Kazakhstan was ranked among countries with the lowest life expectancy in the WHO European Region; health professionals were distributed inequitably across the country and geographic disparities in health status were seen between rural and urban populations.
The concept of transport medicine was conceived: Using the country’s existing transportation infrastructure, a series of trains now travel to stations across the country to provide health services to rural populations; aligning the initiative with overarching health system reforms (the State Health Care Development Programme for 2011–2015 “Salamatty Kazakhstan”), and gaining cross-sector buy-in from the government, helped to support implementation of medical trains; building upon existing infrastructure helped to alleviate the burden of additional resources in the setup and rollout of the initiative; solutions for population health problems were based in a strong understanding of current challenges and were adapted to population and geographic contexts.
