Inequality in the Distribution and Utilization of Healthcare Resources in Kazakhstan (2002-2023): A Spatiotemporal Analysis.

Global progress toward achieving universal health coverage (UHC) by 2030 remains insufficient, as significant regional disparities in access to healthcare persist. In Kazakhstan, the uneven distribution of healthcare resources continues despite reforms aimed at improving equity. This retrospective study analyzed inequalities in the distribution of medical infrastructure, healthcare personnel, and service utilization across 14 regions and 2 cities of republican significance from 2002 to 2023. Data were obtained from national statistical reports on healthcare and population income. The analysis included the following indicators: the number of primary care facilities, hospital beds, healthcare personnel, outpatient visits, and hospitalizations per population. Inequality was assessed using the Gini coefficient and the concentration index, and spatiotemporal trends were visualized through cluster analysis in ArcGIS PRO. Results revealed that southern and western regions exhibit lower availability of hospital beds and healthcare personnel, with moderate levels of inequality particularly evident in outpatient care. Despite Kazakhstan's commitment to UHC, these disparities underscore the need for further measures to ensure equitable access to healthcare services.