Zhuldyz Asanova

Type of the article: Research Article

Abstract
The purpose of this study is to determine the socio-economic and demographic factors of intra-regional inequality in Kazakhstan and their implications for cluster-based innovation in healthcare. A hybrid approach has been used, consisting of a systematic review of 181 publications using the PRISMA 2020 protocol and econometric analysis of the 2001–2024 panel data for the districts of Kazakhstan, consisting of 3,842 observations. Fixed-effects, cluster-robust, and hierarchical mixed-effects models were employed using standardized variables of population size, fertility, mortality, migration, criminality, and investments. The results reveal that the strongest and most robust predictor of intra-regional inequality in Kazakhstan is investment in fixed capital (β = 0.466, p < 0.01; β = 0.399, p < 0.01). Population size has consistently negative effects on intra-regional inequality in Kazakhstan (β = –0.240 to –0.256, p < 0.05 and p < 0.01). In the multilevel model, fertility increases intra-regional inequality in Kazakhstan (β = 0.114, p < 0.01), whereas mortality and net migration decrease it (β = –0.150 and β = –0.037, p < 0.01). The model explained 37.1% of the variance in intra-regional inequality in Kazakhstan (R2 = 0.371). The results suggest that without balanced investment and territorially differentiated policies, cluster-based innovation in healthcare can even reinforce rather than alleviate regional disparities.

Acknowledgment
This paper was carried out within the framework of the following grant projects funded by the Science Committee of the Ministry of Science and Higher Education of the Republic of Kazakhstan: IRN AP26198345 “Reducing socio-economic inequality in the regions of Kazakhstan through investment in and improvement of the organization ofthe healthcare system”.