Articles published on Republic Of Kazakhstan
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- New
- Research Article
- 10.1016/j.fitote.2026.107310
- Jul 1, 2026
- Fitoterapia
- S M Adekenov
Sesquiterpene γ-lactones of plants of the Asteraceae family of the flora of Kazakhstan: Search, distribution, biological activity.
- New
- Research Article
- 10.31489/3136-0807/2026-1-1/21-33
- Jun 28, 2026
- Economic Research and Management Decisions
- Анар Толамисова + 3 more
The purpose of this study is to comprehensively examine the current state and development dynamics of internal migration processes in the Republic of Kazakhstan. The research analyzes the main directions of urbanization, the factors driving population concentration from rural areas to large cities and economically active regions, as well as disparities in socio-economic development across regions. The study also investigates the impact of migration flows on regional economic growth, the concentration of productionpotential, and increasing pressure on urban infrastructure. Economic and statistical analysis methods were employed. The empirical results indicate that internal migration has contributed to the concentration of labor resources and innovative potential in major economic centers, the expansion of the service sector, and increased labor productivity. Furthermore, the study reveals a structural relationship between internal migration, urbanization, and regional divergence. The findings highlight the need for a balanced regional policy, sustainable rural development, and effective management of the consequences of urbanization. They also emphasize the importance of improving internal migration governance mechanisms, ensuring balanced regional development, and modernizing urban infrastructure. The results can be used to incorporatemigration factors into national and regional development policies and to formulate practical recommendations aimed at reducing socio-economic disparities between regions and supporting the country’s long-term economic development.
- New
- Research Article
- 10.53002/150
- Jun 20, 2026
- ВЕСТНИК КАРАГАНДИНСКОГО ГОСУДАРСТВЕННОГО ИНДУСТРИАЛЬНОГО УНИВЕРСИТЕТА
- Talgat Tolenov
The article examines the mechanisms for developing a competitive strategy for the Pavlodar region branch of the «National Center of Expertise» at the SECC of the Ministry of Health of the Republic of Kazakhstan amidst the transformation of the laboratory services market in the Republic of Kazakhstan. Based on 2022-2025 data, an analysis of the branch's financial stability and operational efficiency was conducted. A critical dualism was identified: the presence of unique state competencies alongside declining commercial revenues and personnel shortages. Practice-oriented recommendations have been developed for digital transformation, human resources policy optimization, and the development of other business areas
- New
- Research Article
- 10.53002/139
- Jun 20, 2026
- ВЕСТНИК КАРАГАНДИНСКОГО ГОСУДАРСТВЕННОГО ИНДУСТРИАЛЬНОГО УНИВЕРСИТЕТА
- A.V Nikulshin + 4 more
Under the conditions of the dominance of thermal, primarily coal-fired, generation and the significant role of combined heat and power plants in the electric power industry of the Republic of Kazakhstan, the issue of energy efficiency of the electric power generation sector acquires systemic technical and economic significance. The purpose of this article is to briefly present this issue as an independent subject of scientific and sectoral consideration. It is shown that the contemporary energy agenda usually prioritizes decarbonization, the development of renewableenergy sources, hydrogen energy, and the technological modernization of power systems, whereas the energy efficiency of the electric power generation sector itself much less frequently becomes an independent object of analysis. At the same time, this aspect determines the cost-effectiveness of power generation, the stability of electricity and heat supply, the level of a plant’s internal consumption,and the nature of further modernization of the generation complex. The article reveals the sector-specific features of Kazakhstan’s electric power industry, the strategic priorities of state policy, and the main approaches to understanding the energy efficiency of generation. The necessity of an integrated approach to improving its efficiency is substantiated.
- New
- Research Article
- 10.3390/biology15120937
- Jun 16, 2026
- Biology
- Alexey P Ershov + 4 more
An inevitable decrease in oil production from reservoirs all over the world necessitates the application of microbial enhancement of oil recovery (MEOR) technologies. The high total salinity of formation water is a factor strongly suppressing the growth of most industry-applicable strains of hydrocarbon-oxidizing bacteria. The halotolerant strain Ectopseudomonas guguanensis G3 isolated from an oil reservoir (Republic of Kazakhstan) has demonstrated high efficiency of oil degradation and presumable biosurfactant production. The ability of the strain to utilize crude oil, n-alkanes, toluene, and xylene and its resistance to NaCl concentrations up to 6% were shown, as well as a high decrease in the interfacial tension of the culture liquid. Genomic analysis of the strain confirmed its ability to oxidize aromatic oil compounds and a wide range of n-alkanes (with a chain length up to C30) and revealed its potential capabilities to produce alginate, consume nitrate and urea as nitrogen sources, and synthesize betaine as an osmoprotectant. These findings demonstrate the high potential of E. guguanensis strain G3 to be used in oil reservoirs with high-salinity formation water in the biotechnology of oil displacement through oil degradation and in situ microbial metabolite production.
- New
- Research Article
- 10.46303/jcve.2026.33
- Jun 15, 2026
- Journal of Culture and Values in Education
- Dana Kuatbayeva + 4 more
The development of research competence is a critical mandate for modern teacher education, yet a significant gap persists between theoretical preparation and practical application. This study investigates the formation of research culture among future and practicing teachers in the Republic of Kazakhstan, aiming to identify key components of research competence (motivational, cognitive, operational), diagnose structural barriers, and propose a model for integrating research activities into Initial Teacher Education (ITE). Employing a descriptive mixed-methods design, the study analyzed data from 55 participants, including secondary school teachers and senior pedagogical students in Almaty. Data were collected via a structured questionnaire assessing research attitudes and skill deficits, followed by semi-structured in-depth interviews and task-based assessments to evaluate operational proficiency. Results indicate a bifurcation in skill formation: 47% of respondents reported developing research skills primarily during university coursework, whereas only 30% attributed their development to school practice, highlighting a disconnect in the practicum experience. The primary barriers identified were “inability to process collected data” (a cognitive-methodological deficit), “difficulties with academic literature,” and “lack of time” (a structural barrier). While participants demonstrated high intrinsic interest in research (motivational component), this was frequently undermined by low methodological self-efficacy and insufficient institutional mentorship. The study confirms a “theory-practice gap” in which university-based theoretical training fails to translate effectively into school settings. To address this, a structural model is proposed that integrates specific data-analysis modules and systematic mentoring into the teaching practicum, ensuring that future teachers possess both the motivation and the operational capacity for professional inquiry.
- Research Article
- 10.1016/j.jenvrad.2026.108060
- Jun 3, 2026
- Journal of environmental radioactivity
- N V Larionova + 9 more
Artificial radionuclide levels in land cover of radiological warfare agent test site '4'.
- Research Article
- 10.3390/ph19050789
- May 18, 2026
- Pharmaceuticals
- Galiya Ibadullayeva + 10 more
Background: The growing demand for safe and effective phytopharmaceuticals underscores the importance of studying regionally available medicinal plants. Acorus calamus L. and Calendula officinalis L., widely distributed in the Republic of Kazakhstan, are promising sources of biologically active compounds with significant pharmacological potential. However, the combined use of their CO2 extracts remains insufficiently characterised, particularly regarding possible synergistic interactions. Therefore, the development of new dosage forms and their comprehensive pharmacological and toxicological evaluation is a priority in modern pharmaceutical research. Methods: Concentrated extracts from Acorus calamus rhizomes and Calendula officinalis flowers were obtained using precritical CO2 extraction. Safety was assessed through acute and chronic toxicity studies in laboratory animals according to standard non-clinical guidelines. Animals received graded doses of the extracts and developed formulations (‘Exkair’ tablets and ‘Zerp-Ak-Broncho’ granules). Clinical condition, mortality, body weight, and behaviour were monitored. Biochemical, haematological, and histopathological analyses were performed. Antitussive activity was evaluated in vivo by measuring oedema inhibition relative to reference drugs. Results: The CO2 extracts and formulations demonstrated low toxicity and good tolerability, with no mortality or significant adverse effects observed even at high doses. Biochemical and haematological parameters remained within physiological ranges, and histopathological examination revealed no structural alterations in internal organs. Both ‘Exkair’ and ‘Zerp-Ak-Broncho’ exhibited pronounced antitussive activity, confirmed by significant suppression of oedema. This effect is likely associated with the synergistic action of flavonoids, terpenoids, and phenolic compounds. Conclusions: The findings indicate that CO2 extracts of Acorus calamus L. and Calendula officinalis L., as well as the developed formulations, possess a favourable safety profile and significant antitussive activity. These results support their further development as phytotherapeutic agents in Kazakhstan.
- Research Article
- 10.1038/s41598-026-53028-y
- May 14, 2026
- Scientific reports
- Galina Samigulina + 3 more
The research is devoted to solving the urgent problem of industrial production intellectualization based on the creation of an intelligent HMI display using a unified artificial immune system (UAIS) with neuro-endocrine interaction technologies for the control of complex objects and equipment diagnostics in the oil and gas industry. The developed intelligent adaptive display with a predictive alarm system based on a digital twin of the technological process allows reducing the internal and external load on the operator during the operation of high-tech equipment at oil and gas processing plants. Control of the alarm system is of key importance for ensuring safety and maintaining the efficient operation of the production process, i.e. homeostasis. Of extreme importance is the problem of adequate reaction to decision-making by the operator in case of possible failures in the technological process and equipment operation. This issue is especially acute in the automation of large-scale complex production. The control of the alarm system is dynamic and can change depending on many factors. To process multidimensional information about the state of a complex object and predict the behavior of the system, a unified artificial immune system is used in interaction with an artificial neural network to identify informative features when working with historical data, as well as endocrine regulation of homeostasis in the system. With the help of an intelligent HMI display built on these principles, the internal load on the operator is reduced, which allows for effective decision-making on process management. The results of experiments and modeling using the proposed technology and the developed intelligent HMI display on Honeywell Experion PKS equipment in the Honeywell laboratory of the School of Information Technology and Engineering, Kazakh-British Technical University in Almaty, Republic of Kazakhstan are presented. This UAIS technology can be used with industrial equipment from other vendors for SCADA (Supervisory Control and Data Acquisition) and DCS (Distributed Control System) systems with support for web technologies HTML (HyperText Markup Language) and CSS (Cascading Style Sheets) in the development of displays for workstations and operator panels.
- Research Article
- 10.21869/2223-1560-2026-30-1-79-95
- May 5, 2026
- Proceedings of the Southwest State University
- O A Ivashchuk + 3 more
Purpose of research. The Russian Federation and the Republic of Kazakhstan are member countries of the Kyoto Protocol, an international agreement aimed at reducing greenhouse gas emissions in order to combat climate change. This requires the formation of a model bank for automated management of the allocation of quotas for greenhouse gas emissions into the atmosphere. Methods. Based on the analysis of carbon accounting features, a new trading methodology based on Blockchain technology and the VCG algorithm is proposed, aimed at increasing transparency, security and automation of transactions between market participants. A method and algorithm for implementing carbon emission quotas through the auction system has been developed, which ensures the openness and transparency of the distribution process. Results. In this paper, we have modeled a digital platform for automated carbon emissions trading using Blockchain technology. A study of the existing tools and mechanisms of the carbon emissions quota market has been carried out, its main problems have been identified, such as insufficient transparency of transactions, the risk of fraud and difficulties in monitoring compliance with regulatory requirements. As part of the simulation, smart contracts were developed and tested, which automate the fulfillment of transaction conditions and transaction accounting. The use of Blockchain technology makes it possible to ensure high information security, control the course of trading and prevent unauthorized data changes. An automated system for accounting and conducting transactions increases the efficiency of quota management and reduces transaction costs. Conclusion. The developed prototype of the digital platform promotes the development of an environmentally responsible economy, encourages enterprises to reduce their carbon footprint, and ensures transparency and security in trading environmental quotas. As a result, the proposed model increases the confidence of market participants and contributes to the formation of a sustainable system for regulating greenhouse gas emissions.
- Research Article
- 10.52676/1729-7885-2026-1-228-235
- Apr 25, 2026
- NNC RK Bulletin
- M K Seisenbayeva + 2 more
The paper analyzes the options for further management of spent nuclear fuel (SNF) from the BN-350 reactor facility, which was in operation from 1973 to 1999. Based on the established international experience, recommendations of international organizations and requirements of national legislation, as well as the technologies currently available, possible scenarios for the management of the spent nuclear fuel from the BN-350 reactor facility, including the long-term storage, processing and direct disposal, have been considered. The paper is oriented at forming the recommendations for developing a further strategy for the SNF management in the Republic of Kazakhstan, taking into account long-term safety.
- Research Article
- 10.35295/osls.iisl.2502
- Apr 24, 2026
- Oñati Socio-Legal Series
- Raushan Baizakova + 4 more
This study rests on a critical analysis of the key objectives and significance of alternatives to imprisonment at both the international and Kazakh legal levels. The study explores the available evidence on the effectiveness of alternatives to imprisonment. The exploration of this topic is indispensable for the formulation of a comprehensive, ethical, and economically sustainable criminal justice framework that aligns with international norms and takes into account the unique characteristics of the Republic of Kazakhstan. Such an endeavor would contribute to the refinement of law enforcement procedures and the overall enhancement of the legal system.
- Research Article
- 10.5219/scifood.102
- Apr 22, 2026
- Scifood
- Massimzhan Velyamov + 7 more
The modern sports nutrition industry requires affordable plant-based protein sources with high nutritional potential that can partially replace animal-derived proteins and reduce reliance on imports. Legume grains, as valuable sources of protein and essential amino acids, have considerable potential for developing functional food products. This study aimed to develop and optimise formulations and processing technology for protein–vitamin concentrates (PVCs) derived from plant raw materials-peas, soybeans, and oats-enriched with natural vitamin sources (rosehip and lemon) to expand the availability of affordable sports nutrition products in the Republic of Kazakhstan. The protein base was obtained from regionally adapted cultivars: peas (Aksary), soybeans (Zhansaya), and oats (Syrgalym). The technological process included raw material preparation, aqueous extraction, and enzymatic hydrolysis using pancreatin (3%, pH 8.0–8.2, 43–45 °C), followed by enrichment with lemon extract (10%) and rosehip extract (20%), stabilisation with apple pectin (1%), and drying by either lyophilisation (–50 °C) or convective drying (50 °C). The resulting samples were evaluated for physicochemical, biochemical, sensory, and safety parameters using standardised analytical methods harmonised with internationally recognised ISO and AOAC standards. Optimisation of the formulations increased the content of amino acids, vitamins, and minerals. The obtained PVCs contained 18.79–26.75% protein, L-arginine (1.795–3.631 g/100 g), lysine (1.108–1.222 g/100 g), vitamin C (110.8–125.15 mg/100 g), β-carotene (0.056–0.067 mg/100 g), B-group vitamins, magnesium (119.08–146.57 mg/100 g), and zinc (3.34–3.63 mg/100 g). All samples complied with regulatory requirements for physicochemical, biochemical, sensory, and safety indicators. Convective drying preserved key nutritional and quality parameters at levels comparable to lyophilisation while offering advantages in process efficiency. The developed PVCs are characterised by high protein content and a favourable micronutrient profile and could be further investigated as potential ingredients for the development of functional sports nutrition products. Their implementation could contribute to the development of domestic production and reduced dependence on imported sports nutrition products.
- Research Article
- 10.62327/9djjwnuqkt
- Apr 22, 2026
- Hemispheres
- Lauren Higuchi
From a vital trade corridor for China on the Silk Road to farmland for the Soviet Union, Central Asia has traditionally been viewed as defined by the great powers that surround it. Even after gaining their independence following the fall of the Soviet Union, the Central Asian Republics (CARs) of Kazakhstan, Kyrgyzstan, Uzbekistan, Turkmenistan, and Tajikistan remained largely under Russia’s sphere of influence: their economies, foreign policies, and, especially, security strategies remained closely integrated with Russia’s largely by default.
- Research Article
- 10.18093/0869-0189-2026-36-2-208-216
- Apr 17, 2026
- PULMONOLOGIYA
- S S Kim + 4 more
Cystic fibrosis (CF) is a hereditary multisystem disorder characterized by progressive damage to the respiratory and gastrointestinal systems. Data on adult patients with CF are limited in the Republic of Kazakhstan (RK), and the lack of a national registry makes it difficult to evaluate the clinical and functional characteristics of this population. The aim was to present the genotypic and phenotypic characteristics of adult patients with CF in the RK. Methods. Data from 29 adult patients (18 years and older) with a confirmed diagnosis of CF from various regions of the RK for 2024 were analyzed. Clinical, anthropometric, functional, laboratory, microbiological, and molecular genetic parameters were assessed according to European Cystic Fibrosis Society Patient Registry (ECFSPR) protocols. Results. The mean age of patients was 23.3 years, and the median age at diagnosis was 9 years. BMI was below the target values (19.17 kg/m 2 ). Exocrine pancreatic insufficiency was detected in 80% of patients (fecal elastase < 200 pg/g), predominantly in those with “severe” CFTR genotypes. The F508del mutation was detected in 45% of alleles. “Severe” genotypes, associated with earlier diagnosis, low pancreatic function, and high sweat chloride levels, were identified in 72.4% of patients. The mean FEV 1 value was 60.7% predicted, with 35.8% of patients experiencing severe or very severe airflow obstruction. Chronic Pseudomonas aeruginosa infection was detected in 69% of patients. Initiation of CFTR modulator therapy was associated with a reduction in the exacerbation frequency and the need for intravenous antibiotic therapy in most patients. Conclusion. Adult patients with CF in Kazakhstan are characterized by late diagnosis, decreased nutritional status and respiratory function, and a high rate of exacerbations. Data integration into the ECFSPR is a key step toward developing systemic care and optimizing CF therapy in the country.
- Research Article
- 10.47470/0016-9900-2026-105-3-274-280
- Apr 17, 2026
- Hygiene and sanitation
- Nurlan K Smagulov + 1 more
Introduction. Occupational burnout is a widespread condition characterized by chronic emotional and physical exhaustion, most commonly observed among professionals engaged in intensive interpersonal work. Contemporary prevention strategies are primarily based on psychological interventions, which require specialist involvement and are typically implemented in group settings. This limits their accessibility and individualization. Physiological approaches, particularly the stimulation of the diving reflex, may serve as an effective alternative for personalized use.Aim. To evaluate the effectiveness of the diving reflex stimulation technique as the individual physiological method of the occupational burnout influencing.Materials and Methods. The study was conducted on volunteers having signs of burnout. Over the 10-day period, sessions simulating the diving response with monitoring of heart rate (HR), heart rate variability (HRV), blood pressure (BP), and apnea duration were administered. Burnout symptoms were assessed using the Maslach Burnout Inventory (MBI) before the intervention, immediately after, and on the 10th and 20th day after intervention.Results. Over the 10-day course of diving reflex stimulation, pronounced improvements in physiological and psychoemotional parameters were observed: apnea duration increased, standard deviation NN interval (SDNN) and root mean square of successive differences (RMSSD) rose by 20–30%, the stress index decreased more than threefold, and the Baevsky regulatory systems activity index (PARS) declined from pronounced regulatory tension to values approaching the physiological norm. According to the MBI, emotional exhaustion and depersonalization shifted from high to moderate levels, indicating a reduction in burnout symptoms. The effect persisted throughout the 10- and 20-day follow-up period.Limitations. The limitations of the study are the uniformity of the sample (female students aged of 19–23 years), the absence of the control group, and the short follow-up period. At the same time, the female composition is consistent with the predominant participation of women in occupational groups with the high risk of burnout development (teachers, nurses,), which does not detract from the significance of the results, but emphasizes the need for further research using the wider and more diverse sample.Conclusion. The method of diving reflex stimulation appears to be the effective, affordable, and safe tool for individual exposure, contributing to reducing the severity of the symptoms of occupational burnout and the formation of the stable pattern of autonomic self-regulation.Compliance with ethical standards. All procedures involving human participants were carried out in full accordance with the ethical standards of the institutional and national research committee, as well as with the principles of the Declaration of Helsinki of the World Medical Association (2013 revision) and the European Community Directives (86/609/EEC). The study was approved by the Local Commission on Bioethics of Karaganda Medical University (Protocol No. 17 dated October 22, 2024).Contributions: Smagulov N.K. – study conception and design, data collection and analysis, manuscript writing and editing; Ageyev D.V. – study conception and design, data collection and analysis, manuscript writing. All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final versionConflict of interest. The authors declare no conflict of interest.Funding. The research was carried out within the framework of grant funding from the Ministry of Science and Higher Education of the Republic of Kazakhstan, grant No. AP26100059.Received: June 24, 2025 / Revised: September 4, 2025 / Accepted: October 15, 2025 / Published: April 17, 2026
- Research Article
- 10.1080/21678421.2026.2652327
- Apr 15, 2026
- Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
- Ekaterina V Pervushina + 3 more
Objective To identify and compare the main challenges in diagnosing and managing amyotrophic lateral sclerosis (ALS) from the perspective of neurologists in Republic of Bashkortostan (Russia), Belarus, and Kazakhstan. Methods An anonymous online survey was distributed to neurologists via professional networks from May to October 2025. The questionnaire collected data on demographics, diagnostic and therapeutic approaches, barriers, and suggestions for improvement. Results The survey included 294 neurologists. Over half (58.2%) diagnosed ALS less than once a year. Major diagnostic barriers were limited access to key investigations like electromyography (62.6%) and a lack of specialized ALS centers (37.8%). For treatment, 48% prescribed riluzole, while only 12.9% used edaravone. Critically low rates of gastrostomy placement and respiratory support provision (<10% of terminal patients) were noted by over 80% of respondents. Significant cross-country differences were found: neurologists in Kazakhstan utilized genetic testing and edaravone more frequently; neurologists in Belarus employed muscle/tongue ultrasound more often; neurologists in the Republic of Bashkortostan (Russia) reported higher use of speech therapy and gastrostomy. The most frequently proposed solutions were establishing specialized ALS centers (34%), enhancing physician training (20%), and improving palliative care services (16.5%). Conclusions This multinational survey provides important insights into ALS care in the studied countries, identifying key areas for further development. The results point to opportunities for enhancing diagnostic resources, therapeutic strategies, and palliative care approaches. Enhancing the quality of ALS care requires the development of specialized clinical pathways, the implementation of consensus-based protocols, and the expansion of professional education in multidisciplinary management.
- Research Article
- 10.33619/2414-2948/125/58
- Apr 15, 2026
- Bulletin of Science and Practice
- Kh Anarkulov + 2 more
The article examines the phenomenon of giftedness within the context of the contemporary cultural and educational environment, drawing on psychological-pedagogical, cultural, and historical-pedagogical approaches. Based on an analysis of the works of Soviet, Russian, Kazakh, and international scholars, the content of the concepts “giftedness” and “gifted child” is clarified, and their connection with individual psychological characteristics, creativity, and engagement in activity is revealed. It is emphasized that giftedness cannot be reduced to high intelligence indicators and cannot be reliably identified through standard testing procedures; its recognition requires long-term pedagogical observation, individual analysis, and an understanding of the child’s inner state. The study traces the historical continuity of ideas about giftedness in the works of Kazakh educators of the 19th–20th centuries, where special importance is given to the mentorship model of “teacher–student” interaction and to the role of the teacher in unlocking the individual’s potential. It is shown that these ideas are reflected in contemporary theories of giftedness and in educational practice. Particular attention is paid to the analysis of regulatory and legal documents of the Republic of Kazakhstan aimed at identifying, supporting, and developing gifted children, as well as creating institutional conditions for their guidance. The necessity of a culturally determined, individualized, and activity-based approach to working with gifted children is substantiated. Giftedness is viewed as a developable personal resource and a significant societal potential that requires systematic pedagogical support within the modern education system.
- Research Article
- 10.22495/clgrv8i2p11
- Apr 13, 2026
- Corporate Law & Governance Review
- Maksat Yelikbay + 5 more
This article examines the institutional and legal aspects of combating corruption in the Republic of Kazakhstan through the prism of criminal law. It emphasizes that corruption undermines the foundations of statehood, disrupts the rule of law, and reduces public trust in government institutions, posing a threat to national security. Based on an analysis of legislation and strategic documents, as well as a comparative legal analysis with international standards, a comprehensive approach to reforming criminal legislation and strengthening the institutional infrastructure is proposed. The research demonstrates that the effectiveness of combating corruption largely depends on the consistency of criminal law regulation and the coherence of institutional mechanisms involved in the prevention, investigation, and prosecution of corruption-related offenses. A comparative analysis with international standards and foreign practices confirms the need to adapt national legislation to ensure greater legal certainty and uniformity of law enforcement practice. In conclusion, strengthening anti-corruption policy requires a comprehensive approach combining legislative reform, institutional development, and the formation of a sustainable anti-corruption culture. Improving investigative and judicial practices, enhancing preventive measures, and ensuring alignment with international anti-corruption standards may significantly increase the effectiveness of criminal law responses to corruption
- Research Article
- 10.1093/heapol/czag042
- Apr 7, 2026
- Health Policy and Planning
- Anuska Kalita + 16 more
Using evidence from nine countries (Democratic Republic of Congo, Dominica, Egypt, Kazakhstan, Kenya, New Zealand, Thailand, Tunisia, and Uruguay), we analyze the political economy dynamics that emerged during implementation of primary health care (PHC)-oriented reforms. Across these cases, we identify 10 recurring health-system “shifts” toward stronger PHC orientation, which serve as a descriptive framework for examining the political economy challenges reformers faced and the strategies they used to navigate them. Primary data were collected from 356 participants through key informant interviews, focus groups, and expert consultations and were triangulated with document review. Using deductive mapping and inductive thematic analysis, we identify 10 PHC-focused health-system shifts present in some or all of the cases. These entailed shifts from: (i) short-term initiatives with limited scope to long-term, system-wide transformations; (ii) centralized control to devolved multilevel governance; (iii) hospital-centric resource allocation to strategic reallocations favoring primary care; (iv) physician-dominated care to multidisciplinary teams including non-physician providers; (v) siloed disease-focused services to integrated models of comprehensive care; (vi) peripheral, minimally regulated private sectors to their integration and actively state-stewarded participation; (vii) passive input-based budget allocations and provider payments to strategic purchasing; (viii) perceiving citizens as passive recipients of care to building active community engagement; (ix) ad hoc data collection to embedded learning and accountability; and (x) externally driven changes to local ownership for reforms. Reforms routinely triggered political economy dynamics—opposition from physicians, hospitals, specialists, and central bureaucracies; citizen skepticism; and capacity and patronage challenges under devolution. Strategies to address these included: high-level endorsement and passage of legislation; use of political and economic windows of opportunity; local capacity-building; decentralized autonomy; formal engagement with physician associations; regulated private sector participation; strategic purchasing to incentivize a PHC approach; strong data systems and assessments; community engagement; and locally grounded design with domestic capacity and financing. The paper underscores the value of anticipating political economy dynamics for designing and implementing PHC-oriented reforms.