ABSTRACT
This chapter examines the evolution of health care system in Kazakhstan since its independence. The Soviet health system, which emphasized centralized planning with the principle of free universal health coverage for all, has been adopted by Kazakhstan. To bring major improvements in the health system, the reform measures have altered the institutional and procedural aspects of health care delivery as well as the behavioral aspects of health care providers. In analyzing the health reform programs, four elements in the reform have been examined, namely, decentralization, efficiency and quality, expenditure and financing, and competition. The health financing system consolidates funds at the oblast level, where oblast health departments serve as the single health purchaser or single payer for all state health funds. The National Program of Health Care Reform and Development incorporates a new health financing policy, which aims to improve the linkage between different levels of care, reinvest resources saved through rationalization and decrease regional differences in health financing.
