Traditional Medicine in Modern Kazakhstan: A Mixed-Methods Analysis of Traditional Chinese and Traditional Kazakh Medicine Utilization and Public Policy Implications

Abstract

Background: Traditional Chinese Medicine (TCM) and Traditional Kazakh Medicine (TKM) are increasingly prominent in Kazakhstan's healthcare landscape, yet no population-level data exist on their use, public perceptions, or policy attitudes. This study addresses that gap as both TCM — promoted through China's Health Silk Road initiative — and TKM — revived as part of Kazakhstan's post-independence cultural agenda — gain increasing prominence. Methods: A mixed-methods design was employed. Phase 1 consisted of a cross-sectional online survey, from which 121 complete responses were included in the final analysis. Descriptive statistics, chi-square tests, and binary logistic regression were conducted using Stata. Phase 2 included four semi-structured in-depth interviews analyzed through Braun and Clarke's (2006) thematic framework. Results: TKM use was more prevalent (57.0%) than TCM use (42.1%), with 34.7% of respondents using both systems. Age was the only significant demographic predictor: adults aged 35–44 were significantly less likely to use TKM than those aged 18–24 (OR = 0.055, p = 0.014), suggesting a generational rupture in oral knowledge transmission. Cultural heritage was the primary motivation for TKM use (44.9%) and trusted-source recommendation for TCM use (23.5%). Dissatisfaction with conventional medicine was rarely cited (<4%) as a driver for either system. Family and friends were the dominant information source for both; social media was widely accessed but consistently distrusted. Awareness of the Health Silk Road was limited (15.7% very aware) and was not associated with TCM use. Strong public support emerged for regulating both TCM practitioners (66.9%) and TKM practitioners (71.1%). Qualitative findings identified five themes: stepwise navigation of medical pluralism, an epistemological divide between experiential and evidence-based knowledge, family-centered trust networks, a regulatory void characterized by concerns about unqualified practitioners, and complex cultural and geopolitical tensions surrounding TKM's heritage status and TCM's soft power expansion. Conclusion: TCM and TKM function as complementary additions to, rather than replacements for, biomedical care in Kazakhstan. Traditional medicine use is driven primarily by cultural and social motivations, challenging the assumption that alternative medicine use reflects biomedical dissatisfaction. TKM faces a critical "visibility problem" — a documentation deficit relative to TCM rooted in Soviet-era suppression and insufficient post-independence investment. The regulatory void represents the most urgent public health priority. These findings provide the first empirical foundation for evidence-based traditional medicine policy in Kazakhstan, including practitioner regulation, TKM documentation, and evidence-informed health diplomacy with China.