Health systems in transition : Uzbekistan

114
7.4 Health outcomes and quality of care
7.4.1 Population health
Population health can be assessed by a range of measures, particularly those 
that capture overall and disease-specific mortality and morbidity. Changes over 
time can provide insights about whether initiatives for improving population 
health were successful. However, multiple factors can contribute to changes in 
overall mortality and morbidity patterns, including changes in the economy, 
the education sector, the political and welfare system, and the health system. 
Changes in disease-specific measures, on the other hand, can often be more 
readily linked to specific health sector efforts. Although immunization rates 
are high, health outcomes for a number of other infectious conditions (such 
as tuberculosis and HIV/AIDS) and most noncommunicable conditions (such 
as cardiovascular or respiratory conditions) fare poorly when compared to 
outcomes for health systems in western Europe. However, recent improvements 
in neonatal and maternal mortality (see Chapter 1) can at least in part be 
attributed to improved health service provision.
There were also improvements in recent years in life expectancy at birth. 
However, it is difficult to ascertain the exact progress made, as official statistics 
differ from estimates by international agencies (see Chapter 1). According to 
World Bank estimates, life expectancy at birth in Uzbekistan increased by 
1.6 years between 1991 and 2012, from 66.5 to 68.1 years (World Bank, 2014). 
Similar increases can be observed in Kazakhstan (1.6 years) and Kyrgyzstan 
(1.5 years), whereas much greater gains are estimated to have been made 
in Turkmenistan (2.6 years) and particularly Tajikistan (4.6 years) (World 
Bank, 2014).
Years of life lost (YLL) and disability-adjusted life years (DALY) are other 
metrics that provide information on population health. YLLs take into account 
the age at which death occurred. The metric assigns higher loss to deaths 
occurring at younger age, thus giving information about premature death. 
DALY, in addition to measuring premature death, also aims to capture years 
lost due to ill health and disability (WHO, 2006). Table 7.1 presents conditions 
ranked according to their contributions to total YYL for Uzbekistan in 1990 
and 2010. In this time period, the disease burden of lower respiratory conditions 
decreased, while the burden of noncommunicable conditions, such as ischaemic 
heart diseases, stroke and cirrhosis, increased. 

---

Health systems in transition
  
Uzbekistan