Abstract
The COVID-19 pandemic significantly disrupted healthcare access worldwide, including in Kazakhstan, where healthcare disparities may have worsened. This study examines barriers to healthcare access during the pandemic and factors associated with failed access. A cross-sectional survey of 1021 adults was conducted in Kazakhstan between June and July 2021 using a multistage stratified sampling approach. Weighted analyses accounted for selection biases and non-response. Participants reported barriers to COVID-19-related care, access to healthcare services, and the mode of care received (in person, telemedicine, or not accessed). Fear of contracting COVID-19 (38.9%), hospitalization (24.7%), and isolation-related job or income loss (23.9%) were the most common barriers. Among those needing healthcare (n=753), 21.7 % failed to access services, particularly health products (31.7%), emergency care (21.6%), and inpatient medical care (20.2%). Failed access was significantly associated with chronic conditions (ARR 1.54, 95% CI 1.13–2.11), unemployment (ARR 1.70, 95% CI 1.12–2.57), and food insecurity (ARR 1.34, 95% CI 1.02–1.77). These findings highlight the need for targeted policies to ensure equitable healthcare access during public health crises, particularly for vulnerable populations.