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24 декабря 2019

INFORMATION On the “Primary Health Care Improvement” investment project with the participation of Asian Development Bank (ADB)

The goals and objectives of the project are defined in accordance with the Resolution of the President of the Republic of Uzbekistan dated 29 th of March, 2017 № PP-2857 “On measures to improve the organization of primary health care facilities of the Republic of Uzbekistan activity”

The feasibility study of the project was approved by the resolution of the Cabinet of Ministers of the Republic of Uzbekistan, dated November 1 st, 2018 № 902 “On measures for the implementation of the “Primary Health Care Improvement” project with the participation of Asian development bank (ADB).

The project will contribute to strengthening the health sector in rural areas by equipping rural medical clinics with modern medical equipment and training medical staff in order to expand the services they provide.

The total amount of the project:

57,8 million USD of which:

Government contribution – 12, 8 million USD;

ADB loan – 45, 0 million USD

The project provides for equipping 793 rural medical policlinics with modern medical equipment. Besides, the pilot operation of the health management information system will be carried out in one of the rural regions.

The structure of the “Primary Health Care Improvement” project includes the following components:

1. Procurement of medical and non-medical equipment

This output focused on providing each of newly created medical policlinics with medical and non-medical equipment. Each of the 793 rural medical policlinics will receive the following standard set of equipment:

  • Universal digital ultrasound diagnostic system with color Doppler
  • 12-lead ECG
  • Ophthalmoscope / Otoscope Sets
  • Instrument sets for operating surgeon, obstetrician-gynecologist
  • Patronage bags with contents
  • Electronic scale with height meter
  • Dental units (with accessories)
  • PC’s

Within the framework of the project, all purchased equipment will be registered and serviced by the Republican maintenance center of the Ministry of Health.

Besides that, this output planned to equip 13 regional multi-profile medical centers, TIPME, faculty of advanced training and retraining of doctors in Andijan and Samarkand State medical institutes each with one ultrasound scanner and one ECG to facilitate training activities. The training process will be coordinated and implemented by TIPME, the leading institution, responsible for training and professional development of medical personnel.

2. Strengthening the capacity of the staff of polyclinics.

This output will provide training to about 2,704 health technology operators, doctors, and nurses at family polyclinics to ensure their competence in using the equipment and to improve their diagnostic and therapeutic skills. This in turn will help to improve the quality of care, and public trust in and use of PHC services; and ultimately reduce morbidity and mortality. Under this output, Uzbekistan’s medical training institutions will be provided with the necessary training and equipment to institutionalize the skills of their health staff.

3. PHC monitoring tools institutionalized.

This output will focus on the development and implementation of monitoring tools for the collection, processing, imaging and use of data to strengthen the health system of the Republic and monitor its effectiveness, as well as to achieve the goals of public health and progress in the reform of WHO and PHC.

Currently, the collection and processing of public health data is done in a manual way (on paper), when primary health care institutions submit data to the regional health authorities for further imaging and reporting to the statistics authorities and the Ministry of Health. The output focuses to establish tools and procedures for more effective monitoring of health indicators. The implementation of the activities outlined in this component will carried out in two ways:

First method: a platform for systematic collection of main indicators of primary health care data will be established within the ADB/WHO structure. The health data-monitoring panel will provide the government health interested parties with direct and immediate access to detailed or aggregated health indicator data.

Second method: In (family) medical policlinics with the day-treatment departments in Syrdarya region a pilot implementation and operation of the Health Management Information System (hereinafter - "HMIS"), by providing the necessary equipment and software will be implemented.

Current situation

1. Procurement of medical and non-medical equipment

Tender for the procurement of medical equipment, set of instruments, accessories and PC’s for medical rural policlinics for the amount of 25 million US Dollars (PHCIP/ICB-G1) was announced on April 9, 2019. Bid opening was on May 21, 2019.The evaluation of proposals was completed, the evaluation report sent to ADB, and recommendations of the preliminary report review is received. On August 14, 2019 the report on the results of the technical evaluation of the proposals was submitted for discussion to the meeting of the Procurement Committee. On September 24, 2019, the final meeting of the procurement committee was held to discuss the results of the technical assessment and make the final decision on all the lots. The evaluation report was finalized, taking into account the decision made, as well as the recommendations of the procurement committee. In accordance with the final version of the evaluation report for Lot No. 3, there was made a decision to conduct for re- tender.

On October 8,2019 the ADB approved the evaluation report. ADB’s No Objection for announcement of re-tender for Lot No. 3 received.

On October 10,2019 the financial bids were opened. On November 29, 2019, a meeting of the procurement committee to review and agree the report of financial proposals evaluation was held. Based on the results of review, the decision of awarding a contract to Lot No.2 was taken (procurement of 12-lead ECG, re-tendering Lots No. 1,4 and 5).

There was conducted a study on readiness of dental offices in rural family polyclinics for the acceptance of dental equipment supplied in the framework of the project. In the Republic of Karakalpakstan, as well as in Navoi, Namangan, Bukhara, Ferghana, Andijan, Jizzakh, Samarkand and Kashkadarya regions, monitoring was carried out to study 353 rural family polyclinics. On-site familiarization with the project objectives has been carried out. Recommendations are given on fulfilling the requirements for a dental office and other medical equipment.

2. Strengthening the capacity of the staff of polyclinics.

Starting November 4, 2019, the 1st group of doctors of the Rural Family Policlinics started a 5-month training program for ultrasound doctors. Weekly monitoring of training being carried out.

3. PHC monitoring tools institutionalized.

The Terms of Reference for contracting the SUE “ICT Development Center” as Service Provider under the Primary Health Care Improvement Project for development the Primary Health Care Management Information System (PHCMIS) submitted to ADB for No Objection. On December 18, 2019 the comments and suggestions to the ToR received. Taking into account the comments of ADB, the revised ToR sent to ICT Development Center under the Ministry of health of the Republic of Uzbekistan.

PIU contacts:

100007, Tashkent, Parkent str, 51

Phone/fax: (+998-71) 268 0819, 268 2539, 268 1213

fax: (+998-71) 267-73-47

e-mail: uzphcip.piu@gmail.com