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Home / Other / Analysis / Keeping Finger on the Pulse

Keeping Finger on the Pulse

The quality of medical services has been hotly debated not only in the media, but also in various circles of society over the past months. Meanwhile, the healthcare system has embarked on the way of change, correction of mistakes, which should significantly improve health of the population.

Improvement of quality of medical services has become one of the policy priorities of President Shavkat Mirziyoyev. Since the beginning of the current year, the state’s leader held two meetings with medical professionals to discuss relevant issues of health development. They were also spotlighted at the expanded meeting of the Cabinet of Ministers on the outcomes of socioeconomic development of Uzbekistan in 2016 and key priority areas of the economic program for 2017, as well as in the course of visits to the regions to track the progress.

Healthcare was in spotlight also in the process of discussing the Action Strategy for Five Priority Areas of the Republic of Uzbekistan for 2017-2021, and reflected in the approved version of this document. As a result, transformations have started in almost all areas of healthcare.

The further strengthening of logistical capacity of medical institutions remains a priority. 552 billion soums will be invested in reconstruction and overhaul this year. Construction and installation works will be carried out in a total of 140 medical institutions, including 78 district medical associations, seven municipal hospitals, two regional multidisciplinary medical centers, 16 family polyclinics, 14 psychiatric hospitals, 12 republican medical institutions, and 12 institutions of different purpose.

Equipping of medical institutions with advanced devices will be continued with the priority to high-tech equipment. The list of institutions to be supplied with equipment this year includes municipal, regional medical associations and family polyclinics, republican specialized scientific and practical medical centers, state sanitary and epidemiological surveillance centers, clinics under medical universities, and republican hospitals.

Cancer clinics will receive new radiotherapy equipment for histochemistry laboratories, which will ensure ultra-precise diagnostics of cancer diseases. The Republican Research Center of Emergency Medical Aid is expecting additional equipment as well. The multidisciplinary children's center of the fourth generation, to be built in Tashkent, is also on the list.

The Ministry of Health has been implementing all these projects in cooperation with international financial institutions - Islamic Development Bank, Saudi Development Fund, International Development Agency, Kuwait Fund for Arab Economic Development, and the Korean Eximbank.

Meanwhile, many organizational solutions are called to address urgent problems in ensuring the quality of medical care.

Primary healthcare, with rural health units (RHUs) and family polyclinics, is of particular importance as an important link in terms of prevention and detection of diseases at an early stage and treatment, and strengthening the mother and child health protection system. It is a reason behind the radical innovation, which comes to the establishment of specific polyclinics for girls and women.

The first steps to improve the situation have already been taken. For instance, the number of the registration books that need to be filled by workers of central multidisciplinary polyclinics, family clinics and rural health units, was reduced from 100 to 20. The need for filling numerous documents consumed much time and negatively affected the performance of health workers. The major mission of the medical staff is not about filling out the documents, but about communicating with people, preventing diseases, and treatment. Meanwhile, the development of a range of measures on further streamlining of the primary healthcare is underway.

The documents will address a whole range of urgent problems. There is a need to reconsider the dislocation of rural medical stations, ensure the optimization of ineffective RHUs, and transform some of them into polyclinics. In the long term, it is planned to completely transfer rural health units to a round-the-clock operation. Doctors will be provided with all the conditions they need.

Staffing of RHUs with qualified specialists is the issue in focus. It is planned to develop a practice of assigning qualified doctors of specialized medical centers, republican and regional clinics for conducting scheduled appointments in rural health units and family polyclinics, and thereby strengthen the human resource capacity.

The medical patronage service will be further developed. Patronage nurses and family doctors should visit homes, take preventive measures, for people to feel their care. There is a need for taking a broad range of measures to raise the culture and responsibility of medical workers for the professional decisions they make.

The solution of staff problems at the current stage ranks among the most urgent challenges for the Ministry of Health. Experts are currently working on a drastically new and effective system of advanced training for doctors and other medical workers domestically and in leading foreign clinics, as well as on their financial incentives.

The issue of provision of hospitals and population with medicines and medical products at affordable prices is currently being addressed. In view of ineffectiveness of the previous measures on prevention of retail sales of medicines at an inflated cost, and untapped capacity to comply with the established procedure of state regulation of prices for socially important drugs, the government has made another resolution to address these problems.

According to the resolution of the Cabinet of Ministers, as of April 1, the pharmaceutical activity that implies the retail sale of medicines and medical products will be licensed by the Council of Ministers of Karakalpakstan, regional municipalities, and the Tashkent municipality.

It is also planned to compile rosters of addresses and workers of pharmacy institutions, whose license was terminated due to violations of legislation, also for gross violation of pricing. Once entered in the rosters, the data is deleted upon the expiry of three years.

Along with medicines or medical products purchased, and a cashier’s receipt, a purchaser should be provided with a receipt that indicates the names of the drugs with identification information (title, dosage, packaging, quantity), the information of the cashier, the date of purchase, and the price.

Sales and cash receipts received at the test purchase or control purchase by law enforcement agencies in accordance with the legislation, which prove the fact of selling medications with violation of the pricing procedure, may serve as a ground for suspending or terminating the license of the pharmacy institution.

The State Committee for Privatization, Demonopolization and Development of Competition and the Department for Combating Tax, Currency Crimes and Legalization of Criminal Incomes under the Prosecutor General’s Office are entrusted with ensuring control over compliance with the established procedure for state price regulation by retail medicine sellers.

The Ministry of Health, in partnership with the regulatory authorities, is currently streamlining sales of 340 types of medicines and medical products at fixed prices, assigning a big part to import substitution. Great efforts are concentrated on the implementation of the ‘Program on further development of the pharmaceutical industry for 2016-2020’, approved last September.

A large-scale complex of measures is being taken to sustain the stable operation of all emergency medical units.

According to the Ministry's estimates, satisfactory service for the population requires the availability of 2,400 ambulances, while there are only some 1,800 cars. Half of the fleet is obsolete.

1,200 new vehicles will be purchased for the needs of emergency medical care throughout the country by the end of 2017. A total of 550 of them will be delivered in the next two or three months.

This year, each district will be provided with two reanimobiles equipped with a cardiac monitor, a defibrillator and an artificial lung ventilation device.

The Ministry of Health intends to advance skills of emergency call operators, and supply ambulances with GPS navigators.

Certain measures are being taken to improve the procurement of ambulances with medicines. It is expected that by the end of the year the President will issue a decree on standardization of the expenditures for medicines and medical products of ambulance teams. The funding for this area will be increased by at least four times.

Assigning missions for the Ministry of Health, President Shavkat Mirziyoyev drew attention to the fact that nearly 30,000 citizens have to go abroad for medical treatment and spend huge amounts of money from the family budget due to the low level of diagnosis and insufficient qualification of doctors. A program of measures on the establishment of high-tech aid centers in the regions that will specialize on common diseases is seen as a solution for the multipurpose task. It is supposed that they will be based on new branches of republican specialized medical centers.

Over the past two months, the Government of Uzbekistan has triggered the construction of seven high-tech medical centers in remote regions from Tashkent, thereby creating additional conveniences for the population. The construction of a multidisciplinary children's clinic under the Nukus branch of the Tashkent Pediatric Medical Institute is underway in Karakalpakstan. It is expected to become a major children's medical center in the Aral Sea region in the near future.

The establishment of the Bakulev Cardiovascular Surgery Center branch has been launched in Khorezm region jointly with the leading Russian clinic. There are plans afoot to found branches of republican research and practical centers of urology, eye microsurgery, obstetrics and gynecology in Termez. A branch of the Republican Specialized Center of Urology will be opened in Bukhara. Practical steps have been taken to establish branches of republican centers of cardiology and endocrinology in the Kashkadarya region.

(As part of the social order of the Oliy Majlis Public Fund for the Support of NGOs and Other Civil Society Institutions). 
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