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RESOLUTION OF THE PRESIDENT OF THE REPUBLIC OF UZBEKISTAN

of April 25, 2022 No. PP-215

About additional measures for approach to the population of primary health care and increase in efficiency of medical services

For the purpose of ensuring execution of the tasks determined within the open dialogue of the President of the Republic of Uzbekistan with representatives of health sector which is carried out on March 18, 2022 on the subject "Reforms in Medicine — for Human Dignity":

1. Approve:

The program of measures for improvement of quality of the primary health care given to the population, support and increase in efficiency of activities of health workers according to appendix No. 1;

The schedule of creation in 2022 of makhallinsky medical aid stations in makhallyakh, remote from organizations of primary health care, according to appendix No. 2.

2. To the Ministry of Health (B. Musayev, A. Inoyatov) together with Council of Ministers of the Republic of Karakalpakstan, khokimiyats of areas and the city of Tashkent to take measures for the organization of activities of 136 new Items of the family doctor and family polyclinics in 2022 and 140 new Items of the family doctor and family polyclinics in 2023 according to the schedule of creation of Items of the family doctor and family polyclinics approved by the Presidential decree of the Republic of Uzbekistan of November 12, 2020 No. UP-6110.

3. Determine that:

Items of the family doctor and family polyclinics are created according to reasonable offers of Council of Ministers of the Republic of Karakalpakstan, khokimiyats of areas and the city of Tashkent at the expense of means of local budgets in coordination with the Ministry of Health;

since January 1, 2023 based on branches of family polyclinics on places Items of the family doctor for the purpose of further expansion of network of Items of the family doctor in regions are created;

operating time of day hospitals in Items of the family doctor, family polyclinics and multi-profile central polyclinics of areas (cities) is prolonged to 20.00, since June 1, 2022 for the health workers performing activities in these hospitals the salary supplement is established;

since May 1, 2022 in makhallyakh, remote from organizations of primary health care, makhallinsky medical aid stations are created;

routine medical examinations of the population, the program of screening and patronage are performed exclusively according to the procedure and the terms approved by the Ministry of Health, at the same time intervention of other organizations in this process it is not allowed.

4. Enhance since July 1, 2022 the Rural Doctor program for doctors of Items of the family doctor and family polyclinics in the remote and hard to reach areas. At the same time within the updated program "Rural Doctor":

to all doctors performing activities in Items of the family doctor and family polyclinics in the remote and hard to reach areas the monthly salary supplement in addition in the amount of 2 million sum is established, also at the expense of means of local budgets the part to 50 percent of cost of housing acquired by them on the basis of mortgage loan but which is not exceeding the five hundredfold size of basic settlement size becomes covered;

the doctors who continuously worked within three years in the remote and hard to reach areas are accepted in clinical internship without tests.

To Council of Ministers of the Republic of Karakalpakstan and khokimiyats of areas to take measures for detection of requirement of Items of the family doctor and family polyclinics in medical personnel by makhally, to involvement of doctors, proceeding from requirement in a month - to allocation by it in subsequent housing.

To the Cabinet of Ministers together with the Ministry of Health and the Ministry of Finance to approve the updated list of the remote and hard to reach areas of the country in a month.

5. Resolve implementation by doctors of individual family medical practice since September 1, 2022.

Determine that:

implementation of individual family medical practice does not require opening of separate medical institution, rendering medical services at itself at home or in leased rooms is allowed to doctors of the specified category;

payment to individual family doctors for the services rendered by them to the attached population it is non-paid, it is performed at the expense of the State fund of medical insurance;

experience of conducting individual family medical practice takes root originally until the end of 2022 in the Syr Darya region, in subsequent - step by step in other regions of the country.

To the Ministry of Health (B. Musayev) together with the Ministry of Finance (T. Ishmetov) in three-months time to approve requirements imposed to conducting individual family medical practice and also procedure for financing of these activities and to implement it.

6. Resolve the organization in multi-profile central polyclinics of areas (cities) of types of service on paid basis in addition to the types of the medical services rendered on free basis guaranteed by the state.

Determine that part to 75 percent of the means which arrived from paid services goes for encouragement of health workers of multi-profile central polyclinics of areas (cities).

7. Implement new rating system of efficiency evaluation of activities of Items of the family doctor and family polyclinics since August 1, 2022. At the same time:

the main criteria are indicators of disposal of excess weight, respect for the principles of healthy nutrition, increase in physical activity, prevention of heart attack, stroke, diabetes and oncological diseases in the territory;

each six months the health workers who reached positive indicators are encouraged, the medical institutions which showed the best results are awarded with cash bonus and valuable presents;

the rating system takes root in 2022 in eleven Items of the family doctor and family polyclinics of Almazarsky district of the city of Tashkent both twelve Items of the family doctor and family polyclinics of Uychinsky district of the Namangan region, since 2023 - step by step in all regions of the country.

To the Ministry of Health (B. Musayev) together with the Ministry of Finance (T. Ishmetov) in three-months time proceeding from medical indicators of the population of each region to develop and implement new rating system of efficiency evaluation of activities of Items of the family doctor and family polyclinics in practice.

8. Implement since September 1, 2022 procedure for the reporting of heads of health care system before local Kengashami of People's Deputies and makhallinsky descents of citizens.

Determine that:

heads of multi-profile central polyclinics of areas (cities), family polyclinics and Items of the family doctor report to makhallinsky descents of citizens;

heads of district (city) medical associations - before Kengashami of People's Deputies of areas (cities);

heads of managements of health care of areas - before Kengashami of People's Deputies of areas.

9. To the Ministry of Health (O. Fazilkarimov) till October 1, 2022 to carry out inventory count of the medical equipment in organizations of primary health care. At the same time to take measures on:

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