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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medecol</journal-id><journal-title-group><journal-title xml:lang="ru">Медицина и экология</journal-title><trans-title-group xml:lang="en"><trans-title>Medicine and ecology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2305-6045</issn><issn pub-type="epub">2305-6053</issn><publisher><publisher-name>Карагандинский медицинский университет</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.59598/ME-2305-6053-2026-118-1-170-179</article-id><article-id custom-type="elpub" pub-id-type="custom">medecol-1323</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРГАНИЗАЦИЯ И ЭКОНОМИКА ЗДРАВООХРАНЕНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORGANIZATION AND ECONOMICS OF HEALTH</subject></subj-group></article-categories><title-group><article-title>Анализ текущего состояния и перспективы сестринского дела в сфере первичной медико-санитарной помощи Республики Казахстан</article-title><trans-title-group xml:lang="en"><trans-title>Analysis of the current state and prospects of nursing in primary health care in the Republic of Kazakhstan</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Әләйдарова</surname><given-names>М. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Alaidarova</surname><given-names>M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Мереке Есенғалиқызы Әләйдарова</p><p>010000, г. Астана, ул. Бейбитшилик, 49А</p></bio><bio xml:lang="en"><p>Mereke Esengalikyzy Alaidarova</p><p>010000, Astana c., Beibitshilik str., 49A</p></bio><email xlink:type="simple">alaidarova.a@amu.kz</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Салтабаева</surname><given-names>У. Ш.</given-names></name><name name-style="western" xml:lang="en"><surname>Saltabaeva</surname><given-names>U. Sh.</given-names></name></name-alternatives><bio xml:lang="ru"><p>010000, г. Астана, ул. Бейбитшилик, 49А</p></bio><bio xml:lang="en"><p>010000, Astana c., Beibitshilik str., 49A</p></bio><email xlink:type="simple">mail@amu.kz</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Жаксылыкова</surname><given-names>Г. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Zhaksylykova</surname><given-names>G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>010000, г. Астана, ул. Бейбитшилик, 49А</p></bio><bio xml:lang="en"><p>010000, Astana c., Beibitshilik str., 49A</p></bio><email xlink:type="simple">mail@amu.kz</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Казангапова</surname><given-names>А. Д.</given-names></name><name name-style="western" xml:lang="en"><surname>Kazangapova</surname><given-names>A. D.</given-names></name></name-alternatives><bio xml:lang="ru"><p>010000, г. Астана, ул. Бейбитшилик, 49А</p></bio><bio xml:lang="en"><p>010000, Astana c., Beibitshilik str., 49A</p></bio><email xlink:type="simple">mail@amu.kz</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Байгенжеева</surname><given-names>Р. Қ.</given-names></name><name name-style="western" xml:lang="en"><surname>Baigenzheyeva</surname><given-names>R. K.</given-names></name></name-alternatives><bio xml:lang="ru"><p>010000, г. Астана, ул. Бейбитшилик, 49А</p></bio><bio xml:lang="en"><p>010000, Astana c., Beibitshilik str., 49A</p></bio><email xlink:type="simple">mail@amu.kz</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Уаққазы</surname><given-names>Ғ. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Uakkazy</surname><given-names>G. B.</given-names></name></name-alternatives><bio xml:lang="ru"><p>010000, г. Астана, ул. Бейбитшилик, 49А</p></bio><bio xml:lang="en"><p>010000, Astana c., Beibitshilik str., 49A</p></bio><email xlink:type="simple">mail@amu.kz</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ильясов</surname><given-names>Б. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Ilyassov</surname><given-names>B. B.</given-names></name></name-alternatives><bio xml:lang="ru"><p>010000, г. Астана, ул. Бейбитшилик, 49А</p></bio><bio xml:lang="en"><p>010000, Astana c., Beibitshilik str., 49A</p></bio><email xlink:type="simple">mail@amu.kz</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Тулеуова</surname><given-names>С. К.</given-names></name><name name-style="western" xml:lang="en"><surname>Tuleuova</surname><given-names>S. K.</given-names></name></name-alternatives><bio xml:lang="ru"><p>010000, г. Астана, ул. Бейбитшилик, 49А</p></bio><bio xml:lang="en"><p>010000, Astana c., Beibitshilik str., 49A</p></bio><email xlink:type="simple">mail@amu.kz</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Касымова</surname><given-names>Ф. Д.</given-names></name><name name-style="western" xml:lang="en"><surname>Kassymova</surname><given-names>F. D.</given-names></name></name-alternatives><bio xml:lang="ru"><p>010000, г. Астана, пр-т Туран, 34/1</p></bio><bio xml:lang="en"><p>010000, Astana c., Turan ave., 34/1</p></bio><email xlink:type="simple">fey_di@mail.ru</email><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Башарланова</surname><given-names>М. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Basharlanova</surname><given-names>M. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>10000, г. Астана, ул. Болекбаева, 5</p></bio><bio xml:lang="en"><p>010000, Astana c., Bolekbaeva str. 5</p></bio><email xlink:type="simple">marlan.b@mail.ru</email><xref ref-type="aff" rid="aff-5"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Райымқұл</surname><given-names>Ж. Ж.</given-names></name><name name-style="western" xml:lang="en"><surname>Raiymkul</surname><given-names>Zh. Zh.</given-names></name></name-alternatives><bio xml:lang="ru"><p>010000, г. Астана, пр-т Туран, 34/1</p></bio><bio xml:lang="en"><p>010000, Astana c., Turan ave., 34/1</p></bio><email xlink:type="simple">fey_di@mail.ru</email><xref ref-type="aff" rid="aff-4"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">Кафедра сестринского дела НАО «Медицинский университет Астана»<country>Казахстан</country></aff><aff xml:lang="en">Department of Nursing of Astana Medical University NC JSC<country>Kazakhstan</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru">Кафедра внутренней медицины №3 НАО «Медицинский университет Астана»<country>Казахстан</country></aff><aff xml:lang="en">Department of Internal Medicine No. 3 of Astana Medical University NC JSC<country>Kazakhstan</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru">Кафедра эпидемиологии и биостатистики НАО «Медицинский университет Астана»<country>Казахстан</country></aff><aff xml:lang="en">Department of Epidemiology and Biostatistics of Astana Medical University NC JSC<country>Kazakhstan</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru">АО «Национальный центр нейрохирургии»<country>Россия</country></aff><aff xml:lang="en">National Center for Neurosurgery JSC<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-5"><aff xml:lang="ru">Отделение общей практики клиники «City»<country>Казахстан</country></aff><aff xml:lang="en">Department of General Practice of City Clinic<country>Kazakhstan</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2026</year></pub-date><pub-date pub-type="epub"><day>05</day><month>07</month><year>2026</year></pub-date><volume>0</volume><issue>1</issue><fpage>170</fpage><lpage>179</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Әләйдарова М.Е., Салтабаева У.Ш., Жаксылыкова Г.А., Казангапова А.Д., Байгенжеева Р.Қ., Уаққазы Ғ.Б., Ильясов Б.Б., Тулеуова С.К., Касымова Ф.Д., Башарланова М.А., Райымқұл Ж.Ж., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Әләйдарова М.Е., Салтабаева У.Ш., Жаксылыкова Г.А., Казангапова А.Д., Байгенжеева Р.Қ., Уаққазы Ғ.Б., Ильясов Б.Б., Тулеуова С.К., Касымова Ф.Д., Башарланова М.А., Райымқұл Ж.Ж.</copyright-holder><copyright-holder xml:lang="en">Alaidarova M., Saltabaeva U.S., Zhaksylykova G., Kazangapova A.D., Baigenzheyeva R.K., Uakkazy G.B., Ilyassov B.B., Tuleuova S.K., Kassymova F.D., Basharlanova M.A., Raiymkul Z.Z.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://medecol.qmu.kz/jour/article/view/1323">https://medecol.qmu.kz/jour/article/view/1323</self-uri><abstract><sec><title>Введение</title><p>Введение. Первичная медико-санитарная помощь является базовым звеном системы здравоохранения, обеспечивающим доступность и непрерывность медицинских услуг. Сестринское дело играет ключевую роль в профилактике, уходе и сопровождении хронических заболеваний. Несмотря на реформы в здравоохранении, в Республике Казахстан сохраняются значительные проблемы: кадровый дефицит, дисбаланс распределения специалистов, недостаточная подготовка и ограниченные карьерные возможности.</p></sec><sec><title>Цель</title><p>Цель. Анализ современного состояния сестринского дела в системе первичной медико- санитарной помощи Республики Казахстан, выявление ключевых барьеров и обозначение перспективных направлений развития.</p></sec><sec><title>Материалы и методы</title><p>Материалы и методы. Выполнен обзор нормативных документов, статистических данных Министерства здравоохранения Республики Казахстан, а также публикаций в рецензируемых журналах (2010 – 2025 гг.). Проведено сопоставление с международным опытом внедрения расширенной сестринской практики.</p></sec><sec><title>Результаты и обсуждение</title><p>Результаты и обсуждение. В Казахстане работает около 121 000 медсестер, из них 65 000 – в системе первичной медико-санитарной помощи, при этом сохраняется дефицит 3 800 специалистов среднего звена. В сельских районах 1 медсестра обслуживает до 2 500 пациентов, что ведет к профессиональному выгоранию. С 2020 по 2023 г. заработная плата увеличилась на 20%, внедрено 45 стандартных операционных процедур и расширены магистратура и PhD-программы. Однако доля практики расширенной сестринской роли остается низкой: в Алматы лишь 0,4% медсестер консультируют самостоятельно. В 2024 – 2025 гг. реализованы новые программы обучения, внедряются цифровые технологии и симуляционные центры, что постепенно повышает качество подготовки и расширяет профессиональные функции медсестер.</p></sec><sec><title>Выводы</title><p>Выводы. Дальнейшее развитие сестринского дела требует комплексного подхода: повышения зарплат, обновления образовательных программ по международным стандартам, расширения полномочий медсестер и внедрения цифровых решений. Поддержка государства и интеграция лучших мировых практик позволят укрепить кадровый потенциал и повысить качество медицинской помощи на уровне первичной медико-санитарной помощи.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Introduction</title><p>Introduction. Primary health care underpins equitable access and continuity of services, forming the cornerstone of sustainable health systems. Nursing is central to Primary Health Care delivery, encompassing preventive services, patient care, and chronic disease management. Despite reforms in Kazakhstan, significant challenges persist, including workforce shortages, uneven distribution of personnel, insufficient educational standards, and limited career advancement opportunities.</p></sec><sec><title>Aim</title><p>Aim. To analyze the current state of nursing in Kazakhstan’s Primary Health Care system, identify systemic barriers, and outline development prospects in line with international benchmarks.</p></sec><sec><title>Materials and methods</title><p>Materials and methods. A narrative review was conducted of official reports from the Ministry of Health, national regulatory documents, and peer-reviewed publications (2010 – 2025). Comparative analysis with global advanced nursing practice models was performed.</p></sec><sec><title>Results and discussion</title><p>Results and discussion. Kazakhstan employs about 121,000 nurses, including 65,000 in Primary Health Care, but faces a shortage of nearly 3,800 mid-level staff. In rural areas, one nurse may serve up to 2,500 patients, leading to burnout. From 2020 – 2023, nurses’ salaries rose by 20%, 45 SOPs were introduced, and graduate nursing programs expanded. Yet advanced practice remains limited: in Almaty, only 0.4% of nurses provide independent consultations. In 2024, over 1,100 professionals (including 82 nurses) were trained for new PHC facilities, and 2,850 staff completed updated training. In 2025, the Ministry of Health declared the Year of Primary Health Care, mandating continuous training and digital integration. Positive shifts include simulation centers, distance learning, and digital tools that enhance education and broaden nurses’ roles.</p></sec><sec><title>Conclusion</title><p>Conclusion. Strengthening nursing in Kazakhstan’s Primary Health Care requires a comprehensive strategy: raising salaries, updating curricula to international standards, expanding nurses’ scope of practice, and integrating digital health solutions. Government support and international collaboration are critical to stabilizing the workforce and improving Primary Health Care quality and accessibility.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>первичная медико-санитарная помощь</kwd><kwd>дефицит медицинских кадров</kwd><kwd>профессиональное выгорание</kwd><kwd>реформа здравоохранения</kwd><kwd>медсестра расширенной практики</kwd></kwd-group><kwd-group xml:lang="en"><kwd>Primary Health Care</kwd><kwd>Health Personnel Shortage</kwd><kwd>Burnout</kwd><kwd>Professional</kwd><kwd>Health Care Reform</kwd><kwd>Advanced Practice Nursing</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Бейсенова Г.С., Айдарбекова Ж.Д., Ахметова Р.Л. Высшее сестринское образование в Казахстане: проблемы и перспективы развития. 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