Kazakhstan

Kazakhstan is located in Central Asia with a western border on the Caspian Sea. Formerly a part of the Soviet Union, it is bordered on the north by Russia and on the south by Kyrgyzstan, Uzbekistan, and Turkmenistan. It shares an eastern border with China. At over 2.7 million square kilometers (over 1 million square miles), it is the largest state in Central Asia. More than two-thirds of the country is covered with desert and semi-arid steppes. Only 8 percent of the land is suitable for cultivation. Kazakhstan has abundant natural resources and ports on the Caspian Sea, but its economy has not yet found footing in the post-Soviet era.

The population is 15,285,000 and growing at 0.352 percent annually. The birth rate is 16.23 per 1,000 and the death rate is 9.4 per 1,000. The country is losing 3.32 people per 1,000 to migration each year. Median age is 29.1 years. Life expectancy is 61.9 years for males and 72.84 years for females. Gross national income is $2,930 per person, with 19 percent living in poverty; there is low unemployment.

Communicable diseases are responsible for 2 percent of mortality each year. After a long period of decline though the 1980s, rates of diseases such as tuberculosis, hepatitis, and diphtheria began to climb in the 1990s. The tuberculosis rate is 132 per 100,000, or about 23,000 new cases a year. Vaccinations for TB were halted for a period in 2004 after more than 1,000 people reported bad side effects from an imported vaccine. Negative publicity surround the event has kept vaccination rates low for the last three years. There was also a measles outbreak in 2004 that sickened 1,200 people. The adult prevalence rate for AIDS is 0.1 percent, with about 12,000 believed to be infected with the virus.

Noncommunicable diseases account for 85 percent of mortality in Kazakhstan, and of that number 57 percent are from cardiovascular disease. Risk factors for men include tobacco and alcohol use, high blood pressure, high cholesterol levels, and obesity. For women, the main risk factors are high blood pressure and cholesterol, obesity, tobacco use, and low intake of fruits and vegetables. There has been a sharp increase in cardiovascular diseases since 1990, and it seems to be happening to people at a younger age. With high alcohol use and widespread viral hepatitis, cirrhosis and chronic liver disease are also a frequent cause of illness and death.

UNICEF places child mortality in Kazakhstan at 63 per 1,000 for infants and 73 per 1,000 for children under five. At least 75,000 Kazak children are in orphanages or other state-run institutions. This is a pattern seen around the former Soviet Union, as families have been put under increasing pressures as a result [Page 968]of independent and economic reorganization. The maternal mortality rate remains high at 210 deaths per 100,000 live births, despite 91 percent of women receiving prenatal care and 99 percent giving birth in hospital or with trained care.

The government spends around $65 per capita on healthcare. Like all former Soviet states, Kazakhstan is trying to rebuild its medical system. During the Soviet period, the number of medical staff and hospital beds was emphasized over patient care. That has left a surplus of both: for example, there are 54,600 physicians in Kazakhstan, or 3.54 per 1,000 people. There are 93,800 nurses, or 6.01 per 1,000 people. The attempt to create a modern public-private system is going slowly, and many fear it will leave many people without care, as the average citizen will find it difficult to pay for care out-of-pocket or afford monthly insurance premiums.

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