To the detriment of women, children and the poor
The policy of structural adjustments has led to a sharp reduction of social expenditures and the collapse of the social services sector. Privatisation of social sector entities has failed. Firms offered for sale were not in good condition or in great demand, so investors did not bid on them. In addition, privatisation of health and education has reduced accessibility, and had a negative impact on the poor and on women and children in particular.
Privatisationin Kazakhstan started in 1991 and was carried out in several stages: the retailtrade and service sector from 1991 to 1992; the agro-industrial sector from 1993to 1995; fuel and energy, transport, health, education, science and culture from1996 on. Between 1991 and 1998, 17,070 entities were privatised; 3,276 werejoint stock companies and economic partnerships and 2,606 entities were in thesocial sector.In 2002 about 800 entities in the social sphere are slated to be privatised.
Before1991 state ownership of companies was more than 90%; currently it is 20%, whilethe share of private companies is 80%. In nearly all sectors of the economy theinfluence of the private sector is prevalent. In 1999 the share of the privatesector of the country’s GNP was 50%; 70-75% of industries and 95% ofbusinesses in agriculture and construction have been privatised.
Butrestructuring the economy has not led to more efficient businesses or services.The policy of structural adjustments has led to a sharp reduction of socialexpenditure and the collapse of the social services sector. For example,subsidies for housing and utilities, public transport and bread products havebeen abolished. The state revenue policy over the last years has stressed fiscaldiscipline as a way of combating inflation.
Atpresent, in connection with the programme on fighting poverty, there isdiscussion about subsidising the utilities sector and health system to reduceconsumer prices for services in these critical areas. At existing average incomelevels, half of the population is forced to choose between buying food andpaying utilities.
Onthe one hand, privatisation of social sector entities has failed. Firms offeredfor sale were not in good condition or in great demand, so investors did not bidon them. On the other hand privatisation does not guarantee improvements inperformance. Privatisation in the areas of health and education has reduced thepublic’s access to these services.
Privatehealth: inaccessible for the poorest
Privatisationin the health system is moderate: in 2001 the share of the private sector in thehealth system was 13.4%, including 11% of hospitals and 21.5% of outpatientclinics. The role of private medical institutions, funded from private sources,is limited, since the government covers most of the medical services provided tothe population. The privatisation of pharmacies has been more dramatic; morethan 57% of pharmacies have been privatised.
Thequality of private medical institutions and pharmacies, as a rule, is high.However, access to them for the lower income groups is limited because of highprices. State-provided medical services are generally of lower quality.According to a survey of 1,000 households conducted by the World Bank, the levelof satisfaction of the population in hospitals is 61%, in ambulance services56%, and in outpatient clinics 53%.
Thedeterioration of the education system
Between 1991 and 2001 the number of kindergartens incities was reduced by eight times (87.5%) andthe number of children in them by seven times (85.7%), whereas in the rural areas the situation is even worse: 23 times (95.6%) reduction of kindergartens and 30 times (96.7%) reduction of children in them.
An absenceof kindergartens (day nurseries) is typical for most villages. Currently 10.8%of children receive comprehensive pre-school education services; in rural areasonly 2.4% do.
Inthe public kindergartens that remain, fees have been introduced, the rates ofwhich, as with private kindergartens, are too high for poor families. There islimited access to services that are integrated with the pre-school programme,such as providing meals and primary medical and sanitary aid, includingvaccinations. This has a dual negative impact: children are not adequatelyprepared to start school and their mothers and grandmothers, who have to lookafter them and provide early education, must forgo other types of activitiessuch as income-generating jobs.
Secondaryeducation in Kazakhstan is obligatory. According to the World Bank survey, thelevel of satisfaction of respondents in state education services is as follows:primary school - 51%; secondary school - 55%; universities - 64%. “However,education services are perceived to be relatively corrupt, with 18% ofhouseholds saying corruption was very widespread… only the courts and thepolice were perceived to be more corrupt.”
Theworsening of the education system has an impact on families. Many servicespreviously provided through public schools, such as health and nutrition,nowadays have to be provided through the resources and efforts of the familiesthemselves. Since women are traditionally engaged in bringing up children,reduction of social services and access to them creates a greater burden onwomen. Growing poverty and reduced accessibility and quality of education makeit difficult for families to ensure a good education for their children. In suchsituations women have to re-orient their time toward their families, becomingforced housewives.
InSeptember 2001 there were 185 higher educational establishments, two thirds ofwhich were not state run. Non-state institutions enrol about 35% of studentsoverall. Sixty-seven percent of students of the state higher educationalinstitutions pay fees. There is a firm public opinion that a good qualityeducation can be provided only by the state controlled higher educationalestablishments; young people with less preparation study at private colleges anduniversities and corruption there is higher. Over the last years the process ofprivatisation of the higher educational establishments is being completedthrough incorporation, with sale of shares to the professors of theseinstitutions guaranteeing them further work there.
Thenegative impact of privatisation on women
Closuresor privatisation of the institutions providing utilities and social servicesmost directly infringes upon the interests of women and children, who are themain consumers of these services. Moreover, budget reduction and civil servicecuts in these areas, where the majority of employees are women, have also had anadverse impact on women’s employment and salaries.
Currentlythe system of granting of social benefits in Kazakhstan is being improved bytargeting assistance to more vulnerable groups. However, obtaining benefits forchildren and socially targeted assistance is often complicated by the need fordocumentation, which can be costly to obtain.
· Wages.In Kazakhstan,more women are working in areas directly related to provision of services (suchas health and social services, education, the hotel and restaurant business andfinance). Women workers tend to be concentrated in the very areas of the socialinfrastructure where salaries are being reduced because of inadequate budgets.
· Health.The low quality ofhealth among women is shown in the high percentage of anaemia (70%) due to poornutrition. This in its turn affects infant mortality. In environmentallyunfavourable zones the number of cancers has risen.
Worseningsituation of the rural population
Inrural areas the number of primary medical institutions has sharply decreased. Atthe beginning of 1999, 1,200 populated rural areas had no local medicalservices. Of the 5,400 primary medical and obstetric facilities and 1,810primary medical and obstetric health centres that provided medical aid topregnant women and nursing mothers in 1991, by 2001 there remained 4,700 and 441respectively. Such practices as vaccination, diagnostics, and preventiveexaminations have all but disappeared. According to the data of the NationalStatistics Agency, in 2001 over 31% of sick people had to travel at least fourkilometres to reach outpatient clinics or other centres to obtain medical aid.There are no ambulance services. In some cases women have to deliver theirchildren at home.
Ruralschools are particularly hard hit by withdrawal of state funding. One hundredthirty rural schools are in a state of emergency. Coal supply is a problem inwintertime. The sanitary conditions in many rural educational institutions(availability of toilets, access to water) do not meet acceptable standards,affecting the general conditions and health of children.
Deprivingpoor children of education leads to a further deepening of social inequality andperpetuates poverty to the next generation. The lack of educational andemployment opportunities in villages has caused a migration to larger towns ofmany people whose range of possible pursuits include both ordinary legal andsocially dangerous activities (such as commercial sex, drug traffic, robbery,sale of children). Daily violation of labour and other rights of economicallydisadvantaged groups is observed, with women being the most vulnerable.
Accordingto the data of a National Human Development Report survey of 1,800 households insix provinces (oblysy) of the country (Almaty, Atyrau, East Kazakhstan, Karaganda, NorthKazakhstan and South Kazakhstan), 61% of respondents can barely meet theirminimum material requirements. One-fourth of the respondents reported having tosell their property (clothes or furniture); 29.7% of respondents do not havewinter clothes for all members of the family; one-fourth do not have money foressential medicines; 49.2% buy fruits and vegetables only in season (in summer),when they are not expensive. Only 3.2% of rural people receive free medicalservices; 70% of respondents lack necessary medical services near their homes. Alittle more than a half of respondents expressed satisfaction with the qualityof medical care.
Themajority of rural people are dissatisfied with the quality of potable water(51.5%); only about 4% have hot water at home. Only 42.7% of rural communitieshave a centralised water supply. Fewer than one-third of houses in populatedareas have telephones. Moreover, in 2001 communication services were tending toreduce the number of telephone stations and increase service cut-offs to customers who are unable to pay.
Somesparsely populated rural areas are cut off from basic transport. In suchprovinces as Akmola, Kostanai and East Kazakhstan, 8.2%, 7.6% and 6.1% ofhouseholds indicate that they need to travel more than one hour to reach thenearest public transport stop. In 2001 disruptions in electricity supply ofhouseholds were noted as “very frequent” by 17% of rural households and as“frequent” by 25% of households. The most unstable situations were observedin Zhambyl (43.3%), Kzylorda (30.3%), Kostanai (27.8%) and Karaganda (16.5%).Over 91% of rural people in Zhambyl and over 56% of those in South Kazakhstansuffered from disruptions of their gas supply.
Atthis stage privatisation is viewed as a structural element of state policy withthe anticipated long-term benefits of a wider tax base, the generation of jobs,and the supply of local markets with goods and services of local producers.However, no social programmes are being introduced to analyse the consequencesof privatisation on the people or to improve the poor’s access to socialservices.
 Privatisation in the Republic of Kazakhstan. See: http:www.president.kz/articles/economy_container.asp?Ing=ru&art=privat
 World Bank. Kazakhstan: Governance and Service Delivery: A Diagnostic Report, 24 May 2002. See: http://www.worldbank.org.kz/pdf/KazGovEng.pdf
 United Nations Development Programme (UNDP). National Human Development Report. Kazakhstan, 2002, (in printing).