Health systems in transition : Uzbekistan

Project management, monitoring and evaluation
Establishment of a monitoring and evaluation system, with a 
minimum of two facility surveys and two household surveys
achieved
Source
: World Bank, 2012a.
Project on Woman and Child Health Development (2005–2012)
The Woman and Child Health Development project, supported by the ADB, was 
implemented over seven years, from 2005 to 2012 (for performance indicators 
see Table 6.3; see also ADB, 2012). It aimed to support the government reform 
agenda in primary health care and to improve the efficiency of the woman and 
child health care delivery system. The ADB loaned US$ 40 million in support 
of the project. The project was divided into several components. 
The component on strengthening woman and child health services consisted 
of the following sub-components: 

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Health systems in transition
  
Uzbekistan
99
•
  Support the reorganization of primary care, with a specific focus on 
strengthening referral links for woman and child health between primary 
care units and central 
tuman
 hospitals.
•
  Capacity building for woman and child health services at the primary care 
and 
viloyat
 levels through procurement of equipment and the provision 
of training. In selected 
viloyats
, 81 central 
tuman
 hospitals and 6 
viloyat
 
paediatric and maternity homes were equipped with an essential package 
for woman and child health services. 
•
  The sub-component on continuing medical education focused on 
strengthening education for nurses and midwives. It provided training 
to nurses and midwives at central 
tuman
 hospitals and rural primary 
care units, with a focus on public health, prevention, nutrition and 
basic curative care. Some 10 000 nurses and midwives were expected 
to undergo training. The project also involved the retraining of 
approximately 2500 physicians dealing with obstetrics and paediatrics. 
•
  The sub-component on quality monitoring supported the development 
of clinical pathways and referral frameworks for women and child health 
care. It also built supervisory capacity at the national and 
viloyat
 level 
for the monitoring and improvement of woman and child health care.
•
  The sub-component on health education supported the Institute of Health 
and Medical Statistics in the development and dissemination of health 
education materials on woman and child health. 
The project component on strengthening finance, information and management 
in the Uzbek health system consisted of the following sub-components:
•
  The first sub-component supported the national implementation of the 
primary care financing and management scheme piloted under project 
Health I through training and capacity building. It also piloted hospital 
financing based on diagnosis-related groups. 
•
  The sub-component on management information systems aimed to 
build a population-based health database in five 
viloyats
, in coordination 
with project Health II. It was responsible for the development of the 
Uzbek National Health Data Dictionary, a computer training centre at 
the Institute of Health and Medical Statistics, and an internal electronic 
network for the Ministry of Health. The sub-component further assisted 
in the development of a blood bank information system.
•
  Support was provided to the Ministry of Health to update and strengthen 
national protocols (“
prikaz
”) related to mother and child health.

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The component on blood safety issues aimed to reform the blood storage 
and transfusion system to improve both efficiency and screening for blood-
borne infections (such as HIV/AIDS and hepatitis). The component aimed to 
restructure the framework for blood storage and transfusion, improve protocols, 
and facilitate the establishment of a sustainable national budget for blood safety. 
It included the following sub-components:
•
  helping the government to establish a national framework on blood safety 
that would cover both organizational and management issues;
•
 a 
new 
viloyat
 blood safety framework was established and tested in one 
of the 
viloyats
. A defined package of equipment was procured for the 
National Blood Centre, the Regional Blood Centre, and hospital blood 
banks. The project also provided reagents and supplies for the first year;
•
  the final sub-component supported the replacement of paid donors with 
voluntary, unpaid giving of blood.