KAZAKHSTAN HEALTH PROFILE Meruert Rakhimova, MPH, MD, National Supercourse Director for Kazakhstan, Kanat Shakenov, MPH, DMD and Supercourse’s Team

Authors: Meruert Rakhimova – alumni of Kazakh National Medical University (general therapy, 1999); MPH-Graduate School of Public Health, University of Pittsburgh Kanat Shakenov - graduate of Kazakh State Medical University (Dentistry, 2000); MPH-Graduate School of Public Health, University of Pittsburgh

Kazakhstan Geography MAP OF KAZAKHSTAN Location: Central Asia, northwest of China Area: total: 2,717,300 sq km land: 2,669,800 sq km water: 47,500 sq km Area--comparative: slightly less than four times the size of Texas Land boundaries: total: 12,012 km border countries: China 1,533 km, Kyrgyzstan 1,051 km, Russia 6,846 km, Turkmenistan 379 km, Uzbekistan 2,203 km note: Kazakhstan borders the Aral Sea (1,015 km) and the Caspian Sea (1,894 km) Climate: continental, cold winters and hot summers, arid and semiarid Terrain: extends from the Volga to the Altai Mountains and from the plains in western Siberia to oasis and desert in Central Asia Elevation extremes: lowest point: Vpadina Kaundy -132 m highest point: Zhengis Shingy (Pik Khan-Tengri) 6,995 m Natural resources: major deposits of petroleum, natural gas, coal, iron ore, manganese, chrome ore, nickel, cobalt, copper, molybdenum, lead, zinc, bauxite, gold, uranium Land use: arable land: 12% permanent crops: 11% permanent pastures: 57% forests and woodland: 4% other: 16% (1996 est.) Irrigated land: 22,000 sq km (1996 est.) Natural hazards: earthquakes in the south, mudslides around Almaty Environment--current issues: radioactive or toxic chemical sites associated with its former defense industries and test ranges are found throughout the country and pose health risks for humans and animals; industrial pollution is severe in some cities; because the two main rivers which flowed into the Aral Sea have been diverted for irrigation, it is drying up and leaving behind a harmful layer of chemical pesticides and natural salts; these substances are then picked up by the wind and blown into noxious dust storms; pollution in the Caspian Sea; soil pollution from overuse of agricultural chemicals and salinization from faulty irrigation practices

Economics and Health Indicators 1. GDP (2000): - purchasing power parity - $85.6 billion - real growth rate - 10.5% - GDP per capita: purchasing power parity - $5,000 2. Total expenditure on Health (2000) – ~ 350 million dollars 3. Total expenditure on Health (1999) – 1.5-2% to GNP 4. Number of Physicians (2000) – 7.5 per 10,000 5. Inpatient care beds (2000) – 7.2 (per 1,000 population) Your Comments

Life Expectancy at Birth (2000)                                                              Your Comments

Crude birth rate and death rate per 100,000 (years 1991-2000) Your Comments

Age-specific death rate by sex and age (1997) deaths per 1,000 Total 0-4 5-14 15-24 25-34 Males 47 10 37 64 Fe- males 33 7 14 21 35-44 45-54 55-64 65-74 75+ 108 111 201 188 115 35 46 103 174 277 Your Comments

Deaths by major causes per 100,000 (2000) TOTAL Total 1,005.1 Diseases of the circulatory system 502.3 Neoplasms (malignant and benign) 130.4 Diseases of the digestive system 37.8 Diseases of the respiratory system 71.4 Infectious and parasitic diseases 34.5 Accidents, traumas, poisoning 141.1 Others 87.6 Your Comments

Maternal Mortality (years 1998-2000) Your Comments

Infant Mortality Rate deaths per 1,000 born                                                                                                                                                     Your Comments

Morbidity Ranking The Top 10 health events causing morbidity in Kazakhstan – incidence per 100,000 3,617.3 3,434.4 10. Bone, muscle and connective tissue 3,688.5 3,933.2 9. Infectious and parasitic 3,773.4 3,361.0 8. Neurological 3,748.5 3,561.6 7. Accidents and poisoning 4,726.1 4,664.5 6. Skin+subcutaneous tissue 5,192.7 4,967.3 5. Ophthalmologic 6,270.2 6,320,3 4. Genitourinary tract 6,528.1 6,289.0 3. Cardiovascular 7,679.6 7,396.2 2. GI tract 24,719.3 22,636.7 1. Respiratory system Incidence in 2000 Incidence in 1999 Disease Your Comments

Major health risk factors in Kazakhstan: High levels of alcohol and drug abuse Poor quality of drinking water (in some areas) High levels of unemployment Your Comments

Useful Internet links related to health in Kazakhstan Official web site of Kazakhstan (Background) http://www.president.kz/ Republic of Kazakhstan Social Protection Project, supported by World Bank http://www.worldbank.org/children/costs/kazak.htm targeting kindergarten age children Maternal Health Around the World http://www.safemotherhood.org/facts_and_figures/health_around_the_world.htm Maternal Mortality in Asia http://www.overpopulation.com/faq/Health/mortality/maternal_mortality/asia.html

Useful Internet links related to health in Kazakhstan (cont’d) Also some websites in Russian language: http://www.tele.med.kz http://www.kazmed.kz http://snspkz.lorton.com www.med.kz http://www.lorton.com/dcentre http://pharmnews.kz http://kazfarm.dan.kz

This lecture is based on the following sources of information Statistical report on health and health care in Kazakhstan for the year 2000. Ministry of Health, RK (2001). Statistical report on health and health care in Kazakhstan for the year 1999. Ministry of Health, RK (2000). CIA report on Republic of Kazakhstan – www.cia.gov. Kazakhstan Demographic and Health Survey 1999.// Academy of Preventive Medicine, Almaty, Kazakhstan, Macro International Inc., Calverton, Maryland, USA.

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