. The review highlights emerging best practices, including standardized translational reporting, decision-support tools, predefined genomic action triggers, and multidisciplinary collaboration, as critical mechanisms for closing the D2D gap. Persistent inequities in access to genomic surveillance capacity, particularly in low- and middle-income countries, further underscore the need for governance models that prioritize sustainability, local ownership, and equitable capacity building. Overall, this review argues that realizing the full public health value of genomic AMR surveillance requires moving beyond technological advancement toward intentional systems-level integration that aligns genomic intelligence with timely, evidence-informed public health decision-making.

ABSTRACT: One of the major public health emergencies that has affected lives globally is infectious disease outbreaks. These issues are of great concern due to their potential to transcend borders. The control and management of such outbreaks even with the attention channelled towards it globally has been a difficult task in many developing and underdeveloped countries of the world of which the majority of sub-saharan african countries fall under. However, with this review, we aim to contribute to the body of knowledge dedicated towards control of infectious diseases by analyzing the preparedness of Sub-Saharan African (SSA) countries in managing infectious disease outbreaks based on lessons from recent outbreaks (with focus on COVID-19, Lassa fever and Ebola outbreaks). In carrying out this narrative review, we make use of PubMed and African Journals Online (AJOL) as the primary literature sources. To ensure we capture publications from reputable organizations that are solely involved in control of infectious diseases in the region, we carried out a grey literature search.
However in this review, we synthesized challenges such as weak healthcare systems, inadequate healthcare infrastructure, inefficient surveillance systems, poor data management and reporting practices, limited laboratory capacity and reliance on external donors for supplies during emergencies.
The review proposes potential interventional measures aimed at addressing these challenges aimed at enhancing the preparedness
The findings from this review provide critical insights into the preparedness gaps and potential interventions, informing policy and practice to enhance the region's resilience future outbreaks.

ABSTRACT: Background: Vaccination is one of the most effective public health interventions yet increasing numbers of unjustified medical exemptions in Kazakhstan threaten both herd immunity and public trust. In 2020 alone, over 208,000 temporary and 2,600 permanent exemptions were issued—often based on questionable clinical criteria. This study aims to explore the drivers behind the rising number of medical exemptions in Kazakhstan, with a particular focus on the perspectives and attitudes of healthcare professionals.
Methods: A qualitative approach was employed, combining a desk review of national immunization policies and statistical reports with 27 in-depth interviews conducted in 2021–2022. Participants included healthcare providers and public health experts across urban and rural regions of Kazakhstan. Thematic analysis was used to identify key patterns in the data. Relevant national regulations were also reviewed and compared with international standards.
Results: Thematic analysis revealed four major areas of concern: (1) inconsistencies in pre-vaccination monitoring practices, (2) variability in post-vaccination follow-up procedures, (3) divergent roles and responsibilities among stakeholders in granting medical exemptions, and (4) limitations in surveillance and data systems for tracking and verifying exemptions. Findings suggest that physician over-cautiousness, legal insecurity, parental pressure, and inconsistent training are key drivers of unnecessary exemptions. The overdiagnosis of precautionary conditions—particularly by specialists such as neurologists—further contributes to false contraindications. These practices erode vaccine confidence and create barriers to timely immunization.
Conclusion: Addressing the growing problem of unwarranted medical exemptions requires policy reform, clearer clinical guidelines, enhanced physician training, and improved digital monitoring systems. Strengthening these areas is essential for restoring public trust, reducing unjustified exemptions, and ensuring high vaccination coverage in Kazakhstan.