Mainstreaming Gender in ADB Operations, by Sector
65
the number of male students in higher medical education is much higher compared with
female
students, and slowly increasing: 11,800 (59%) vs. 8,300 (41%) in 2014; 12,600 (60%)
vs.8,400 (40%) in 2015; and 13,200 (60.3%) vs. 8,700 (39.7%) for males and females,
respectively in 2016.202
disparities in male and female enrollment in tertiary education can be attributed to several
root causes, including (i) a longer education period (i.e., 7 years of full-time study to become
a certified medical doctor); (ii) study periods coinciding with the traditionally favored age for
marriage and childbirth;
203
and (iii) financial costs of tuition that become
especially problematic
after marriage, since grooms’ parents very often are reluctant to cover the costs.
Sex-disaggregation among working medical doctors is close to parity, with 40,900 (49.6%)
male doctors vs. 43,200 (50.4%) female doctors in 2016. Gender asymmetry among working
medical nurses is even higher than the ratio of medical college students: 36,600 (10.8%) males
vs. 299,800 females (89.2%) in 2014; 30,300 (9%) males vs. 306,100 (91%) females in 2015;
and 31,500 (7.7%) males vs. 309,800 (92.3%) females in 2016. the available sex-disaggregated
statistical data do not specify the ratio for management
staff in the health sector, but rather
provide cumulative figures for managers and specialists (78.9% females vs. 21.1% males)
(footnote 205). this needs further exploration and analysis.
although the demand for health specialists has decreased over the last 10 years, employment
of graduates from medical higher education institutions has grown steadily (82.3% in 2014 vs.
90.87% in 2016), even though health care is among the lowest-paying
sectors of the economy,
occupying 10th place in the wage hierarchy.
204
202
data provided by the State Committee on Statistics to adB in September–October 2017 for this CGa update.
203
demographic Institute under the University Higher School of economics. Russian Federation. 2014. demoscope weekly.
L. a. tzhai
On fertility issues in Uzbekistan
http://www.demoscope.ru/weekly/2014/0617/analit02.php.
204
the average annual salary in the sector is SUM877,310.
Table 8: Sex-Disaggregation in Professional Medical
Educational Institutions
and among Work Personnel
(%)
Group
2014
2015
2016
Women
Men
Women
Men
Women
Men
Students/medical
colleges
58.9
41.1
75.2
24.8
75.2
24.8
Students/higher
medical institutions
59.1
40.9
40
60
39.7
60.3
Working medical nurses
89.2
10.8
91
9
92.3
7.7
Working medical
doctors
51.2
48.8
51.6
48.4
51.4
49.6
Source: data provided by the State Committee on Statistics to adB in September–October 2017 for this CGa update.
66
Uzbekistan Country Gender Assessment Update
4.
ADB Interventions
during the past years, when the state’s attention was devoted to improving reproductive health
indicators, adB funded the Mother and Child Health development project (completed in
2012), which resulted in considerable progress: maternal mortality decreased (23.1 per 100,000
live births in 2011 vs. 18.9 in 2015
205
and 17.4 in 2016). the mortality rate for children younger
than 5 years is also decreasing (15.1 per thousand in 2015 vs.10.7 per thousand in 2016).
206
In 2017, adB began collaborating with the government in the framework of the primary Health
Care Improvement project, which supports
health service optimization, improves and expands
primary health care services in rural areas. New rural family polyclinics will have modern
diagnostic equipment, accompanied by capacity building for rural health workers.
5. recommendations
•
Support continuous monitoring of health care–associated costs and efforts to achieve
universal health coverage within health-related projects and programs.
•
Upgrade further projects in the health sector to eGM category,
accompanied by Gap,
as a part of the loan agreement and allocate necessary resources for implementation.
•
Support capacity building on the use of medical innovations, including a Health
Management Information System within the primary Health Care Improvement
project, with a 50% quota for female technical and professional staff.
H. Education
1. Context
the Constitution of Uzbekistan guarantees that: “[everyone shall have the right to education.
the state shall guarantee free secondary education. Schooling shall be under state
supervision.”
207
the educational system in Uzbekistan begins with pres-chool and includes mandatory primary,
secondary general, and secondary special education. the tertiary
level includes educational
institutions that implement academic and professional programs in compliance with
government standards, irrespective of departmental subordination and forms of ownership.
2. Government Commitments
Reforms have been introduced to improve all sub-sectors of the education system. a special
Ministry on preschool education was established in 2017.
208
Reforms in higher education
205
Ministry of Health of Uzbekistan. 2016.
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