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Challenges to equitable access to urogenital care in urban and rural Kazakhstan: a mixed-methods study
Nurgul Darmen1, Gulshara Aimbetova2, Maiya Zhakupova2
1Marat Ospanov West Kazakhstan Medical University, Aktobe, Kazakhstan.
Background:
Addressing urban-rural inequalities is essential for universal health coverage. This study examined disparities in access to genitourinary (GU) care in Kazakhstan.
Methods:
A cross-sectional mixed-methods study was conducted in urban and rural areas of Almaty region (2024-2025). Quantitative data (n = 721) were analyzed using chi-square tests and logistic regression. Qualitative interviews with urologists (n = 11) were thematically analyzed.
Results:
Sex distribution was similar. Urban residents had higher education, while rural residents reported better financial status. Most sought initial care at PHC, though self-treatment was common. Rural residents relied more on PHC and had longer waiting times; urban residents more often used private services. Workforce shortages and limited diagnostic capacity were key barriers, especially in rural areas.
Conclusion:
Urban-rural disparities in GU care hinder progress toward universal health coverage in Kazakhstan. Strengthening rural workforce and diagnostics is needed.
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