International Journal Of History And Political Sciences
9
https://theusajournals.com/index.php/ijhps
VOLUME
Vol.05 Issue08 2025
PAGE NO.
9-13
10.37547/ijhps/Volume05Issue08-02
Reforms Implemented in The Medical and Healthcare
System of Uzbekistan In the Early Years of
Independence: Problems and Achievements (In the
Example of Jizakh Region)
Bobobekova Nargiza Ismatullayevna
Doctoral student of QarSU, Uzbekistan
Received:
13 June 2025;
Accepted:
09 July 2025;
Published:
11 August 2025
Abstract:
This article examines the implementation of health care reform measures in the first years of
independence in the Jizzakh region, focusing on hospitals located in several regional districts. It also analyzes the
potential of doctors, nurses, and pharmacists, who are the guardians of health care, the role of women working
in the system, the level of training of health care institutions, and the current problems and achievements in the
field.
Keywords:
Measures to reform the healthcare system, medical institutions, problems in the healthcare system,
doctors, nurses, female doctors, rural medical stations, family clinics, material and technical base of medical
institutions, medical equipment, medicines, gynecology, obstetrics, pediatrics, FAP (paramedic-obstetric
stations).
Introduction:
From the first years of independence,
within the framework of the implementation of
measures to reform the healthcare system in our
Republic, specific work began to be carried out to form
a modern system of providing medical care to the
population, and despite a difficult period, certain
results were achieved. In particular, the system of
providing primary medical and sanitary care was
improved by initially organizing rural medical stations,
urban and rural family polyclinics, and the population's
access to these services was expanded. A single
centralized system of providing emergency medical
care was created, and the network of republican
specialized scientific and practical medical centers
providing medical care to citizens, including on the
ground, was improved.
A number of targeted national programs have been
implemented to strengthen the reproductive health of
the population and protect motherhood and
childhood. The establishment of republican and
regional screening centers to prevent children from
being born with hereditary and congenital diseases was
the beginning of positive achievements [1].
So, how was the implementation of measures to
reform the healthcare system ensured within the
Jizzakh region in the first years of independence? How
did it proceed at the level of districts? What was the
level of capacity of doctors, nurses, and pharmacists
who were the guardians of healthcare? What was the
position of women working in this system? What was
the level of training of medical institutions? What were
the existing problems in the field? Who were the
winners?
According to statistical analyses, in 1991, more than
2,500 doctors and pharmacists with higher education
and about 6,800 middle-level medical workers worked
effectively in the health care institutions of our region.
Of these, 6 are health care workers who have rendered
service in the Republic, 14 are candidates of medical
sciences, and more than 700 category doctors have
devoted all their knowledge and skills to the cause of
human health[2,3-b].
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International Journal Of History And Political Sciences (ISSN
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2771-2222)
Also, in 1991, there were 3 medical schools in the
region, which trained more than 1,000 mid-level
medical workers for healthcare institutions. More than
700 doctors improved their skills in higher medical
institutions in Moscow, Leningrad, Kazan, Kharkov,
Tashkent, Samarkand and other cities [3, ibid.].
Sources show that the achievements in maintaining
public health in hospitals, not only in our region, but
also throughout the Republic, since independence,
have led to a decrease in various diseases due to the
improvement of the quality of medical care provided to
the population, the increase in the number of beds in
existing hospitals, and the re-equipment with modern
equipment.
the implementation of measures to reform the
healthcare system in terms of the activities of the
Jizzakh regional hospital and district hospitals located
in several districts.
We can see from the sources that by 1991, the Jizzakh
Regional Hospital team had achieved a number of
successes in providing qualified medical services to the
population. For example, a department for treating
voice diseases equipped with modern equipment was
opened at the “Maslahat” polyclinic under the Regional
Hospital, which began to show good results from the
very first day. Olya Eshtokhtarova, an actress of the
regional theater, noted the following in an interview
with the correspondent of the “Jizzakh Haqiqati”
newspaper:
“A pleasant voice is of primary importance for artists. It
is clear that no one likes a song sung in a hoarse voice.
The opening of the “voice disease treatment room”,
which was opened at the initiative of the experienced
doctor Halima Karimova, head of the ear, throat and
nose department of the regional hospital, was
especially important for us artists. Here, every day from
eight o'clock, the attending physician Ergash Otaboyev
receives patients and helps them recover from their
ailments” [4,4
-b].
There are also problems in the regional hospital, and
the chief physician of the regional hospital, E. Ermatov
(chief physician of the Jizzakh regional hospital since
1991), spoke about the following in terms of ways to
eliminate them and plans to be implemented in the
future. In particular, the existing problems:
-low number of seats,
-lack of modern medical equipment,
-most of the staff do not have sufficient qualifications,
-he acknowledged that the equipment is outdated, and
therefore there are difficulties in diagnosing some
diseases, which in turn has caused various objections
among patients [5,3-b].
" Our thirteenth five-year plans reflect the work we will
do to solve the above problems," writes E. Ermatov.
According to specific measures:
-Construction of an additional 120-bed medical facility,
increasing the number of beds to 825,
-establishment of departments for treating patients
with anemia and chronic kidney disease, as well as
vascular diseases, which were not previously
established in our region,
-specialized medical care types amounted to 28 types
until 1991, and will be increased to 35 types in the
future,
-retraining 20-25% of doctors every year,
-Training 2 neurologists and 2 hematologists to
implement new methods of vascular surgery,
-provide close assistance to district hospital staff,
- implementing measures to teach other hospital
specialists the procedures used at the regional hospital,
Sources indicate that these plans and measures were
later put into practice [6, ibid.].
In turn, although the problems mentioned are also
observed in the districts of Jizzakh region, we can see
that effective progress has also been made. For
example, in 1982, a 3-story hospital with 105 beds and
a polyclinic with a capacity of 250 patients was put into
operation in Uchtepa, the center of Jizzakh district
(now Sharof Rashidov district), and initially doctors
such as T. Boboyev, Sh. Sultanov, Sh. Yusupov worked
in their specialties.
By 1991, many hospitals and pharmacies were also
established in state farms in this district. In particular,
there were 4 hospitals with 315 beds, 10 doctors, 4
paramedics, an outpatient clinic, a pharmacy and its
departments, and a sanitary service. In these medical
institutions, headed by A. Ahmedov, 61 doctors, 254
nurses and pharmacists were in the service of the
people [7,2-b]. With the commissioning of a modern
medical facility for its time with 235 beds, completed in
1989, medical services to the population were further
improved. At that time, the hospital had internal
diseases, obstetrics and gynecology departments, and
a polyclinic for 100 patients. The hospital expanded
year by year, and in March 1991, an 80-bed
neurological department was opened for patients with
cerebral circulation disorders. This department played
an important role in protecting the health of the
population. Patients with neurological diseases used
physiotherapy treatments. All conditions were created
for this. From this year, a 6-bed intensive care unit was
also established in order to constantly monitor
seriously ill patients and provide timely modern
medical services. The work of qualified first-class
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International Journal Of History And Political Sciences (ISSN
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doctors T. Odiljonov, B. Bakayeva, T. Poldoshev, and
nurses M. Hoshimova, R. Hasanova, and Kh. Toshkulova
in the rapid recovery of patients' health is
commendable [8,3-b].
The first medical institution in the Du'stlik district,
founded in 1970, was opened as a medical center in
one of the rooms of the houses under construction,
simultaneously with the construction of the district
center. It was headed by a doctor-paramedic Natalya
Pavlova. In 1971, an outpatient clinic was opened in a
residential building, and by the end of the same year, a
75-bed hospital and a pharmacy were opened, and an
"Ambulance" vehicle was put into operation. Doctors
such as M. Segizboyeva, Kh. Vahobov, O. Jorgatayev,
and V. Mayelocha gained popularity among the people
in the hospital [9,2-b]. Gradually, medical networks
were formed throughout the district. In particular, by
1980, a new 4-story hospital building with 240 beds was
put into operation together with a polyclinic, where
doctors such as Yakshiliq Baratov, Rahmonkul
Suvonkulov, and Ravshanov headed the hospital
departments.
In 1991, the district's medical institutions had 570
people (some sources state 520 people. Source: Sunnat
Qosimov. Development of medical services in Qoriq //
Jizzakh reality, 21.12.1991, No. 94 (2901), 2-b) and 700
people could be treated on an outpatient basis [10.5-
b]. There were 3 hospitals, 17 outpatient clinics, 2
paramedic medical stations, a pharmacy and its
departments, and a sanitary service [11.2-b]. The
hospital was staffed by 117 doctors [12, ibid.] (some
sources say 93 doctors. Source: Jurakulov.M. Health
guards // Jizzakh truth, 22.06.1991, No. 75 (2882), 5-b),
321 nurses [13, ibid.] (some sources say 340 nurses.
Source: Jurakulov.M. Health guards // Jizzakh truth,
22.06.1991, No. 75 (2882), 5-b) and pharmacists. 38
doctors [14, 5-b] and 24 nurses [15, ibid.] were first-
class physicians.
Of course, where highly qualified doctors and nurses
work, the quality of public health care is also high. For
example, we can see from the statistical data that by
1993 the number of infectious diseases in the district
had decreased by half, and the number of child deaths
had decreased by the same amount. The therapist
Gulchehra Saidahmedova and the senior nurse of the
children's hospital Shohsanam Muminova also made a
worthy contribution to achieving such achievements
[16, ibid.]. These two medical workers had a high rank
among the people due to the conscientious
performance of their duties. They often spent their free
time among the population, giving advice on medicine
and the prevention of various diseases. According to
the results of our analysis, women played a significant
role in the effective organization of the district's health
care system. Our female doctors who have held
leadership positions have made their worthy
contribution to the proper formation of the triad,
despite the subtleties of the management field.
But there was one truth. It is true that since the first
years of independence, serious reforms have been
carried out in the field of healthcare, and many
measures have been taken to provide specialized
medical services, protect motherhood and childhood,
provide the population with medicines, and raise a
physically strong and spiritually healthy generation.
However, there were still many problems in this area
that were waiting to be solved. These include the weak
material and technical base of medical institutions, the
lack of necessary emergency medical centers and
pharmacies in rural family clinics, the lack of personnel,
the low level of improvement in the condition of
patients due to diagnostics and low qualifications of
doctors, their forced treatment in foreign countries for
a large amount of money, the existence of obstacles to
the work of entrepreneurs in the development of the
private medical system, and the fact that 74 percent of
the population's need for medicines is met through
imports [17].
Regarding the problems of 1991, doctor Sarimsok
Qosimov admitted the following in an interview with
the newspaper "Jizzakh haqiqati":
There are many problems. There are currently 3
infectious diseases hospitals in Jizzakh. They are trying
to merge them. In my opinion, it would be better if the
jaundice hospital itself was separate. The material and
technical base of the hospitals is inadequate. There are
not enough beds. We need disposable needles.
Telephones do not work. New modern devices are
urgently needed. Many medical institutions are not
adequately supplied
with medicines,
medical
equipment, supplies, and patient care items. Without
these, medical services cannot be rebuilt [18,4-5-b].
In conclusion, 1991 was a difficult period for the
Republic of Uzbekistan. It was a time when the country
gained independence, separated from the former
USSR, and a new national health policy was being
established. Therefore, it was a time when the system
faced challenges, but also achieved some successes.
If we look at the problems, firstly, we can see a sharp
decrease in funding during this period. That is, after the
collapse of the USSR, funds allocated from the central
budget stopped, as a result of which the shortage of
equipment, medicines, and technology in medical
institutions increased.
Secondly, the obsolescence of existing equipment. The
equipment in almost all hospitals and polyclinics in the
republic was mainly installed in the 1970s and 1980s
International Journal Of History And Political Sciences
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International Journal Of History And Political Sciences (ISSN
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2771-2222)
and was not updated in 1991 due to economic factors.
Third, there were disruptions in the supply of
medicines. The reason was the sharp increase in the
price of imported medicines and the insufficient local
production.
Fourth, the problem of staff shortage was one of the
most pressing. Because during this period, the
emigration of highly qualified specialists abroad
increased, and economic difficulties in the republic led
to a decline in the quality of education in the system of
training young personnel.
Fifth, the difficulty of providing medical services in rural
areas. The main reasons for this were weak
infrastructure, a lack of qualified doctors, and modern
equipment.
In 1991, Ilhom Jamolov, the acting chief physician of the
Regional Infectious Diseases Hospital, believed that the
problems in the medical and healthcare sectors could
not be eliminated until these existing problems were
completely eliminated.
Despite this, the republic's medical and healthcare
system continued to develop, albeit slowly. In
particular,
-First, the foundation of the National Health System
was created. That is, the Ministry of Health of the
Republic
of
Uzbekistan
began
to
operate
independently, and an independent national health
policy was established.
-Legislative reforms have begun in the field of medicine
and healthcare. In particular, laws have been adopted
on the development of healthcare and providing the
population with medical care on a state-guaranteed
basis.
-The foundation for the production of national
medicines has been laid. Several local pharmaceutical
enterprises have been established and work has begun
to reduce dependence on imports.
-Disease control centers have been established. As a
result, certain results have been achieved in preventing
the spread of infectious diseases through sanitary and
epidemiological services.
This does not mean that all programs implemented in
the former USSR have been canceled. Programs and
projects that were effective have been preserved to a
certain extent. For example, we can have prevention
and vaccination programs, as a result of which many
diseases among children have been prevented.
Despite the difficult period, the role of women in the
development of medicine and healthcare was also
unparalleled.
First
, they were the leading force in
providing services to the majority of the population.
They played a leading role in particular in the fields of
gynecology, obstetrics, pediatrics and primary care.
Also, rural polyclinics and FAP (field nurse-midwifery
stations) were staffed mainly by female specialists.
Secondly
, they were also active in prevention and
promoting a healthy lifestyle. That is, in protecting the
health of children and women, teaching them sanitary
and hygienic habits, vaccination and prevention
programs were also carried out mainly by female
doctors.
Third
, despite economic difficulties, including low
salaries and financial problems, many female doctors
have not left the profession. This process has been an
important factor in maintaining stability in the field.
Fourth
, social and spiritual influence was a leading
force in them. Women doctors were considered
trustworthy figures in the community and in the
community, and their gentleness and cultural level in
communicating with the population were a great
advantage.
Fifth
, opportunities for professional development have
emerged. In particular, in the early years of
independence, short-term training courses for female
specialists were organized through international
organizations (WHO, UNICEF, etc.). Some female
doctors continued to engage in scientific work and later
rose to the positions of professors and directors.
In the first years of independence, the implementation
of measures taken in the healthcare sector of
Uzbekistan, despite the difficult political and economic
conditions, was one of the state's priority tasks aimed
at protecting the health of the population and was
consistently organized at the republican and regional
levels.
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