Monday, 07 November 2022

President Tokayev Moves Ahead in Social Reforms Featured

Published in Analytical Articles

By Svante E. Cornell and Albert Barro

 

November 7, 2022

 

In his September 2022 address to the nation, President Kassym-Jomart Tokayev spent an inordinate amount of time on social issues, and in particular on reforms in the education and healthcare sector. This stems directly from the growing inequities in the provision of services in the country, where rural and remote areas in particular do not benefit from the same level of service provision as larger cities. The social reforms introduced by President Tokayev aim at correcting these problems, but their success will be dependent on the broader political reforms that intend to change the relationship between citizen and state in Kazakhstan. 

Kazakstan flag small

BACKGROUND: For over a decade, Kazakhstan has been accelerating its efforts to implement far-reaching reforms to accelerate the development of the country. Much of the attention on these reforms have focused on the political and economic aspects of reforms, which have been significant indeed. Under President Nursultan Nazarbayev, Kazakhstan launched several large reform programs, most notably Kazakhstan-2050. But President Nazarbayev prioritized economic reforms, while seeking to delay political reform until the economic situation had improved. This was understandable given the difficult geopolitical situation of Kazakhstan. However, it gradually became clear that important obstacles to both economic and social reform laid in the political realm – such as the continued prevalence of a mentality and culture in state institutions that prioritized the state before the citizen, rather than seeing the purpose of state institutions to be to provide services to the citizen. Associated with this institutional culture was problematic management and a tolerance for corruption. President Kassym-Jomart Tokayev, upon taking power in 2019, called attention to these problems, and immediately resolved to push political reform alongside economic and social reform. Following the unrest of January 2022, furthermore, President Tokayev launched yet another package of far-reaching political reform. 

This, however, does not mean that social reform is being ignored, nor that it should be. As has been seen in instances of public dissatisfaction over recent years, social issues are at the heart of the concerns of the population of Kazakhstan – a population that saw great improvements in living standards from 1992-2008, but somewhat of a stagnation since then. Having achieved middle-income status, many Kazakhstanis now focus increasingly on the quality and accessibility of education, healthcare, and social protection.

In the education sector, Kazakhstan has a history of large and comparatively successful reforms. The Bolashak program, launched almost immediately following independence, provided opportunities for high-achieving students to study abroad, and over ten thousand have done so. But Kazakhstan’s reforms have not focused solely on higher education. One of the most successful programs has seen the rollout of preschool education, and efforts to improve the status, pay, and training of teachers in primary and secondary education. Kazakhstan joined the Bologna process, and the implementation of international standards has done a lot to improve the education system. 

Kazakhstan also invested in elite institutions – the Nazarbayev Intellectual Schools and Nazarbayev University, which have catered to high-achieving students. These institutions have obtained ample resources and have been highly successful – NIS scores in PISA tests, for example, are high above the average in OECD countries. Kazakhstan’s difficulty has been to replicate this success across the width of the education system. Access to education in rural and remote areas remains difficult. And whereas NIS and NU have benefited from academic and financial autonomy, the same is not the case for regular schools, whose principals have much less freedom to run their institutions the way they see fit. In other words, the rest of the public school systems suffersfrom immense state bureaucracy. And regular schools – particularly in rural and remote areas – lag far behind the NIS in standardized testing. This should come as no surprise given the disproportional part of the education budget that is allocated to the NIS and NU.

Healthcare reforms in Kazakhstan are in many ways similar to the education sector. Certain reforms have aimed very high and proven remarkably successful. Capabilities at the high end have been developed, including a medical school at Nazarbayev University, advanced cancer treatment and research, and the development of an indigenous pharmaceutical industry. In addition, Kazakhstan has rolled out a compulsory health insurance system that is sustainable in the long run.

In the field of social protection, Kazakhstan has succeeded in putting in place an adequate system to protect the unemployed, the disabled, as well as mothers and children. In addition, a strong and sustainable pension system has been introduced. Still, the country faces challenges: an aging population will complicate matters, and the continued persistence of high-level corruption and mismanagement of assets and investments is a matter that requires attention.

IMPLICATIONS: In his September 1, 2022, address to the nation, President Tokayev acknowledged the priority put by the population on social issues, and focused considerable attention to reforms in the social sector that would improve education, healthcare and social protection and in particular provide a more equitable delivery of services in these areas to the population. 

In the education sector, the question going forward is to what degree the NIS and NU model can be replicated in the rest of the education system – which does not benefit from having selected the best students and given them the most resources. Human resources are a particular challenge: finding qualified teachers for the needs of Kazakhstan has proven difficult, and is made even harder by the government ambition to develop trilingualism: that not only should Kazakh, Russian and English be taught, but that certain subject matters should be taught in these languages. While the initiative is laudable, in practice the country lacks teachers with language skills to be able to teach in all three languages. This suggests that some initiatives in the education sector may have been overly ambitious.

In his address, President Tokayev announced an initiative to create 800,000 student places that “meet modern requirements.” He then addressed the need to reduce the difference of quality of educational infrastructure in urban and rural areas, and promised that funds seized by the state as a result of the struggle against corruption – i.e. proceeds of illegal activity – would be allocated to the construction of secondary schools. In addition, he emphasized the importance of technical and vocational educational institutions that focus on the real needs of the labor market – i.e. seeking to retool this sector to be demand-driven and match the graduates with the needs of the Kazakh economy. 

In a major initiative, Tokayev announced the creation of personal education vouchers through unified educational accounts. This voucher program would revolutionize the financing of education, tying money to the student rather than to the physical school – and changing incentive structures for school administrators to deliver quality services to students. Though President Tokayev did not specify it, such a voucher system is normally tied to a broader school choice system, which often allows parents to choose privately run schools, such as charter schools, thus providing competition to public schools. While such efforts have been politically controversial in many countries, many U.S. states and a dozen OECD members have allowed school choice and voucher systems in order to reform a problematic public education sector. Similarly in the higher education sector, President Tokayev focused on financing: making available higher education grants to high-scoring students and concessional loans for higher educations to a broader public in order to be able to attend higher education.

In the healthcare sector, just as in the education sector, Kazakhstan’s challenge is to scale the advances that have been made to meet the needs of society as a whole. One challenge has been to provide adequate primary healthcare services that run independently of major hospital systems. Another has been to train enough medical staff to provide adequate coverage of the population. Indeed, Kazakhstan needs to double the ratio of doctors per capita to meet the OECD average. In particular, providing adequate access to medical services in rural and remote areas has proven difficult to implement. 

Still, the advances are visible. Before the pandemic, Kazakhstan saw rapidly improving life expectancy numbers, reaching 73 years, a strong improvement over numbers in the 1990s. While the pandemic was a temporary setback, the country also learned valuable lessons on the weaknesses of its healthcare system.

Concerning healthcare, President Tokayev lamented the division of medical care into state-guaranteed and insurance-covered packages, and spoke of the need to “finally launch a system of voluntary health insurance.” Mostly, however, he focused on the inequalities in the healthcare system, particularly concerning rural areas. He called for a “national project aimed at the needs of the rural population” to be launched in 2023, aiming at building and equipping medical and obstetric stations in 650 villages lacking medical facilities over two years, thus providing access to primary care for over a million citizens. In addition, 32 district hospitals will be modernized to provide more advanced care for rural areas.

CONCLUSIONS: Kazakhstan has conducted considerable work in the social sector to develop into a high-middle income country, responding to the population’s needs and providing conditions for the further human development of the population. This work should be commended, but there is much work left to be done, in conditions that are far from ideal.

Social reforms are intimately connected with the broader reform agenda that President Tokayev has made into a centerpiece of his presidency. It is true that the social reforms build on policies that were advanced in the 2000s and even the late 1990s. But the success of social reforms will depend in no small part on the development of the broader management system in the country and on the nature of Kazakhstan’s state institutions. All reforms in education, healthcare and social protection would be unable to fulfill their potential if the Kazakh state continues to feature remnants of the Soviet state mentality – institutions riddled with mismanagement and corruption, and whose personnel harbor a view of state-society relations that prioritizes the state at the expense of society. 

President Tokayev’s political reforms aim squarely at changing this logic, and to develop instead a new mentality in state institutions in which the state exists not for its own sake, but to provide services to the population of the country. Because much of the social sphere is under the umbrella of the state, this shift in mentality – itself directly linked to the political reforms being implemented – is absolutely crucial for the long-term success of reforms in the social sphere as well.

Svante E. Cornell is Director and Albert Barro a Project Associate with the Central Asia-Caucasus Institute & Silk Road Studies Program.

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The Central Asia-Caucasus Analyst is a biweekly publication of the Central Asia-Caucasus Institute & Silk Road Studies Program, a Joint Transatlantic Research and Policy Center affiliated with the American Foreign Policy Council, Washington DC., and the Institute for Security and Development Policy, Stockholm. For 15 years, the Analyst has brought cutting edge analysis of the region geared toward a practitioner audience.

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