Аңдатпа
Objective. To assess the level of healthcare-associated infections (HAIs) during cesarean section and obstetric services in maternity facilities in Kazakhstanfor2024, and to identify the main determinants and the effect of seminar-based training.Methods. An observational analytical study was conducted using official 2024 regional statistics from all 17 oblasts and 3 cities of republican significance (n=20). Indicators included the number of deliveries, cesarean sections, overall obstetric complications per 1000 deliveries, and cesarean-related infectious complications per 1000 cesarean sections (HAIs). Data were analyzed in R (v4.5.2) using correlation analysis, regression modeling, and clustering (K-means and hierarchical clustering). Group differences were assessed using the Kruskal–Wallis test for continuous variables and the chi-square test for categorical variables. Data were analyzed in aggregate form without personal identifiers.Results. Substantial regional heterogeneity was identified. The highest overall complications per 1000 deliveries were observed in North Kazakhstan (0.900), West Kazakhstan (0.828), Abai (0.695), and Pavlodar (0.687). Cesarean-related HAI rates per 1000 cesarean sections were highest in North Kazakhstan (3.839), Abai (2.996), Pavlodar (2.573), and West Kazakhstan (1.942). K-means and hierarchical clustering consistently classified regions into three groups: (1) moderate delivery volumes and generally lower HAI burden; (2) large cities and southern regions with high delivery and cesarean volumes and mixed infection indicators; (3) regions with intermediate profiles. In correlation analysis, HAI occurrence was strongly associated with reported violations of asepsis/antisepsis, hand hygiene, and disinfection/sterilization requirements (r=0.72–0.80). Regression modeling explained 74.5% of HAI variability (R²=0.745), with asepsis/antisepsis and disinfection/sterilization violations showing the strongest contribution. The number of staff who completed infection-control seminars showed no statistically significant association with HAI indicators (r=0.03; p>0.6).Conclusions. HAIs in maternity facilities in Kazakhstan demonstrate marked regional differences, with the highest burden concentrated in North Kazakhstan, West Kazakhstan, Pavlodar, and Abai. The leading determinants were non-compliance with aseptic practices and failures in disinfection/sterilization processes, while seminar-based training as currently implemented did not show measurable impact. Strengthening practical IPC compliance, auditing critical procedures, and adopting region-specific prevention strategies are essential to reduce HAIs in obstetric care.Keywords:healthcare-associated infections,maternity facilities,cesarean section,infection prevention and control (IPC),regional analysis,Kazakhstan,clustering,regression analysis,training effectiveness.