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5PROSPECTS FOR REFORMING THE MATERNAL AND CHILD
HEALTH SERVICE
1Rasulova Nilufar, 2Ismailova Feruza
1Associate Professor of the Department of Public Health and Health Management, Tashkent
Pediatric medical institute (Uzbekistan) 21st year master's student in health care management and public health, Tashkent Pediatric
medical institute (Uzbekistan) https://doi.org/10.5281/zenodo.7880777
Abstract. Since the year of independence, our country has been taking measures to improve health and reform the maternal and child health service. Over the past decade, major reforms have been implemented aimed at improving the efficiency and effectiveness of the healthcare system. Reform plays an important role in protecting the health of mothers and children.
Keywords: health protection, mother, child, UNICEF, health reforms.
The healthcare system is mainly aimed at the state level, which in turn is divided into three levels of hierarchy: the national (republican) level, the regional level and the local level, consisting of districts or cities, with a relatively small share of the private sector. The private sector still represents a small part of the system and is mainly represented by pharmacies, private medical clinics, and institutions engaged in the production and supply of medicines or medical equipment. The Ministry of Health plays an important role in the organization, planning and management of the healthcare system of Uzbekistan. Since there is a single integrated model in the health care system, in which the state is the main provider of health services for the population, almost all medical workers are government employees.
The healthcare system still follows an integrated approach contractual relations are not developing. Some problems are related to the financing of healthcare. This shows the implications for ensuring equality in the financing and consumption of medical services by the population. A further increase in the share of public spending on health care will make it possible to apply strategies that provide better financial protection of public health. This may include the expansion of the basic package of services and the formation of a social package of free medication for outpatient treatment, as is practiced in some other CIS countries. Targeted and well-thought-out reform initiatives in these areas are likely to lead to improved access, equity, quality of care, efficiency and effectiveness. The quality of maternal and child health services is increasingly recognized as a problematic aspect, efforts are constantly being made to improve treatment protocols, review medical education, continuous professional development, as well as quality assurance and improvement of structures. In the future, these efforts need to be intensified in order to further improve the quality of medical care. The solution may be further investments in healthcare information systems. There is a lack of data on the functional status, satisfaction of women, accessibility and quality of services for the child. In recent years, more than 160 regulatory documents have been adopted to reform the system of protection of mothers and children. As a result, important changes are taking place in all parts of the healthcare system. Starting from primary medical care and ending with specialized centers, new technologies are being introduced everywhere, the achievements of world science and medicine are widely used. In remote areas, it is necessary to organize a system of targeted medical care at a high level, improve the efficiency
of medical services provided to mother and child, further improve outpatient care after discharge, develop emergency and specialized medical care, introduce medical genetics programs and modern screening of pregnant women. In order to strengthen the health of mother and child, identify measures aimed at creating the conditions necessary for the birth of a healthy child, as well as the implementation of the tasks identified within the framework of the open dialogue of the President of the Republic of Uzbekistan with representatives of the healthcare sector on the topic "Reforms in medicine — for the honor and dignity of a person" held on March 18, 2022. Priority areas for strengthening the health of mothers and children in 2022-2026: the introduction of disease prevention among pregnant women, mothers and children, their early diagnosis and recovery in the primary health care system, including: strengthening advisory work on the birth, development and upbringing of a healthy child, promoting proper nutrition and increasing physical activity of pregnant women and mothers, formation of healthy lifestyle skills; effective prevention of diseases by providing children, pregnant and lactating women with vitamins and minerals free of charge, as well as carrying out targeted screening activities; introduction of high-tech and innovative methods of diagnosis and treatment, as well as continuous improvement of the scientific potential of workers in the field. Since 2016, the Republic of Uzbekistan has embarked on a reform process that covers all social sectors of health protection, defines a new standard of government responsibility to citizens and revises the prospects for the realization of children's rights in Uzbekistan. These reforms are taking place in difficult conditions. Changes in social policy and social services require innovation and training, significant capacity building and investment to address the remaining gaps and inequalities in the realization of children's rights in Uzbekistan. Like other Central Asian countries, Uzbekistan is heavily affected by climate change and the risk of natural disasters, especially earthquakes, landslides and droughts. Ecological disaster in the Aral Sea region in the Republic. As a result of climate change, aggravated by the Aral Sea disaster, Uzbekistan is facing the problem of water scarcity, which, in turn, may lead to insufficient food security in some regions of the country. Although GDP growth is projected in the future, in 2017 Uzbekistan had a budget deficit of 0.1% of GDP,2 and the state external debt increased by more than 100% between 2016 and 2019. It is against this background that UNICEF in Uzbekistan is conducting an analysis of the situation of children. Expand the home and outpatient care system, taking into account the role of foster nurses in early detection and intervention for children with disabilities, victims of violence and children from various risk groups, as well as training foster nurses to change gender norms in families and local communities in which they provide services. Continue strengthening immunization and nutrition programs. Improve access to mental health, psychosocial care, reintegration and rehabilitation services for children at risk. Promote healthy lifestyle campaigns, including information and measures to combat alcohol, drug use, sexually transmitted diseases, and HIV. To improve knowledge about social norms, rights violations and vulnerabilities for which there is insufficient data, this will include conducting a comprehensive analysis of social norms and cultural practices in order to develop communication strategies for behavior change that can help reduce the vulnerabilities of children. Knowing that the elimination and change of gender and discriminatory practices will take a lot of time, work in this area can begin in families, it is necessary to consider and study methods of upbringing and care in traditional households and local communities, involve religious leaders to develop and implement strategies aimed at reducing vulnerability among children and women, strengthen the fight for the elimination of negative cultural traditions, such as early marriages, as well as the fight against
gender-based violence and domestic violence. There is also a need for more data and understanding about children's problems, as well as about mental health problems among young people. In addition, more research is needed to better understand the prevalence and exposure of children to various types of violence. In conclusion, it should be noted that, in general, the planned measures to improve the health care system clearly illustrate the priorities of socio-economic policy. This approach of the state will allow to modernize and strengthen this sphere, as well as lay the foundations for its long-term development. In the end, the risks to the health and life of the population will decrease.
REFERENCES
1. 2019/2020 SITUATIONAL ANALYSIS OF THE SITUATION OF CHILDREN IN UZBEKISTAN. UNICEF.
2. Rakhmatullayev, Abdullayev and Kazbekov (2017). "Water-energy-food-ecological interrelation in Central Asia: from transition to transformation".
3. Abdullaev U. (2020). "State-owned Enterprises in Uzbekistan: Overview and some reform priorities", Institute of the Asian Development Bank.
4. Decree of the President of the Republic of Uzbekistan No. 5938 dated February 18, 2020 "On measures to improve the socio-spiritual atmosphere in society, further support of the mahalla institute, as well as raising the system of work with families and women to a new level"
