Health systems in transition : Uzbekistan

6.1 Analysis of recent reforms
Since independence, Uzbekistan has embarked on several reforms of the health 
sector with the aim of adapting to the challenges of the new social, political 
and economic environment. In the early years of independence, however, 
specific and detailed long-term plans for health reform were lacking. The first 
major policy document on health reform was issued in 1998 and focused on 
primary and emergency care systems. In the following years, reform initiatives 
expanded to cover secondary and tertiary care, academic training and medical 
science. Two underlying principles were at the basis of health reforms from the 
beginning, although they were not officially stated: the government intended to 
remain the primary player in the delivery of health services and there was an 
increasing shift of costs to users, particularly for services not included in the 
guaranteed benefits package.