Asian development bank

Government Commitments

the ongoing reformation process for the health-care system has addressed many of the above issues. From its first days of independence, Uzbekistan has undertaken major efforts to improve medical care, provide universal health coverage, and maintain free primary health

care. One component of health system reforms was the transformation of primary health care and establishment of an institution of general practitioners. Under successive reforms, health infrastructure was improved and modernized; staff was trained; treatment protocols were updated; and new financing and management reforms were piloted. ¹⁹³ the government has made a substantial investment in tertiary-level care, including the establishment of multi-profile pediatric and regional hospitals and upgrading district and other specialized hospitals.
Health care is undergoing radical transformations in diverse segments. For instance, improvements in sanitary epidemiological services¹⁹⁴and pharmaceuticals¹⁹⁵ aim to ensure dynamic and sustainable development of the national pharmaceutical industry, saturate the domestic market with quality and safe medicines based on domestic raw materials, increase production of import-substituting pharmaceuticals (supported by broad tax and customs benefits for local producers), and attract foreign investments.¹⁹⁶

Some legal interventions worked to improve the support system for vulnerable populations. Orphanages, boarding houses, and other social rehabilitation facilities (Murruvat, Sahovat)

¹⁹¹ Ministry of Health of Uzbekistan. 2017. Presentation at the Women’s Committee of Uzbekistan Annual Conference. 14 december tashkent. Uzbekistan.
¹⁹² M. ahmedov, R. azimov, Z. Mutalova, S. Huseynov, e. tsoy, and B. Rechel. 2014. Health System Review. Health Systems in Transition. Uzbekistan. p.41. More recent statistics were not available during CGaU preparation.
¹⁹³ Ministry of Health of Uzbekistan portal. https://www.minzdrav.uz/projects/detail.php?Id=13363&version=contrast; Successive projects Health-1, Health-2 and Health-3 projects (1996–2018). In the frames of the Health-2 project (2004–2011), 2,389 rural health units and 25 family health centers were provided with equipment. the project provided training to 3,770 general practitioners and benefited more than 18 million people. the Health-3 project (2011–2018) is a logical extension of Health-2, which focused on access to primary health care services and addressed the rise of noncommunicable diseases. Over 1,000 doctors have attended training courses for general practitioners
in the framework of Health-3 project, and 3,000 physicians will complete training by the end of 2018.http://www. vsemirnyjbank.org/ru/news/feature/2014/02/12/primary-care-and-disease-prevention-become-priorities-in- uzbekistan
¹⁹⁴ Law of the Republic of Uzbekistan #393 (26 august 2015). On Sanitary and Epidemiological Welfare of the Population.
¹⁹⁵ Law of Republic of Uzbekistan # 399 (4 January 2016). On Medicines and Pharmaceutical Activity (New edition). decree of the president # 2647 (31 October 2017). On Measures for Further Improvement of Providing the Population with Medicines and Medical Products; decree of the president # 4985 (16 March 2017). On Measures for Further Improving the System of Emergency Medical Care.
¹⁹⁶ decree of the president # 2596 (13 September 2017). On Measures for Further Development of Pharmaceutical Industry of the Republic of Uzbekistan in 2016–2020.
64 Uzbekistan Country Gender Assessment Update
were moved from the Ministry of Social protection to the Ministry of Health).¹⁹⁷ the reforms aim to further strengthen social support for the disabled and elderly persons living in boarding houses.¹⁹⁸

the latest transformations in the public health-care system aim at dramatically improving efficiency, modernizing the system of highly specialized medical care, and improving the prevention and early detection of diseases, including in rural areas.¹⁹⁹ the reform focuses on enhancing the role of scientific and practical medical centers in relevant areas of specialization, promoting privatized health care, and developing robust competition. the transformations

in private health care provide for necessary conditions to deliver high-tech medical services, attract foreign investments and highly skilled specialists, develop medical tourism, and export health services.²⁰⁰
the most recent decree of the president of Uzbekistan envisions “female consultations” in the structure of family polyclinics and rural medical posts charged with the responsibility of

medical consultation to adolescent girls and women of childbearing age.²⁰¹ these developments allow assumptions on a more holistic approach toward health care and social safety nets as articulated earlier in this chapter.

3.