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Poznań, Poland - Morasko Kampus, room: 3.160
Kin solidarity and informal payments in healthcare of post-Soviet Kazakhstan and Kyrgyzstan
It is often maintained in scholarly literature that corruption represents one of the main threats to the proper functioning of healthcare systems in post-socialists region and in post-Soviet countries in particular. Researchers describe the so-called informal payments – bribes and other forms of ‘reward’ for medical services in such states as post-socialists Hungary or post-Soviet Russia, Ukraine and Kazakhstan. However, while informal payments are often presented as a significant barrier to access care, it has been noticed that their complex nature and specific role in a given sociocultural context should be taken into account. In Kazakhstan and Kyrgyzstan, where reforms of the healthcare systems have not produced entirely satisfactory effects so far, such ‘extra-payments’ can be understood as a means to establish social ties with a good doctor, which is a kind of investment for the future and also a way to diminish uncertainty and common distrust of medical personnel. In addition, it should be remembered that people’s health-seeking strategies and ways of coping with illness have important social dimensions. In the case of Kazakhstan and Kyrgyzstan, a great role of the solidarity of relatives, and also friends, is observed when someone needs expensive medical assistance, and this is part of a wide system of informal reciprocal exchanges. This presentation will be based on my fieldwork in Almaty between 1995-2000 and in Bishkek between 2011-2013.