Quality of Primary Healthcare Services in Kazakhstan: A Systematic Review and Meta-Analysis of Patient-Centred Outcomes and Implications for Nursing Practice and Policy.
Makhabbat Shurenova, Amin Tamadon, Nadiar M Mussin and 2 others
PMID 42310885WHAT IT FOUND
About 56% of primary healthcare users surveyed in Kazakhstan reported favourable satisfaction, but system-level performance varied widely and the overall figure was too unstable to guide care.
Key findings
01Across four studies, the pooled proportion of patient-reported satisfaction with primary healthcare services in Kazakhstan was 0.56 (95% CI: 0.53–0.59).
02The pooled system-level primary healthcare performance estimate was 0.64 (95% CI: 0.52–0.75), but the authors said it should be interpreted with extreme caution because heterogeneity was I² = 98.4%.
03Individual patient satisfaction estimates ranged from 0.53 to 0.60, while system-level proportions varied from 0.47 for screening coverage to 0.74 for nursing service quality.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only eight studies were included, all from Kazakhstan, so the results may not apply to other countries or health systems. Each meta-analysis had fewer than five studies, so pooled estimates may be unstable. System-level results had very high heterogeneity (I² = 98.4%), and the authors called the pooled estimate exploratory. Most included studies were cross-sectional and some used convenience sampling, so they cannot show what caused satisfaction or performance differences. Studies were mostly from urban settings, especially Almaty, and rural areas were underrepresented. Only English-language studies were searched, and grey literature was not included, so Russian or Kazakh studies and reports may have been missed. Authors did not contact study authors for missing data. Publication bias could not be assessed reliably because each analysis had only four studies.
Declared interests
The research received no external funding, and all stages were conducted independently by the authors. The authors report nothing to disclose.
The easy way to misread this
Do not read the pooled 0.64 system-level estimate as a reliable measure of primary healthcare performance. It came from four studies with very high heterogeneity (I² = 98.4%), and the authors called it exploratory.