Primary health care reform in Uzbekistan

• Published in: The International journal of health planning and management Vol. 22; no. 4; pp. 301 - 318
• Main Authors: Ahmedov, Mohir, Rechel, Bernd, Alimova, Vasila, Azimov, Ravshan
• Format: Journal Article
• Language: English
• Published: Chichester, UK John Wiley & Sons, Ltd 01-10-2007; Wiley Subscription Services, Inc
• Subjects: Central Asia; Doctors; Financing; Health administration; Health care industry; Health Care Reform - organization & administration; health reform; Humans; Primary care; Primary health care; Primary Health Care - organization & administration; Public health; Reforms; Regional variations; Rural areas; Social change; Uzbekistan; Uzbekistan
• ISSN: 0749-6753; 1099-1751
• DOI: 10.1002/hpm.897

In recent years, primary health care in Uzbekistan has seen dramatic changes in organization, management and financing. The Soviet multi‐tiered system of primary care is being replaced by a two‐tiered system, consisting in rural areas of rural physician points (SVPs) and outpatient clinics of central rayon hospitals. A state‐guaranteed benefits package of primary care services has been introduced and financing is increasingly based on capitation. In addition, a considerable number of physicians and nurses have been trained in general practice. There are, however, a number of challenges that remain. One of them is the considerable regional differences that exist in health financing. Another challenge is that some rural areas have difficulties attracting primary care workers. Overall, the institutional and financial link between primary and secondary care needs to be strengthened, as at present GPs have an incentive to refer patients to higher levels of care, which is financially inaccessible for large parts of the population. Copyright © 2007 John Wiley & Sons, Ltd.