Health systems in transition : Uzbekistan

5. Provision of services 
I
n public health, the sanitary-epidemiological services have retained 
their traditional focus on environmental health services, food safety and 
controlling communicable diseases. However, new players have emerged, 
including the HIV/AIDS centres, the Institute of Health and Medical Statistics, 
primary health care units and NGOs. 
Primary care services are provided by public primary care facilities, 
outpatient clinics of public secondary and tertiary institutions, and private 
outpatient clinics. In rural areas, the first point of contact is the rural physician 
point, while secondary outpatient care is provided by outpatient clinics of central 
tuman
 hospitals. Four types of rural physician points have been determined, 
each with a specified number and type of personnel, space and equipment. In 
all cases, they are staffed by GPs, who lead the team efforts at the practice. 
In urban areas, primary health care and selected secondary care services 
are provided by polyclinics, with catchment populations of between 10 000 and 
80 000 people. All types of polyclinics (previously separate for adults, children, 
and polyclinics specializing in women’s health) are currently transformed into 
family polyclinics which provide primary care for all groups of the population. 
Specialists in urban family polyclinics are expected to be gradually replaced 
by GPs.
In rural areas, the first points of contact for patients seeking secondary care 
from the public sector are 
tuman
 hospitals or 
tuman
 medical unions (previously 
called central 
tuman
 hospitals) with multi-specialty outpatient units. In urban 
areas, 
viloyat
 and city multi-profile hospitals deliver inpatient care for the 
population. At 
viloyat
 level, many disease categories and population groups 
are treated in separate hospitals. These include children’s hospitals, tuberculosis 
hospitals, hospitals treating sexually transmitted and dermatological diseases, 
neurological and psychiatric hospitals, cardiology hospitals and hospitals