ACCESSIBILITY OF DENTAL CARE TO PREGNANT WOMEN IN ALMATY: AN ANALYSIS OF AWARENESS, ROUTING AND TARIFF POLICY
Madraimov N. Laktionova M. Kulmanbetov R. Baimuratova M. Julaev I.
1 October 2025
Georgian medical news
2025Issue 36773 - 80 pp.
INTRODUCTION: Despite the inclusion of dental examination in the screening package of the guaranteed volume of free medical care (GVFMC), the coverage of pregnant women with dental care in Kazakhstan remains extremely low. Untimely treatment, lack of awareness and financial barriers contribute to the deterioration of the oral cavity and the increased risk of pregnancy complications. MATERIALS AND METHODS: As part of the doctoral thesis, a survey of 455 pregnant women was conducted from September to December 2024 on the basis of voluntary informed consent. The authors questionnaire was used with questions about seeking dental care. The analysis included descriptive characteristics, medians and interquartile range, and comparison of index of caries according to the Kruskal-Wallis test. Additionally, a retrospective analysis of CSHI tariffs for 2020-2024 for key types of dental services was conducted, taking into account their importance for pregnant women and comparing them with clinical results. RESULTS: Only 17.6% of women went to the dentist during pregnancy, only 4.8% of them - for preventive purposes. The median index of caries was 6.0 (IQR: 5.0-7.0) for those who did not apply, and 2.0 (IQR: 2.0-3.0) - for those referred by an obstetrician-gynecologist, p<0.001. Despite the fact that 81.3% were registered before the 10th week, few people received preventive care, which indicates routing problems. Only 14% patients were fully informed, and 65% patients paid extra for treatment. Complaints were related to inattentive attitude (28%), insufficient qualifications (22%) and inconvenient schedule. The analysis of CSHI tariffs showed a slowdown in growth in 2024 after a jump in 2021-2023, which worsens the gap between real costs and service coverage. CONCLUSION: The study revealed low coverage, insufficient information and economic barriers. Interdisciplinary collaboration needs to be strengthened, routing needs to be improved, and tariff policies need to be reviewed.
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1Kazakhstan Medical University Higher School of Public Health, Republic of Kazakhstan, Almaty, Kazakhstan
2LLP Ls Clinic; Department of Public Health and Social Sciences of Medicine, Kazakhstan Medical University Higher School of Public Health, Almaty, Republic of Kazakhstan
Department of Pediatric Dentistry, Kazakh National Medical University named after S.D. Asfendiyarov, Republic of Kazakhstan, Almaty, Kazakhstan
4Aesthetic Gynecology Studio Chain EliteBeam, Republic of Kazakhstan, Almaty, Kazakhstan
1Kazakhstan Medical University Higher School of Public Health
2LLP Ls Clinic; Department of Public Health and Social Sciences of Medicine
Department of Pediatric Dentistry
4Aesthetic Gynecology Studio Chain EliteBeam
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