RESOLUTION OF THE PRESIDENT OF THE REPUBLIC OF UZBEKISTAN

of May 19, 2025 No. PP-185

About additional measures for realization of reforms in health care system

For the purpose of ensuring execution of the Presidential decree of the Republic of Uzbekistan of May 19, 2025 I decide No. UP-88 "About Measures for Consecutive Continuation of Reforming of Health Sector by Enhancement of This System and the Principles of Rendering Medical Services to the Population in the Republic":

I. Purposes

1. Determine main objectives of enhancement of health care system within implementation as pilot project of new model of the organization of health care system in 15 areas (cities) of the republic since July 1, 2025, in the Samarkand region - since January 1, 2026 (further - the Pilot project):

(a) improvement of quality and efficiency of the medical services rendered in family polyclinics by cardinal review of activities of organizations of primary health care;

(b) specific determination of tasks and functions of departments of district (city) level of the Ministry of Health, family polyclinics, the central hospitals, and also the rights and obligations of the population and health workers in case of delivery of health care;

(c) increase in knowledge and qualification of health workers, implementation of system of worthy payment of their work;

(d) acceleration and monitoring of the reforms performed by means of reforming of district (city) link of vertical management of the Ministry of Health;

(e) program implementation "90-day changes in the medicine" including short-term measures when rendering medical services to the population.

II. Creation of public health departments of areas (cities) and enhancement of activities of medical institutions

2. For the purpose of realization of the Pilot project, carrying out permanent monitoring and the analysis of its execution, and also widespread introduction of the Pilot project in all regions of the republic to form public health departments of areas (cities) with the status of the legal entity based on medical associations of areas (cities).

3. Approve the Standard organizational structure of public health departments of areas (cities) according to appendix No. 1*.

4. Determine the main objectives of public health departments of areas (cities):

(a) carrying out inventory count of the operating organizations of primary health care and by results of inventory count their transformation in the form of family polyclinic of the corresponding type with the status of the legal entity according to requirements of the Pilot project;

(b) transformation of multi-profile central polyclinics to consulting and diagnostic departments of the central hospitals;

(c) reorganization of medical crews according to new standard rates, the organization and control of attachment of the population to them within the Pilot project;

(d) carrying out certification of health workers on the basis of transparent mechanisms of providing subordinated medical institutions with qualified personnel, by its results acceptance for work of health workers on complete rate and creation for them worthy working conditions;

(e) control of the conclusion of agreements between family doctors and the attached population, and also contracts between medical institutions in the corresponding territory and Fund of national health insurance, and also their observance;

(e) control of accomplishment of the approved performance indicators of activities of health workers, and also their stimulation on the basis of results;

(g) the organization of rendering to the population of out-patient and stationary medical services, and also providing with medicines on free basis within the guaranteed amounts of medical care covered at the expense of means of the Government budget;

(h) ensuring advanced training of workers of medical crews according to the special training program of family health, leading employees - on management rates together with medical educational institutions according to the procedure, established by the Ministry of Health;

(i) taking measures to decrease in operational load of health workers by means of digitalization of business processes in activities of subordinated medical institutions and transfer to electronic form of all reports which are kept in paper form;

(j) accumulation of the means optimized within the Pilot project on the corresponding personal treasurer account opened for public health departments of areas (cities), their direction on financing of the expenses connected with realization of the Pilot project;

(k) conducting monitoring of rendering not medical services (food, washing, sterilization and other), and also works on transfer to private sector of the inefficient and empty buildings and constructions on the basis of public-private partnership or outsourcing;

(l) implementation of rendering paid services in medical institutions and rendering assistance in expansion of their types;

(m) ensuring connection to the Platform of digital health care of all state and non-state medical and pharmaceutical organizations in the corresponding territory, including drugstores;

(o) development of suggestions for improvement of condition of health care in the corresponding territory by the analysis of indicators of health of the population, the illness rate and other data.

5. Determine the main activities of medical institutions within the Pilot project:

(a) for family polyclinics:

(i) the conclusion of agreements between medical crews and the attached population, timely and high-quality rendering medical services within the packet guaranteed by the agreement based on the approved standards of treatment, national clinical protocols;

(ii) the conclusion of the contract of purchase of medical services with Fund of national health insurance proceeding from the number of the attached population;

(iii) implementation in family polyclinics of services of the family doctor, pediatrician, obstetrician-gynecologist and specialists in diagnostics, dental services - on the basis of outsourcing;

(iv) carrying out regular assessment of activities of family doctors proceeding from number of the population served by them;

(v) providing the population with necessary medicines within the guaranteed packet on free basis according to programs of individual treatment and improvement;

(vi) implementation of activities for rendering exit medical services by health workers for the citizens living in descents of citizens makhally, located at distance more than 10 kilometers from family polyclinic;

(vii) the organization of medical examination of the population for the purpose of detection of diseases at early stages, and also works on vaccination of the population according to the National calendar of preventive inoculations and in emergency situations, ensuring reproductive health and safe motherhood, implementation of propaganda activities among the population on maintaining healthy lifestyle, physical activity, refusal of addictions;

(viii) provision of the electronic direction on acceptance to specialists of narrow profile and in hospitals;

(b) for the central hospitals of areas (cities):

(i) conclusion of the contract of purchase of medical services with Fund of national health insurance;

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