Health systems in transition : Uzbekistan

viloyat
, 
city and 
tuman
 health authorities. The institutions at the national level include:

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Health systems in transition
  
Uzbekistan
15
•
  medical centres and research institutions;
•
  institutions of higher medical education: medical schools, institutions of 
postgraduate medical education, the Pharmaceutical Institute, and some 
colleges for health professionals;
•
  health care delivery institutions classified as being of national importance.
Fig. 2.1 illustrates the structure of the health system in Uzbekistan in 2014, as 
envisioned by a 
Presidential Decree
 in 2007. New institutions were planned to 
be established, but were not yet in place in 2014. For instance, new diagnostics 
centres were planned to be established in every regional centre. 
Health care institutions at the 
tuman
 and 
viloyat
 level represent the second 
and third managerial and regulatory layer of the Uzbek health system. At the 
viloyat
 level, each of the 13 regional units (12 
viloyats
 and Karakalpakstan 
Autonomous Republic) and the City of Tashkent have an administration called 
a 
khokimiat
 (Cabinet of Ministers in Karakalpakstan) headed by a 
khokim
 
(governor; Head of the Cabinet of Ministers in Karakalpakstan). These heads 
of government are appointed by the President. 
Viloyat
 governing bodies form a new system of regional administration 
and have replaced the executive committees of the 
viloyats
 and the municipal 
authorities of the former Soviet system. Their finance departments collect a 
significant share of government revenue, of which they keep a proportion. 
The next hierarchical level of administration is formed by 
tuman
 governments, 
which are headed by a 
tuman khokim
. These 
tuman
 governments are increasingly 
responsible for administering funds for social assistance and for managing 
health and social services.
Regional health care is managed by the respective health departments 
within the 
viloyat
 government. These regional health authorities form part 
of the statutory health system and are accountable to their respective 
viloyat 
government and the Ministry of Health (Cabinet of Ministers, 1999a). They 
coordinate and control activities of health-related institutions in their territory, 
whatever the form of ownership (Cabinet of Ministers, 1999a). Regional health 
authorities also supervise 
viloyat
 health care providers and institutions that 
form part of the third hierarchical layer of the health system and are accountable 
to 
tuman
 or city health authorities. Fig. 2.3 shows the organizational structure 
of regional health departments. 

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Health systems in transition
  
Uzbekistan