Health systems in transition : Uzbekistan

5.13.2 Maternal and child health 
Almost all services for maternal and child health are provided in the public 
sector. Inpatient services are provided by maternity or children’s hospitals 
or departments for the population in the respective catchment area. At the 
tuman
 level, services for maternal and child health are provided as part of 
primary care either by GPs or by specialists (paediatricians or obstetricians-
gynaecologists) at central 
tuman
 hospitals. More specialized care is provided 
at 
viloyat
 and national level, typically by stand-alone facilities with outpatient 
and inpatient units. 
The maternity care hospitals or departments are divided into a unit for 
pregnant women (which includes beds for normal deliveries and postnatal 
care) and a unit dealing with complications. The new structure of maternal 
health care also introduced a vertically integrated management and monitoring 
framework for maternal and child health, and respective departments are 
organized within 
viloyat
 health authorities and the Ministry of Health. The 
departments coordinate, manage and monitor the activities of all maternity and 
children’s hospitals and related services. 
Maternal and child health, including antenatal care, form part of the 
guaranteed package of services. A number of preventive and screening 
protocols were developed by the Ministry of Health and are strictly implemented 
nationwide. According to the protocols of the Ministry of Health, pregnancies 
are registered in the first three months, with subsequent monthly checks and 

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Health systems in transition
  
Uzbekistan
90
examinations until delivery. Neonatal care starts from the first day of life in 
delivery departments. In the first two years, the child is regularly examined 
by the primary care provider at set time intervals established by the Ministry 
of Health. 
Rural physician points and polyclinics have a special registry for women 
of reproductive age and provide regular check-ups and screenings. All 
cases are first managed by primary care providers. When the primary care 
provider deems it necessary, patients are referred to the next level of care. In 
rural areas, the next level might consist of specialists at central polyclinics or 
maternity hospitals or units. In urban areas, polyclinics employ obstetricians/
gynaecologists. Specialized outpatient care can therefore be provided at the 
primary care institution itself. Cases requiring inpatient care are referred to 
urban inpatient facilities for maternal care. Child care follows the same pathway 
in the public framework with public primary care providers being the first points 
of contact. When required, children will be referred to paediatric hospitals. 
As a result of high infant and maternal mortality rates (see Chapter 1), 
maternal and child care have become one of the main governmental priorities in 
the health sector. A number of governmental programmes were developed with 
the aim of decreasing infant and maternal mortality, including a family planning 
programme. Furthermore, maternity and child health screening centres were 
established throughout the country and teams specialized in resuscitation and 
haemostasis were established at all 
viloyat
 centres. Extensive international 
support was provided for these and other initiatives. UNICEF, UNFPA, USAID 
and WHO assisted in the piloting of promotional and educational programmes, 
such as Safe Motherhood, Safe Vaccination and Breastfeeding (Borchert 
et al., 2010).

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