December 29, 2015
Primary health care institutions are planned to reach international standards in the level of their equipment within the framework of “Health-3” project by the year 2018. This will promote improvement in the quality of medical services at rural health units, family policlinics, central district and municipal out-patient hospitals, as well as hospital care at municipal and district associations.

An Uzbekistan Today reporter talked to the director of “Health-3” project bureau Valijon Khakimov on how the plans are being implemented.

“What needs to be done to achieve the targets?”

“It has been envisaged to provide 517 medical establishments with modern medical equipment and equipment for utilization of wastes and furniture. The list has been determined on the basis of time sheet for fitting out medical establishments of the district and municipal levels. This will enable to create conditions for full coverage of rural and urban population with quality medical care at the level of primary out-patient and in-patient establishments.”

“The project was launched in 2012. What has been thus far?”

“172 district and municipal medical associations with a hospital and an out-patient hospital within its structure, 39 central municipal; medical policlinics and 173 municipal family policlinics of the Republic have received medical equipment worth $39,6 million. Including modern roentgenological equipment in a set with digitizers, which provide an opportunity to conduct roentgen diagnostics without x-ray films with the use of computer technologies, Ultra sound equipment with color scanners, ECG devices, gastro-fiberscopes, monitors for patients and pulse-oximeters.”

“What further deliveries do you expect in the future?”

“We are planning to furnish medical establishments covered by the project, to the amount of $40 million. These will include X-ray equipment, dental equipment, vehicles for medical establishments located in remote and hard-to-reach areas. We also plan to procure medical and laboratory furniture, sets of instruments, diagnostic and eye-care equipment and computers.”

“The “Health-3” project also addresses personnel issues. The most complicated direction is transition of the primary chain to the principles of general medical practices. How is the work going on in this direction?”

“Training of physicians, sub-district internists and pediatricians of municipal family and multi-profile out-patient hospitals at 10 months long courses has been continued. Upon successful completion of the course and passing exams they get a new speciality “general practitioner”. If in the past the main contingent of the courses were physicians of rural health units, then now physicians of family and multi-disciplinary policlinics constitute the majority of trainees. Thus, in 2015 specialists of urban family out-patient hospitals made up 47.,5% of trainees, physicians of central multi-discipline out-patient hospitals – 24.,1%, while in September 2015 another 594 sub-district internists and pediatricians were enrolled at these training courses.

“The program of retraining specialists is being updated on an annual basis. Presentations and handouts were revised in 2014 in accordance with the latest achievements of evidence-based medicine. In 2015, the program of the manual was supplemented with materials in compliance with recommendations of the chief specialists of the Ministry of Health.”

“The “Health-3” project takes an active part in shaping the system of continuous education. What has been done in this direction?”

“Short-term workshops have been conducted in nine current trends of general medical practices for chief specialists of district medical associations of Tashkent and Tashkent region and 226 trainers have been trained. Then we started to train family out-patient physicians. Thus, during the 9 months of this year 2480 physicians of rural health units, family and multi-disciplinary out-patient hospitals and 10372 nurses improved the level of their qualification only in the Tashkent region alone.”

“What about the training of other specialists?”

“For the purpose of rendering efficient medical assistance to children at the level of central district out-patient hospital is was proposed to introduce a strategy of stationary integrated treatment of children’s diseases. For this we had conducted 10 days long workshops for pediatricians of district medical associations of Jizzakh, Navoi, Samarkand and Syrdaryo regions; next on the agenda are trainings for specialists of Namangan, Andijon, Qashqadaryo and Surkhondaryo regions. We also have plans to train nurses of all pediatric wards.

“Brief clinical protocols in four areas: gastroenterology, pulmonology, endocrinology and cardiology have been elaborated for raising the quality of medical services at therapeutical wards under central district hospitals. Workshops have been conducted in training regional trainers, which will in their turn hold short-term seminars for physicians of therapeutical profile in six directions, which will be introduced at central district hospitals following training of medical nurses of therapeutical wards of district medical associations.”

“There is a need for further improvement of healthcare establishments’ management and financing systems for achieve maximum efficiency …”

“We keep working on the improvement of strategic planning and perfection the financial management system at the healthcare establishments, including those at the primary care, district and regional management levels. We also continue gradual spread of per capita funding for all municipal family out-patient hospitals of the Republic and testing of hospital payment system based on contracts depending on the cost of medical services. An information healthcare management system is being elaborated in support of testing the system of hospital funding. The program of management training of healthcare establishments directed towards raising the potential of managing medical institutions and their financial systems has been expanding on a stage-by-stage basis.”

(Source: «Uzbekistan Today» newspaper)


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