Challenges for Developing Palliative Care Services in Resource- Limited Settings of Kazakhstan

Islam Salikhanov; Stephen R Connor; Gulnara Kunirova; Fatima Khashagulgova; Gulzhaina Nazarova; Byron Lawrence Crape; Maria C Katapodi

doi:10.3389/phrs.2023.1605672

Challenges for Developing Palliative Care Services in Resource- Limited Settings of Kazakhstan

Public Health Rev. 2023 Aug 18:44:1605672. doi: 10.3389/phrs.2023.1605672. eCollection 2023.

Authors

Islam Salikhanov¹, Stephen R Connor², Gulnara Kunirova³, Fatima Khashagulgova⁴, Gulzhaina Nazarova⁴, Byron Lawrence Crape⁵, Maria C Katapodi¹

Affiliations

¹ Department of Clinical Research, University of Basel, Basel, Switzerland.
² Worldwide Hospice Palliative Care Alliance, Fairfax, VA, United States.
³ Kazakhstan Palliative Care Association, Almaty, Kazakhstan.
⁴ National Research Cardiac Surgery Center, Astana, Kazakhstan.
⁵ School of Medicine, Nazarbayev University, Nur-Sultan, Kazakhstan.

Abstract

Background: Approximately 40 million people in need of palliative care worldwide, while 80% of them live in low- and middle-income countries. Kazakhstan, a low-to middle-income country with a reforming healthcare system, is committed to improving quality and accessibility of care for its 100,000 terminal patients in need of palliative care. Policy Options and Recommendations: To join the group of countries where palliative care is available, accessible, and affordable, Kazakhstan must integrate palliative services into the mainstream healthcare system at all levels, from primary healthcare to hospices, and from major cities to remote villages. Based on the evidence thoroughly collected directly from the Ministry of Health, authors propose a feasible set of recommendations regarding palliative policy, pain relief, infrastructure, workforce, and education, which could be implemented in LMICs beyond Kazakhstan. Conclusion: This study presents an analysis of challenges, recent developments, and needs of palliative care in Kazakhstan, including funding, policy, workforce, education, and infrastructure, providing an evidence base and recommendations for future development of palliative care in Kazakhstan and in other LMICs.

Keywords: Kazakhstan; challenges; health policy; low-middle income countries; palliative care.

Grants and funding

Commission of the European Union, Horizon 2020 Marie Sklodowska-Curie Award to IS and Swiss Cancer League KLS-4294-08-2017, PI: MK, MC for the CASCADE study.