Health systems in transition : Uzbekistan

4.1 Physical resources
4.1.1 Infrastructure
Infrastructure planning in Uzbekistan’s state-owned health system is primarily 
the responsibility of the national government. Major investments are planned 
and funded by the national government, whereas small-scale capital investments 
also come from local governments. The national government conducts regular 

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Health systems in transition
  
Uzbekistan
60
infrastructure evaluations and keeps an updated registry of inventories in public 
health institutions. Based on governmental priorities and on recommendations 
of the Ministry of Health, annual capital investments are planned and included 
in the state budget. The bulk of investments is channelled through national 
priority programmes. Some minor capital investments are being made at 
the 
viloyat
 or 
tuman
 level and by health institutions, depending on available 
resources. Examples of major infrastructure investments are the investments 
in primary care facilities and central 
tuman
 hospitals through projects funded 
by the World Bank loan; investments in paediatric hospitals through grants and 
loans from the ADB Woman and Child Health programme, the EU, UNICEF, 
WHO and the KfW; and investments in public health laboratories through 
projects of the United States Centers for Disease Control (CDC) and Defense 
Threat Reduction Agency (DTRA) and the Korea International Cooperation 
Agency. The most recent major public investments in the health sector (totalling 
over US$ 100 million) are planned for equipping tertiary specialty centres and 
the emergency care network, as well as facilities for cancer and tuberculosis 
care (Cabinet of Ministers, 2012a), and mental health. Government planning 
is also clearly visible in the trends of hospital and hospital bed numbers in the 
public sector in recent years.
The government does not control capital or other types of investments in 
the private health sector. The private sector does not receive direct subsidies 
from the government for capital investments. Several indirect subsidies are in 
place, however, such as customs tax breaks for medical equipment (President 
of Uzbekistan, 2007d).
The ratio of hospital beds per population (both for hospital beds overall 
and acute care hospital beds) has been reduced substantially over the last two 
decades (Fig. 4.1), in line with developments in other countries of the region 
(Fig. 4.2). However, these statistics only cover beds in the public sector and 
do not capture those in the private sector. Public sector beds can be divided 
into those financed from state funds and those based on self-financing. 
Further cuts to state-financed beds are planned for the years 2012–2015. 
The largest cuts are planned at the 
tuman
 level, with anticipated reductions 
of about 19%. Overall, approximately 14% of state-funded beds (17 949 out 
of 127 119 beds) are planned to be cut between 2012 and 2015 (Cabinet 
of Ministers, 2012a).

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Health systems in transition
  
Uzbekistan