Support to Health Sector Reform in the Aral Sea Region

Swiss TPH and its local partner ISIDA Consulting Company are implementing a feasibility study on behalf of the KfW Development Bank and the Ministry of Health of the Republic of Uzbekistan that focuses on further developing the health system in the Aral Sea Region.

Deliverables include a concept note based on a desk review of published literature, analysis of secondary data from the Ministry of Health and State Institute of Statistics, as well as the collection of primary data collected through the WHO Harmonised Health Facility Assessment (HHFA) Tool. Based on confirmation of the concept note, a full-blown feasibility study report will be completed. The HFFA tool is also to be used in Kashkadarya oblast and submitted as an additional deliverable.

Initial findings reveal that there are huge variances between districts in the Aral Sea region. There is also a gradual increase in the overall mortality rate due to an aging population and accordingly a change in the age structure of the population. There are high and increasing air, soil and water pollution levels across the region, especially around the urban areas of Nukus city - but also in Khorezm oblast, where people reported a high health burden from dust storms coming from the Aral Sea. Cardiovascular diseases cause the largest burden of disease (approximately 27% of all disability-adjusted life years (DALYs), followed by respiratory infections and tuberculosis (9%) and neoplasms/cancers (8%) (7). There are also health systems challenges related to human resources for health, health financing, maintenance and waste management that need to be addressed.

In close consultation with the Ministry of Health and streamlined with the ongoing and planned investments of other development partners, the potential focus areas for this future German investment of EURO 32 million are being assessed. The work is planned for completion by the end of 2021.


Helen Prytherch

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