Development finance assessment

Spending on health
Government spending on health in Uzbekistan is comparable to other lower middle-
income countries and the average for the Caucasus and Central Asia. Both as a share of GDP 
(2.2 percent) and as a share of budget expenditures (less than 8 percent), health outlays are 
modest. 
Non-communicable diseases (NCDs) are on the rise and pose serious health and 
development challenges to the economy. Their economic cost is equivalent to 4.7 percent of 
the GDP as per WHO studies. Government expenditure on health care for NCDs represents 
only 17.2 percent of all NCD-related costs. They account for 79% of all deaths in the country. 
A disproportionate share of resources is used for tackling these lifestyle diseases, while 
primary health care remains underfunded. 
Current allocation of health spending is inequitable. The health delivery model focuses 
on specialty hospitals over primary health centers, equipment over skills, and curative over 
preventive health care (Ahmedov et al., 2014). This is neither efficient nor equitable and may 
increase the cost, including high out of pocket expenses, of healthcare resulting in greater 
exclusion (SDG 3.8).
While the system is already underfunded, the recently adopted ambitious health system 
reform and draft health financing strategy calls for a strong financing architecture to succeed. 
The related draft Concept for the piloting of State Health Insurance to support service delivery 
reform in Syrdarya will help to set the foundations for this architecture.
Increasing health spending, especially considering the COVID-19 related pressures, will 
be critical to achieve health related SDGs and boost human capital. Until the Health Financing 
Strategy and Concept of the Syrdarya pilot, there has been limited strategic planning and 
management of the health sector. Estimates of financing needs for the sector are incomplete 
or outdated, especially now in the context of the ambitious reform agenda. 
The UN Joint Programme of the Joint SDG Fund will support the Ministry to institutionalize 
strategic planning, including priority-setting in the establishment of a State Guaranteed 
Benefit Package, and strengthen the link between plans and budgets. This benefit package 
will be costed. Opportunities and frameworks for private-public partnership will be explored. 
These efforts will lead to more efficient allocation and use of financial resources, and address 
chronic underinvestment in the health sector. 

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DEVELOPMENT FINANCE ASSESSMENT FOR THE REPUBLIC OF UZBEKISTAN