Kazakhstan

Kazakhstan is a central Asian republic that was conquered by Russia in the 18th century, became a Soviet Republic in 1936, and achieved independence in 1991. The population is a mix of several ethnic groups, including Kazakh (53.4 percent) and Russian (30 percent, primarily migrants during the Soviet period); 47 percent of the population are Muslim and 44 percent Russian Orthodox. Kazakhstan has the largest economy of any other central Asian state and enjoys vast natural resources and political stability. The Gross Domestic Product (GDP) in 2008 was $11,500, up from $10,400 in 2006. The population is about 15.4 million, with a median age of 29.6 years: the population growth rate is about 0.4 percent with a total fertility rate of 1.88 per woman. Life expectancy for males at birth is 62.58 years and for females is 73.47 years. Literacy is almost universal, with 99.8 percent of men and 99.3 percent of women considered literate, and children expected to attend school up to age 15 or 16.

A health worker in training in Astana, Kazakhstan. Newborns are now kept with the mother day and night.

The Kazakhstan government spends about 3.5 percent of GDP on health care, or about $30 in 2002. This constituted almost 60 percent of the total spending on health care, the remainder being primarily out-of-pocket private expenditures. The standard of child and maternal health care is quite high: [Page 617]childhood immunization rates for the major diseases are near 100 percent, 82 percent of pregnant women received at least one prenatal care visit, and 71 percent received four or more prenatal care visits. Fifty-seven percent of women use modern contraceptive methods. Almost all (99 percent) births are attended by skilled health personnel and take place in health care facilities (98 percent).

The rate of birth complications is high for mothers but low for infants: the maternal mortality ratio in 2000 was 201 per 100,000 live births (this rate would need to be reduced by over 70 percent to meet the Millennium Development Goals) but the stillbirth rate was 29 per 1,000 total births, and the neonatal mortality rate was 32 per 1,000 live births, both low relative to comparable countries. Save the Children, an international organization devoted to improving maternal and child health, places Kazakhstan in its Tier II or less developed countries, where it ranks 6th out of 66 countries on the Women's Index (taking into account factors such as life expectancy, maternal mortality, availability of modern contraception, and maternity leave benefits); and 9th out of 66 countries on the Mothers' Index (taking into account additional factors related to children's health and well-being, such as the under-5 mortality rate and gender parity in primary school enrollment).