Kazakhstan Plans Healthcare Pay Rise for 77,000 Workers From January 2027

Experienced rural doctors could receive 760,000 tenge a month

Kazakhstan plans to increase pay for more than 77,000 primary healthcare workers from January 1, 2027, with government salary projections showing that the most experienced general practitioners in rural areas could receive 760,000 tenge a month, up from 534,000 tenge.

President Kassym-Jomart Tokayev instructed the Government to raise salaries for district healthcare specialists by up to 40%, depending on their continuous service. The instruction forms part of a broader effort to strengthen local clinics, expand the responsibilities of general practitioners and gradually increase funding for primary healthcare.

The Health Ministry has outlined proposed supplements of 20%, 30% and up to 50% of base salary, depending on experience. Tokayev's instruction refers to salary increases of up to 40%, while the ministry's proposed maximum supplement is 50% of base salary. The final calculation rules, including how those percentages fit together and how breaks in service would be treated, have yet to be explained.

For patients, the intended change is practical: keeping experienced doctors and nurses in the clinics and rural medical facilities where people first seek help. Primary healthcare includes assessing symptoms, detecting disease early and regularly monitoring people with long term conditions.

Health Minister Akmaral Alnazarova said the priority was improving the quality and availability of care in urban polyclinics and rural outpatient facilities. The ministry is placing particular weight on retaining staff in rural communities, where replacing an experienced practitioner can be difficult.

How the proposed service supplements would work

The Health Ministry's proposed scale rewards uninterrupted service rather than giving every eligible worker the same percentage increase. A base salary is the amount attached to a position before other payments are added. A supplement calculated from that base can therefore differ from the percentage increase in a worker's total earnings.

The proposed thresholds are:

• More than two years of continuous service: a supplement equal to 20% of base salary.
• More than three years of continuous service: a supplement equal to 30% of base salary.
• More than five years of continuous service: a supplement of up to 50% of base salary.

The wording matters for someone approaching an anniversary at work: the proposals say more than two, three or five years. The ministry also gives salary projections for staff with the least experience, indicating that increases are envisaged beyond the longest serving group.

The policy covers district services within primary healthcare, including general practitioners and nursing staff. These are the teams responsible for providing care to the population attached to a local clinic or medical facility.

What the largest projected increases mean

The Health Ministry estimates that rural general practitioners with the longest service could see monthly salaries increase from 534,000 to 760,000 tenge. That is an additional 226,000 tenge, or about 42.3% of the current projected salary.

Urban general practitioners in the same experience category could receive 607,000 tenge instead of 425,000 tenge. The difference is 182,000 tenge a month, approximately 42.8%.

For experienced nursing and other staff in the ministry's middle medical personnel category, the rural projection rises from 284,000 to 401,000 tenge. In cities, the corresponding figures are 224,000 and 318,000 tenge. Those increases amount to 117,000 and 94,000 tenge respectively, or roughly 41% to 42%.

The ministry presents these figures as possible salaries after the new payments are introduced. Actual earnings would depend on a worker's position, location and eligible service.

What less experienced staff could receive

Rural general practitioners in the ministry's lowest experience category could receive 450,000 tenge a month, compared with 386,000 tenge before the change. Urban doctors in that category could move from 307,000 to 358,000 tenge.

Those increases are 64,000 tenge in rural areas and 51,000 tenge in cities, both approximately 16.6%. The projected percentage gains are smaller than those for the most experienced doctors, reflecting the policy's focus on rewarding continued service.

Rural nursing and other middle medical personnel with the least experience could see pay rise from 221,000 to 256,000 tenge. Their urban counterparts could receive 202,000 tenge instead of 173,000 tenge. These represent increases of 35,000 and 29,000 tenge a month.

The location gap would remain substantial. Under the projections, an experienced rural general practitioner would receive 153,000 tenge more each month than an experienced urban practitioner, compared with a current gap of 109,000 tenge. Kazakhstan's public pay system already includes additional payments for some medical workers serving rural areas.

Why retaining clinic teams is the priority

Alnazarova has linked the proposed payments directly to the strength of the primary healthcare workforce. Her explanation places the experience of doctors and district nurses at the centre of the effort to improve services.

The health minister described the purpose of the measures in these terms:

Our priority is improving the quality and accessibility of care for the population in polyclinics and rural outpatient clinics, which depends on the qualifications and experience of general practitioners and district nurses.

For a patient with a chronic condition, a stable clinic team can mean seeing a practitioner who already knows their medical history, previous treatment and monitoring needs. The ministry expects the supplements to encourage experienced staff to remain in these jobs and help reduce shortages.

Lyazzat Toktybayeva, a general practitioner at Astana City Polyclinic No. 8, also sees higher salaries as a way to attract younger people to medicine and help experienced doctors stay in the profession. Her assessment connects recruitment with retention: clinics need new entrants, but they also need established staff who can support them.

Toktybayeva advocates mentoring, support for young practitioners and better working conditions in rural areas alongside higher pay. Those measures address the day to day reasons a doctor might choose to remain in a particular clinic.

Broader responsibilities need equipment and time

Tokayev's instruction includes expanding the authority of general practitioners and gradually increasing primary healthcare funding. Giving these doctors more responsibility could allow more medical decisions to be made at the first point of contact, reducing some journeys and referrals for patients.

Toktybayeva explained how a broader role could work when doctors act within their professional competence:

If doctors' powers are expanded within their competence, many issues can be resolved at the primary healthcare level. This will allow patients to save time and may reduce the workload on specialist doctors.

The Astana doctor said wider responsibilities should come with suitable technical equipment, further training and adjustments to workload. She also called for simpler information systems and less paperwork so that doctors can spend more of their working time with patients.

Her priorities include more screening, better monitoring of chronic conditions, easier access to laboratory tests and modern diagnostic equipment in clinics. Screening means checking for signs of disease before symptoms appear, making prevention and early treatment a larger part of a clinic's work.

Budget reserves are a possible funding route

Askhat Aimagambetov, identified as a Kurultai deputy, said budget reserves could finance the increases. He pointed to two possible sources: the Government reserve and a reserve for presidential initiatives.

Aimagambetov said the draft budget was before parliament and that amendments could allow the payments to begin on January 1, 2027. He also referred to experience and qualifications when discussing how increases would vary between workers.

The deputy presented reserve funding as a possible route for implementing the instruction. He did not give a total cost for the healthcare pay package or specify an allocation from either reserve.

The broader wage announcements also included a proposed increase in Kazakhstan's minimum wage from 85,000 to 110,000 tenge, although a figure of 100,000 tenge was also cited for the same January change. The announcement using 100,000 tenge put the number of beneficiaries at 1.8 million people, including more than 370,000 public sector workers. The Government will need to confirm the intended minimum wage figure.

Other medical workers are also in line for support

The Health Ministry is considering separate payments for psychologists and social workers in primary healthcare to recognise the emotional demands of their work. Those proposals concern the strain involved in supporting people through difficult personal, health and social circumstances.

The ministry says medical salaries have been increasing in stages since 2021. It also identifies higher payments from the beginning of 2026 for approximately 24,000 infectious disease service specialists and 9,000 ambulance workers.

Together, those two groups account for about 33,000 workers. The planned district service measure would cover more than 77,000, making its stated reach more than twice as large. The figures describe different programmes and should be considered separately when assessing their coverage.

The sequence of measures is:

• 2021: The Health Ministry says staged increases in medical workers' pay began.
• Beginning of 2026: Higher payments were provided for approximately 24,000 infectious disease staff and 9,000 ambulance workers.
• October 28, 2026: Tokayev's annual address, titled Current Tasks of Kazakhstan in a New Historical Cycle, included the instruction to raise district healthcare pay.
• January 1, 2027: The planned start date for the new district service salary increases.

What changes for workers and patients

Experienced district doctors and nurses stand to receive the largest projected cash increases. Rural general practitioners at the top of the experience scale could gain 226,000 tenge a month, while the projected increase for their least experienced rural colleagues is 64,000 tenge.

Patients would encounter the reform through staffing and services rather than through the payroll rules themselves. The ministry's aim is to keep skilled teams in clinics and rural facilities, while broader responsibilities for general practitioners could bring more care closer to home.

Toktybayeva's recommendations identify the practical work accompanying that ambition: reducing excessive workloads, improving equipment, supporting younger staff and making tests more accessible. The salary proposals and those workplace changes address different parts of the same staffing problem.

Key Points

• Kazakhstan plans salary increases for more than 77,000 district primary healthcare workers from January 1, 2027.
• Tokayev instructed the Government to raise pay by up to 40%, depending on continuous service.
• The Health Ministry proposes supplements of 20%, 30% and up to 50% of base salary at different service thresholds.
• Experienced rural general practitioners could receive 760,000 tenge a month; their urban counterparts could receive 607,000 tenge.
• Less experienced doctors and nursing staff are also included in the ministry's salary projections.
• Budget reserves have been suggested as a funding source, while additional support for primary healthcare psychologists and social workers remains under consideration.