Аңдатпа
The Compulsory Social Health Insurance system is a key mechanism for ensuring equitable access to healthcare services for all citizens. However, limited awareness and understanding of compulsory social health insurance particularly among rural populations -hinder its effective implementation. Improving the functioning of the Compulsory Social Health Insurancesystem and enhancing public health literacy are therefore essential priorities in strengthening Kazakhstan’s healthcare system. This study aims to examine the opinions of uninsured rural citizens regarding the Compulsory Social Health Insurance Fund, focusing on their awareness, perceptions, and the main barriers to participation. A qualitative research design with content analysis was applied. The study population included uninsured residents of the Terekti district, West Kazakhstan region. Semi-structured interviews consisting of seven open-ended questions were conducted among individuals attending the Terekti District Hospital. Sampling continued until data saturation was achieved, resulting in 12 participants. Data were analyzed using inductive and deductive approaches, with verbatim transcription of all interviews. Triangulation involving a scientific supervisor, a practical supervisor, and a graduate student was used to ensure the validity and reliability of the analysis. The analysis identified 10 codes, 7 categories, 7 subcategories, and 7 main themes. Rural residents demonstrated awareness of the importance of compulsory social health insurance and acknowledged its role in improving healthcare access. However, participation remained low due to several socio-economic and organizational factors. The main barriers included unemployment, unstable income, high contribution rates, insufficient information dissemination, and dissatisfaction or mistrust toward healthcare service quality and system management. Although rural residents recognize the significance of the Compulsory Social Health Insurance system, their engagement is limited by economic and informational constraints. Addressing these barriers through improved public awareness, financial flexibility, and better-quality medical services could enhance trust and participation in the system.Keywords:compulsory social health insurance, contribution,payment, rural residents.