Background: No comprehensive short-form health literacy (HL) survey tool has been available for general use across Asia. Objective: This study aimed to develop and validate a short-form HL instrument derived from the 47-item European Health Literacy Questionnaire (HLS-EU-Q47). Methods: A population survey ( N = 10,024) was conducted from 2013 to 2015 using the HLS-EU-Q47 in 1,029 participants from Indonesia, 1,845 from Kazakhstan, 462 from Malaysia, 1,600 from Myanmar, 3,015 from Taiwan, and 2,073 from Vietnam. Validation of the short form was evaluated by principle component analysis, internal consistency, Pearson correlation, and regression analysis. Key Results: Based on responses from six countries, a 12-item short-form HL questionnaire (HLS-SF12) was developed, retaining the conceptual framework of the HLS-EU-Q47 and accounting for the high variance of the full-form (i.e., 90% in Indonesia, 91% in Myanmar, 93% in Malaysia, 94% in Taiwan, and 95% in both Kazakhstan and Vietnam). The HLS-SF12 was demonstrated to have adequate psychometric properties, including high reliability (Cronbach's alpha = .85), good criterion-related validity, a moderate and high level of item-scale convergent validity, no floor or ceiling effect, and good model-data-fit throughout the populations in these countries. Conclusions: The HLS-SF12 was shown to be a valid and reliable tool for HL surveys in the general public in six Asian countries. [ HLRP: Health Literacy Research and Practice . 2019;3(2):e90–e102.] Plain Language Summary: A health literacy survey was conducted from 2013 to 2015 in six Asian countries using the European Health Literacy Questionnaire (HLS-EU-Q47). The collected data were used to develop and validate a comprehensive short-form questionnaire. A health literacy questionnaire with 12 items (HLS-SF12) that retains the original conceptual framework of the HLS-EU-Q47 was demonstrated to be reliable and valid.

A survey of 1 194 respondents aged 45+ living in Almaty (Kazakhstan) to assess satisfaction with the quality of medical care was conducted. Specially trained interviewers visited respondents at home and filled questionnaires, which included questions on socio-demographic characteristics, the characteristics of medical care during the past year, bad habits, self-assessment of health, trust to doctors and the respondent's opinion on quality of health care. Binary logistic regression was used to analyze the data. Adjustment was performed for socio-demographic characteristics of respondents and the peculiarities of medical care. Altogether, 55.7 % (95 % CI 52.9; 58.5) of respondents were not satisfied with the quality of medical care. In multivariable analysis dissatisfaction with the quality of health care was associated with education, income, and self-, but the most influential factor was distrust of doctors (OR = 19, 95 % CI 12; 30). Thus, measures aimed at increasing the trust in doctors, especially the development of personalized medicine, have a potential increase the degree of satisfaction of the population with the quality of medical care. This study can serve as a start point for a panel study to monitor population's satisfaction with the quality of health care.

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The aim of research: To conduct a comparative analysis of pathologies included in the List of orphan (rare) diseases in Kazakhstan for 2015 and 2020 with a further assessment of the dynamics of changes in the structure of the included diseases. Methods. In this paper, by using logical, systematic, and documentary analysis, a comparative analysis of the current legislation on the regulation of the treatment of orphan diseases in the Republic of Kazakhstan was carried out, as well as a comparative analysis of changes in this legislation. The data was used for 2015 and 2020. Results. Within the framework of the Order "On approval of the List of Orphan (Rare) Diseases" of the year 2015, this List included patients with the following diseases: (C) various types of neoplasms (this group included 16 nosologies, which is 32% of the total number of the included diseases), (E) diseases of the endocrine system, eating disorders and metabolic disorders (9 nosologies were included, the coverage rate was 18%), (D) diseases of the blood, hematopoietic organs and individual disorders involving the immune mechanism (8 nosologies were presented, which accounted for 16% of the total coverage of the included diseases), (G) diseases of the nervous system (total-4 nosologies, 8% of the total coverage), (A-B) some infectious and parasitic diseases (Anthrax, Crimean hemorrhagic fever, Malaria, Leishmaniasis – 4 nosologies, 8% of the total coverage), (Q) Congenital anomalies, deformities and chromosomal abnormalities (there are 3 nosologies, 6% of the total number), (M) Diseases of the musculoskeletal system and connective tissue (there are 2 nosologies, 4% of the total number of nosologies covered) and 1 disease according to the ICD-10 codes: (I) Diseases of the circulatory system, (J) Diseases of the organs, (K) Diseases of the digestive system, (L) Diseases of the skin and subcutaneous tissue. In 2020, the List of orphan diseases and medicines for their (orphan) treatment was updated. According to the new document, 62 groups of nosologies were already covered, that is 12 nosologies more than in 2015 and which accounts for 12%. The ratio of nosology coverage has not changed over time. Conclusions: In conclusion, it should be noted that due to the economic and political changes carried out in the field of health care in Kazakhstan over the past ten years, the coverage of medical care for patients with orphan diseases is constantly increasing. The drug supply of the corresponding categories of patients is also growing. The updated Code and by-laws will contribute to strengthening the health of the nation, including patients with rare (orphan) diseases. It is worth noting that an important factor is the development and approval of rules for the formation of the List of orphan diseases and medicines for their treatment with certain selection criteria. Thus, undoubtedly, there is an improvement in the dynamics of access to medical care for patients with orphan diseases in the Republic of Kazakhstan. Keywords: Orphan diseases, Rare diseases, Orphan medicines, Drug policy, Kazakhstan.