Overview

Key points

• Uzbekistan’s health system provides a basic set of publicly financed health services but it does not yet cover all essential services or medicines; a more comprehensive package is currently being piloted.
  
• Health services are largely public, with the Ministry of Health playing a central role in organization, planning and management.
  
• The health system provides a basic tax-financed package of care, nominally free for all. Coverage has improved substantially over the last 20 years but does not yet cover all essential services or medicines.
  
• Public spending on health is comparatively low (US$ 673 PPP per person in 2021) and out-of-pocket (OOP) spending high, creating challenges in access to health services especially for those from poorer households.
  
• Health spending is dominated by medical goods, mostly medicines (35.7% in 2019).
  
• Reforms since 2018 have included efforts to decentralize, to improve primary care and health financing, and to introduce digitalization.
  
• Since 2021, Syrdarya Oblast has piloted a strategic purchasing and primary care-based model with more comprehensive care. This has been a success and there are plans to roll out the model nationally, although this will require substantial investment.
  
• Hospital capacity has increased in recent years but strengthening primary care is a major focus of reforms, and includes encouraging a team-based approach and better coordination.
  
• After years of decline Uzbekistan has achieved a slow increase in health workforce (doctor) numbers, but distribution is uneven and salaries low. Migration is a continuing concern, exacerbating shortages.
  
• Life expectancy in Uzbekistan has improved over the past two decades, but suffered a slight decline due to the COVID-19 pandemic.
  
• Infant and maternal mortality rates remain high, but have declined in recent years.
  
• Routine childhood vaccination rates are high but some communicable diseases remain a concern, particularly multidrug-resistant tuberculosis.
  
• Noncommunicable diseases (NCDs) are the main cause of mortality and morbidity, with cardiovascular disease the leading cause of death for both men and women.
  
• Key risk factors affecting mortality and morbidity are poor diet, high blood pressure, smoking and air pollution.