Gendered Burden in Family-Based Informal Care for Older Adults in Kazakhstan

Background

Informal caregiving is central to long-term care, especially where formal services are limited. In Kazakhstan, rapid population ageing and underdeveloped formal care place disproportionate responsibility on families, highlighting potential gender inequalities. This study aims to assess care-related burden and quality of life among informal caregivers providing care to older adults in Kazakhstan.

Methods

A cross-sectional study was conducted in four Kazakhstani cities (January-July 2023) with 400 informal caregivers. Data were collected via the iVICQ questionnaire, including CarerQol-7D, CarerQol-VAS, and Caregiver Strain Index plus (CSI+). Multivariate regression analyses identified predictors of quality of life and caregiver burden.

Results

Caregivers’ mean age was 42.7 ± 12.7 years, most were women (79.3%), family members (81.8%), with higher education (52.3%). Mean CarerQol-7D was 87.2 ± 49.5, CarerQol-VAS 8.1 ± 1.9. Nearly half (47.3%) reported burden, 15.3% experienced high burden (CSI+). Key challenges included physical health, financial strain, daily activity limitations, and relationship difficulties. Female caregivers had higher odds of burden (OR = 4.87, 95% CI: 1.38–17.10). Caregiver health and caregiving hours also predicted burden. Higher care-related quality of life correlated with better caregiver and recipient health, while Kazakh ethnicity was linked to higher quality of life and lower burden, suggesting protective cultural and family support.

Conclusions

Informal caregiving in Kazakhstan imposes substantial burden, with women disproportionately affected. Cultural factors may buffer some negative impacts, but reliance on informal care raises sustainability concerns. Integrating caregiver assessment into routine care and developing gender-sensitive, community-based support, including respite care, is essential to reduce inequalities and enhance caregiver well-being.

Key messages

• Caregiving in Kazakhstan is highly gendered, women face disproportionate burden.

• Gender-sensitive, culturally adapted support and respite services are critical to strengthen long-term care and improve caregiver outcomes.