Health systems in transition : Uzbekistan

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7. Assessment of the health system
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lthough there are only limited system-wide data available on health 
system performance, a number of trends and challenges can be 
identified. The country has undertaken major efforts to improve the 
efficiency of the health system, ensure an equitable distribution of health 
facilities and protect vulnerable groups of the population from catastrophic 
health expenditure. Despite an increasing share of public expenditure on health, 
the high share of out-of-pocket payments and the limited scope of the benefits 
package to include only primary and emergency care mean that financial 
protection of the population from the consequences of ill health is still limited, 
with resulting problems for health equity and access to services. Quality of 
care is increasingly recognized as a problem, with ongoing efforts to update 
treatment protocols and revise medical education, continuous professional 
development, and quality assurance and improvement frameworks. There are 
also efforts to improve allocative efficiency, with a higher share of resources 
devoted to the reformed primary health care system. Other challenges to health 
system performance in Uzbekistan include the practice of informal payments 
and the fact that user experience has so far been a rather neglected area of health 
service provision.