overall while these aggregate statistics suggest that access is generally adequate large variations in the number of contacts with the health system in different regions suggest that in some of them at least access may be significantly constrained shortages of medical personnel in rural areas poor transportation services and lengthy travel times to health care facilities are also likely to undermine access to services in remote areas across the country who across regions greater use of outpatient care and relatively less of inpatient care are strongly correlated with per capita bed numbers suggesting that structures eg the existing hospital infrastructure shape service delivery in different ways across regions indeed looking beyond the frequency of contacts with providers the fundamental question is whether services provided mirror in attention frequency priority resources etc data systems in kazakhstan provide limited information on the nature of services delivered and in particular on the coverage of interventions related to the management of the chronic diseases that increasingly affect the population