Capital: Tashkent
Population: 26 million
Area: 447 sq. km
GNI (US $, billion): 10.8
Gross National Income Per Capita: $420
Expenditure on Health as % of GDP: (2002)
Public: 2.5%
Private: 3%
Total: 5.5%
Annual Population Growth Rate: 1.3%
Total Fertility Rate: 2.3
Life Expectancy at Birth: 67
Infant Mortality Rate: 57 per 1,000
In Uzbekistan, ZdravPlus supports the nationwide expansion of pilot reforms at the rural Primary Health Care (PHC) level, which were begun under the ZdravReform Project and the previous ZdravPlus Project, in addition to bringing those reforms to urban primary health care and general inpatient care. In this process, ZdravPlus collaborates closely with the World Bank's Health II Project and the Asian Development Bank's Women and Child Health Development Project to coordinate the implementation of these next steps in the reform process.
ZdravPlus plays an active role in policy dialogue and working groups and provides technical assistance to secure the needed legislative, regulatory and policy support, and the realignment in institutional structures, roles and relationships necessary for successful implementation of the health reforms.
Providing technical assistance to Uzbekistan as the country rationalizes use of health care resources involves supporting national roll-out of per capita finance and management systems for rural PHC, and development and implementation of urban PHC and hospital financing and management reform pilots in Tashkent, Samarkand, Marghilon and Guliston. This includes health delivery system restructuring, pooling of funds, new provider payment systems and improved health information systems and health management.
ZdravPlus has a number of important objectives with regards to improving service delivery in Uzbekistan . These include specific activities such as the development of a hospital-based IMCI training program which links hospital staff to IMCI trainings for PHC doctors, building off of the WHO's integrated management of childhood illness curriculum and taking the management of common childhood illness in children under age five one step further. Reproductive Health activities include developing a training module on safe motherhood, supporting the distribution of contraceptives, and providing IUD training to midwives who work in areas which lack qualified Ob/Gyns. Underpinning these, and other activities such as Lab Trainings, will be a constant focus on further disseminating the principles of Evidence-Based Medicine, with ZdravPlus supporting the development of up-dated clinical practice guidelines.
Emphasis with regards to population and community health is placed on two areas; marketing the reforms and health promotion. Marketing the reforms aims to inform policy makers, educate health workers, and improve public understanding of the reforms. National level roundtables are held at the MOH, health workers are given information during regular meetings at oblast and rayon levels and General Practitioner training courses, and a brochure has been developed for the general population about PHC reforms. In addition, town meetings are held where opinion leaders explain the reforms and the public has a chance to ask questions and voice its needs and concerns. Marketing the reforms serves to develop a health system that is more responsive to the population's needs by de-mystifying the health care system and encouraging the population to ask for higher quality health care. Health promotion activities under ZdravPlus focus on developing the capacity of local institutions to carry out health promotion activities, including helping local health facilities to carry out patient education activities.
More information on ZdravPlus's activities in Uzbekistan can be found on the Road to Results and Recent Activity Highlights pages of this web-site and Technical Documents can be accessed through our online Public Library; for additional information contact us at office@zplus.kz.