Background Palliative care (PC) improves the quality of life of patients and their families facing life-threatening illness through relief of physical, emotional, and psychological suffering and pain. Identification of modifiable determinants of obstacles to universal quality PC in resource-poor settings like Kazakhstan can represent an example for other countries with similar challenges in PC provision. The 2015 Quality of Death Index, which evaluates global distribution of availability and effectiveness of PC, places Kazakhstan 50th out of 80 countries assessed. The Association of Palliative Care of Kazakhstan reports a substantial unmet demand for increased accessibility to pain relief medications, increased numbers of PC facilities, and training courses for medical care professionals. These improvements are supported by legislation and national policies.

Specific Aims to identify specific determinants of obstacles to provision of PC in a resource-limited developing country including drug availability, opportunities for healthcare professionals to receive training in palliative medicine and policy development process, as well as to evaluate the status and cost-effectiveness of PC provision in Kazakhstan.

Methods The study employs qualitative research in form of purposive recruiting with content analysis, semi-structured in-depth interviews until targeted participant numbers are completed or saturation is achieved. Consent was provided by participants. The data is then translated into English, coded and analysed. With the new study findings, supplemented by published literature and government documents, the best practices within the socio-cultural context of Kazakhstan are systematically determined.

Preliminary results The determinants of barriers to palliative care provision in Kazakhstan are associated with the limited availability of opioids, lack of specialist training and insufficient public awareness concerning palliation.