Abstract
ABSTRACT Aims To systematically evaluate the quality, accessibility and patient‐centred performance of primary healthcare services in Kazakhstan and to generate pooled quantitative estimates of key patient‐centred and system‐level outcomes, with specific attention to their implications for primary healthcare nursing practice, nurse‐led quality improvement and nursing policy. Design Systematic review and meta‐analysis conducted in accordance with PRISMA guidelines. Data Sources Scopus, Web of Science and PubMed were systematically searched for eligible studies published between January 2015 and December 2025. Review Methods Observational, cross‐sectional, mixed‐methods and interventional studies assessing PHC quality domains in Kazakhstan were included. Two reviewers independently screened studies, extracted data and assessed methodological quality using the Joanna Briggs Institute (JBI) appraisal tools for observational studies and the Cochrane RoB 2 tool for the cluster‐randomized trial. Random‐effects meta‐analyses were conducted for (1) patient‐centred outcomes and (2) system‐level PHC performance indicators. Statistical heterogeneity was assessed using the I 2 statistic, and publication bias was evaluated using funnel plots. Results Eight studies met the inclusion criteria and were included in the qualitative synthesis and meta‐analysis. Four studies contributed data on patient‐centred outcomes, yielding a pooled patient satisfaction proportion of 0.56 (95% CI: 0.53–0.59; I 2 = 48.7%). Four studies reported system‐level performance indicators, with a pooled estimate of 0.64 (95% CI: 0.52–0.75; I 2 = 98.4%). Funnel plots were used for descriptive purposes only and were interpreted cautiously, as each meta‐analysis included only four studies, making reliable assessment of publication bias not feasible. Conclusion This systematic review and meta‐analysis provides the first consolidated quantitative assessment of PHC quality in Kazakhstan. While patient satisfaction and system‐level performance appear moderate, substantial heterogeneity and regional disparities remain. Strengthening PHC quality will require standardized performance indicators, enhanced digital health integration and targeted interventions to reduce urban–rural inequalities. Impact The findings of this study have important implications for clinical nursing practice and healthcare management. Given the central role of primary healthcare nurses in patient communication, care coordination, chronic disease monitoring, and preventive services, the identified gaps in patient satisfaction and system‐level performance highlight key areas for nursing‐led improvement. Enhancing nurse involvement in patient education, continuity of care, and service accessibility may contribute to improved patient experiences and health outcomes. These findings support the need for strengthening nursing capacity, expanding nurse‐led models of care and integrating nursing perspectives into PHC quality improvement strategies within Kazakhstan's evolving healthcare system. Patient or Public Contribution Not applicable.