Comparative Study of Health Care System in Three Central Asian Countries: Kazakhstan, Kyrgyzstan, Uzbekistan / 보건행정학회지

BACKGROUND: The objectives of the study are to find out the effect of the implementing reform in three Central Asian countries, identify its impact on health status and health care delivery systems. This study address to identify strong and weak points of the health systems and provide a recommendation for further health care organization. METHODS: A comparative analysis was conducted to evaluate the effects of implemented policy on health care system efficiency and equity. Secondary data were collected on selected health indicators using information from the World Health Organization Global Health Expenditure Database, European Health Information Platform, and World Bank Open Data. RESULTS: In terms of population status, countries achieved relatively good results. Infant mortality and under-5 mortality rate decreased in all countries; also, life expectancy increased, and it was more than 70 years. Regulations of the health systems are still highly centralized, and the Ministry of Health is the main organ responsible for national health policy developing and implementation. Among the three countries, only Kyrgyzstan was successful in introducing a national health system. Distribution of health expenditure between public expenditure and out-of-pocket payments was decreased, and out-of-pocket payments were less the 50% of total health expenditure in all countries, in 2014. CONCLUSION: After independent, all three countries implemented a certain number of the policy reform, mostly it was directed to move away from the old the Soviet system. Subsequent reform should be focused on evidence-based decision making and strengthening of primary health care in terms of new public health concepts.

Prevalence of Intestinal Helminth Infections in Dogs and Two Species of Wild Animals from Samarkand Region of Uzbekistan

This study aimed to determine the prevalence of intestinal helminth parasitic infections and associated risk factors for the human infection among the people of Samarkand, Uzbekistan. Infection status of helminths including Echinococcus granulosus was surveyed in domestic and wild animals from 4 sites in the Samarkand region, Uzbekistan during 2015–2018. Fecal samples of each animal were examined with the formalin-ether sedimentation technique and the recovery of intestinal helminths was performed with naked eyes and a stereomicroscope in total 1,761 animals (1,755 dogs, 1 golden jackal, and 5 Corsac foxes). Total 658 adult worms of E. granulosus were detected in 28 (1.6%) dogs and 1 (100%) golden jackal. More than 6 species of helminths, i.e., Taenia hydatigena, Dipylidium caninum, Diplopylidium nolleri, Mesocestoides lineatus, Toxocara canis, and Trichuris vulpis, were found from 18 (1.0%) dogs. Six (T. hydatigena, Toxascaris leonina, Alaria alata, Uncinaria stenocephala, D. caninum, and M. lineatus) and 2 (D. nolleri and M. lineatus) species of helminths were also detected from 5 Corsac foxes and 1 golden jackal, respectively. Taeniid eggs were found in 2 (20%) out of 10 soil samples. In the present study, it was confirmed that the prevalences of helminths including E. granulosus are not so high in domestic and wild animals. Nevertheless, the awareness on the zoonotic helminth infections should be continuously maintained in Uzbekistan for the prevention of human infection.

A Comparative Study on Primary Health Care in Republic of Korea and Republic of Uzbekistan / 보건행정학회지

BACKGROUND: Primary health care (PHC) plays a major role to ensure the basic right and equal distribution of the essential health care services. This study presents comparative analyses of PHC in Korea and Uzbekistan, discusses the existing scenario and the challenges, and provides recommendations. METHODS: This study reviewed secondary data from Korea's National Statistical Information Service and the State Committee of the Republic of Uzbekistan on Statistic, regulatory legislation, research reports, and policy papers by research and international institutions. We focus on comparing input and outcome health data, PHC structure, and health expenditure. RESULTS: Overall health status of the population in Korea is better than in Uzbekistan; both countries achieved more than 95% immunization coverage. The reforms implemented in both countries provide initial health care service delivery. However, there are several challenges such as the distribution of the staff between urban and rural areas and interest of the graduates on specialization rather than working in PHC system. CONCLUSION: PHC plays an important role in the provision of medical services to the population, addressing both health and social problems; it is the best tool for achieving universal coverage for basic health needs of the population. The community health practitioners in Korea and nurses in Uzbekistan plays main role in universal coverage through providing essential health care services. Continuous reform of the PHC system should be directed to strengthen the capacity of the PHC staff in health promotion knowledge and activities as well as to encourage population to improve their own health.

A Comparative Study on Primary Health Care in Republic of Korea and Republic of Uzbekistan / 보건행정학회지

BACKGROUND: Primary health care (PHC) plays a major role to ensure the basic right and equal distribution of the essential health care services. This study presents comparative analyses of PHC in Korea and Uzbekistan, discusses the existing scenario and the challenges, and provides recommendations. METHODS: This study reviewed secondary data from Korea's National Statistical Information Service and the State Committee of the Republic of Uzbekistan on Statistic, regulatory legislation, research reports, and policy papers by research and international institutions. We focus on comparing input and outcome health data, PHC structure, and health expenditure. RESULTS: Overall health status of the population in Korea is better than in Uzbekistan; both countries achieved more than 95% immunization coverage. The reforms implemented in both countries provide initial health care service delivery. However, there are several challenges such as the distribution of the staff between urban and rural areas and interest of the graduates on specialization rather than working in PHC system. CONCLUSION: PHC plays an important role in the provision of medical services to the population, addressing both health and social problems; it is the best tool for achieving universal coverage for basic health needs of the population. The community health practitioners in Korea and nurses in Uzbekistan plays main role in universal coverage through providing essential health care services. Continuous reform of the PHC system should be directed to strengthen the capacity of the PHC staff in health promotion knowledge and activities as well as to encourage population to improve their own health.

Prevalence of Serum IgG Antibodies to Cystic Echinococcus Antigen among Patients in an Uzbekistan Emergency Hospital

Cystic echinococcosis (CE) is one of the most widespread zoonotic helminthiases, which can last an asymptomatic infection for several years. The purpose of this study was to demonstrate serum antibody prevalence of CE among asymptomatic people in Uzbekistan using ELISA. A total of 2,547 serum samples were collected, 66 from confirmed CE patients and 2,481 of patients with other diseases than CE at a hospital in Tashkent, Uzbekistan. The serum samples were screened for CE specific IgG antibodies by ELISA using cystic fluid antigen obtained from sheep. The serum antibody positive rate was 89.4% (59/66) in CE and 3.6% (89/2,481) in other disease patients. The present ELISA recognized 89.4% sensitivity and 96.4% specificity. The ELISA absorbance of positive samples was distributed 0.271-0.971 for CE and 0.273-0.887 for other disease patients. The other disease patients with high absorbance over 0.3 were 50 (2.0%) who were presumed to be active CE patients. The patients in their 40s showed the highest positive rate of 5.2% (P=0.181), and women were 4.4% while men were 3.1% positive (P=0.136). The data confirmed that there are many asymptomatic patients of CE in Tashkent. It is indicated that CE is an endemic disease of public health importance in Uzbekistan.

The situation of the rehabilitation in Uzbekistan / 国際保健医療

<B>Introduction</B><BR>The purpose of this paper is to contribute to those who would be involved in rehabilitation in Uzbekistan and who require deepening their understanding of medical and welfare system of the country. The research has significance in the sense that there are very few Japanese articles that touch upon the rehabilitation system and also people with disabilities in Uzbekistan until present.<BR><B>Method</B><BR>The information was collected from August 2010 to June 2012. During the two years of my work as a physical therapist at the National Centre of Rehabilitation and Prosthesis Invalids in Uzbekistan, the research methodologies were formal and informal interviews, observations and field visits.<BR><B>Results</B><BR>In Uzbekistan, these is no educational system which can give a diploma of physical therapist or occupational therapist, therefore, medical doctors and nurses play significant roles to see patients and to practice therapy in the Rehabilitation Centre.<BR>By observing the situation at the Rehabilitation Centre, there were many differences between Uzbekistan and Japan in environment of rehabilitation. In Uzbekistan, more than half of patients had some orthopedics diseases. Also, the annual number of patients admitted to the Centre was above 4,000 as well as the average number of days for hospitalization in the Centre was around two weeks.<BR><B>Conclusion</B><BR>Observing the situation of the Rehabilitation Center in Uzbekistan, medical perspective is taken into consideration as one and only important methodology in rehabilitation. On the other hand, social and vocational rehabilitations are not well-considered in the Centre. It is crucial to include and develop the social and vocational rehabilitation systems for people with disabilities to fit in the community as they were before.

Infection Status of Hydatid Cysts in Humans and Sheep in Uzbekistan

Uzbekistan is endemic of cystic echinococcosis (CE). In order to estimate endemicity of CE, we collected data from emergency surgery due to CE in 2002-2010 and also investigated the prevalence of hydatid cysts in the liver and lungs of sheep at an abattoir in Uzbekistan from July 2009 to June 2010. In 14 emergency hospitals, 8,014 patients received surgical removal or drainage of CE during 2002-2010, and 2,966 patients were found in 2010. A total of 22,959 sheep were grossly examined of their liver and lungs, and 479 (2.1%) and 340 (1.5%) of them were positive for the cyst in the liver and lungs, respectively. Echinococcus granulosus is actively transmitted both to humans and sheep, and CE is a zoonotic disease of public health priority in Uzbekistan.