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ORIGINAL RESEARCH article

Front. Public Health
Sec. Public Health Policy
Volume 12 - 2024 | doi: 10.3389/fpubh.2024.1454420
This article is part of the Research Topic Public Health Challenges in Post-Soviet Countries During and Beyond COVID-19, Volume II View all articles

Interrupted Time Series Analysis of the Impact of the COVID-19 Pandemic and Compulsory Social Health Insurance System on Fertility Rates: A Study of Live Births in Kazakhstan, 2019-2023

Provisionally accepted
Indira Karibayeva Indira Karibayeva 1Sharapat Moiynbayeva Sharapat Moiynbayeva 2*Valikhan Akhmetov Valikhan Akhmetov 2Sandugash Yerkenova Sandugash Yerkenova 2Kuralay Shaikova Kuralay Shaikova 2Gaukhar Moshkalova Gaukhar Moshkalova 2Dina Mussayeva Dina Mussayeva 3Bibinur Tarakova Bibinur Tarakova 4
  • 1 Georgia Southern University, Statesboro, Georgia, United States
  • 2 Kazakhstan School of Public Health, Almaty, Kazakhstan
  • 3 Siberian State Medical University, Tomsk, Tomsk Oblast, Russia
  • 4 Kazakh National Medical University, Almaty, Kazakhstan

The final, formatted version of the article will be published soon.

    The COVID-19 pandemic triggered global health crises, affecting population health directly through infections and fatalities, and indirectly by increasing the burden of chronic diseases due to disrupted healthcare access and altered lifestyle behaviors. Amidst these challenges, concerns regarding reproductive health and fertility rates have emerged, necessitating an understanding of their implications for policymaking and healthcare planning. Furthermore, Kazakhstan's healthcare landscape underwent significant changes with the reintroduction of compulsory social health insurance system in January 2020, coinciding with the onset of the COVID-19 pandemic. This study aims to assess the impact of the COVID-19 pandemic and compulsory social health insurance system on fertility rates in Kazakhstan by examining live birth data from 2019 to 2024. Using Interrupted Time Series analysis, we evaluated the effect of the COVID-19 lockdown announcement and compulsory social health insurance system implementation on monthly birth rates, adjusted for the number of women of reproductive age from January 2019 to December 2023. In the final model, the coefficients were as follows: the effect of the COVID-19 lockdown was estimated at 469 (SE = 2600, p = 0.8576); the centering variable was estimated at 318 (SE = 222, p = 0.1573), suggesting no significant trend in monthly birth rates over time; the insurance effect was estimated at 7,050 (SE = 2,530, p < 0.01); and the effect of the number of women of reproductive age was estimated at -0.204 (SE = 0.0831, p = 0.01). The implementation of the compulsory social health insurance system, rather than the announcement of the COVID-19 lockdown, has had a significant positive impact on live birth rates in Kazakhstan. However, despite governmental efforts, live birth rates are declining, potentially due to unaddressed health needs of fertile women and economic challenges. Urgent policy-level actions are needed to address gaps in healthcare services and promote reproductive health.

    Keywords: COVID-19, fertility rates, Live Birth, maternal and child health, Kazakhstan

    Received: 25 Jun 2024; Accepted: 15 Aug 2024.

    Copyright: © 2024 Karibayeva, Moiynbayeva, Akhmetov, Yerkenova, Shaikova, Moshkalova, Mussayeva and Tarakova. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Sharapat Moiynbayeva, Kazakhstan School of Public Health, Almaty, Kazakhstan

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