Uzbekistan HiT (2014)
Uzbekistan has one of the lowest estimated life expectancies in the WHO European Region (64.8 years for males and 71.5 years for females in 2012). The government remains the principal owner and public funder of the health system and the private sector is still small.
Being one of the poorest countries in the WHO European Region, one of the main challenges is the limited coverage of the publicly financed benefits basket and the large scale of private out-of-pocket payments.
The share of public expenditure has increased in recent years, and the government has tried to protect the most vulnerable groups of the population, but for many people secondary or tertiary care and outpatient pharmaceuticals have to be financed from their own resources, resulting in inequities in access to health services.
The government has aimed to ensure a more efficient use of existing resources, scaling back the extensive hospital sector and restructuring the primary health care system, with a gradually increasing role of general practitioners. Slowly, new mechanisms for the payment of health care providers are also being introduced, in particular capitation payments for primary health care. For specialized outpatient and inpatient care, there has been increasing reliance on user fees, but this might have negative repercussions for access to care.
Quality of care is another area that is receiving more attention, with efforts to update treatment protocols and to revise medical education, continuous professional development and quality assurance and improvement frameworks. Attempts to improve allocative efficiency through increased allocation of resources to primary health care (as opposed to secondary and tertiary care) are also being undertaken, but there is much scope for further progress.
HiT health system reviews are country-based reports that provide a detailed description of a country’s health system and of reform and policy initiatives in progress or under development. More up-to-date information on many countries can be found on our Health Systems and Policy Monitor (HSPM).