Health systems in transition : Uzbekistan

Project Health II (2005–2012)
This project had four components: primary care development; financing and 
management; public health services; and project management, monitoring and 
evaluation (World Bank, 2012a). 
The component on primary care development envisaged the following 
activities:
•
  Reconstruction of and equipment for new rural primary care units. 
•
  Expanding the restructuring of primary care into urban areas in the form 
of pilot initiatives. Up to 30 urban polyclinics were selected as pilot sites 
and patients were free to enrol in them. 
•
  Intensifying the training of GPs and laboratory technicians. The training 
of GPs encompassed both the undergraduate level, where it involved 
changes of the curriculum, and the retraining of practising physicians. 
•
  Provision of continuing medical education by two newly established 
centres: the Centre for Evidence-Based Medicine and the Centre for 
Continuing Medical Education. 
•
  Conducting a comprehensive workforce survey.

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Health systems in transition
  
Uzbekistan
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The component on financing and management aimed to scale up the rural 
financing and management pilots initiated under Health I, in particular the per 
capita financing pilots at the primary care level. The component also aimed to 
develop a physician bonus system to address physician shortages in rural areas. 
It was envisaged that the management information system developed within 
Health I would be replicated nationally. In addition, capacity building in health 
management was supported at the undergraduate and postgraduate level, and 
a system of national health accounts developed. 
The component on improving public health services included the following 
activities:
•
  capacity building, including the development of a national public health 
strategy, the establishment of a school of public health, and support for 
health promotion and community-driven health programmes;
•
  prevention of HIV/AIDS, tuberculosis and sexually transmitted diseases, 
including through the implementation of the national strategy on HIV/
AIDS and the nationwide extension of the DOTS (directly observed 
treatment, short-course) approach in the management of tuberculosis;
•
  strengthening the public health infrastructure, including through 
the development of an integrated electronic surveillance database 
for communicable diseases, the training of laboratory staff, and the 
refurbishment of selected laboratories.
The component on project management, monitoring and evaluation was 
primarily concerned with the implementation of a Strategic Monitoring and 
Evaluation Plan, which had been previously developed. It also supported regular 
surveys and evaluations to assist implementation of the project. 
The project costs were estimated at US$ 118 million, of which US$ 40 million 
was provided by the World Bank in the form of loans and the rest came from 
government funds.
Explicit performance indicators were established for three of the four project 
components and most goals had been achieved by 2011 (Table 6.2). 

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Health systems in transition
  
Uzbekistan