Thanks to the Emergency Medical Services Project, better trained and managed medical personnel in hospitals across Uzbekistan will be appropriately equipped to help millions of people impacted by accidents and medical emergencies. The project was approved in April 2018 by the World Bank’s Board of Executive Directors and will be financed by a US$100 million credit.

The project launch workshop took place today at a seminar in the Samarkand regional branch of the Republican Scientific Center for Emergency Medical Aid involving representatives of the Ministry of Health of Uzbekistan and the World Bank.

The existing emergency medical services (EMS) system in Uzbekistan is highly fragmented, with little coordination between districts and regions across the country, due to the absence of integrated and computerized dispatch services to operate and monitor the activities of specialized ambulance teams required at the scene.  

In the meantime, the volume of calls requiring hospitalization of patients continues to increase. In 2017, 15.6 million outgoing calls were made to 103 in Uzbekistan, of which 8.7 million people received medical care. In 87% of cases, medical care was provided to patients at home, in 12% of cases they were hospitalized, and in 1% of cases, the calls were false.

Uzbekistan currently has one ambulance per 18,300 people, even though it should have been at the level of 1:13,000, according to national standards. Moreover, most of the current fleet of ambulances are unsuitable for providing modern pre-hospital care. They have limited space for providing life-saving care en route to the hospital and for storing emergency equipment.

Additionally, medical personnel providing services under the existing EMS system have limited access to equipment, drugs, and supplies. Their skills and abilities to diagnose and treat injuries, including from road traffic accidents, cardiovascular diseases and medical emergencies cases, need to be vastly improved.

The principal beneficiaries of the Emergency Medical Services Project will be people with trauma, medical and obstetrical emergencies. Hospitals across the country will receive support to enhance their capacity to effectively respond to these emergencies.

The project will develop integrated dispatch centers in all 12 regions of Uzbekistan, and in the capital, which will be responsible for receiving calls, dispatching all ambulances within their borders and monitoring their performance. The dispatch centers will be crucial to the effective and efficient use of EMS resources and their core element will be a common computer-aided dispatch and communications system capable of monitoring the distribution and availability of resources in order to respond to emergencies rapidly and effectively.

The project will invest in the initial training of physicians and nurses in emergency medicine to encourage more staff to work in this area. In addition, it will acquire and distribute around 60 modern Advance Life Support ambulances among hospitals across Uzbekistan, as well as essential equipment needed for those vehicles to deal with trauma and medical emergencies, including obstetrical and neonatal emergencies.

Improved response times, better equipment and better training, should result in better outcomes in terms of reduced mortality and morbidity, increasing confidence among Uzbek citizens in the quality and professionalism of the EMS. In turn, this should lead to increased utilization of the service for true emergencies with concomitant improvements in outcomes.

“World Bank is happy to support the reforms in the healthcare sector in Uzbekistan that are being implemented by the Government with the aim to provide high-quality medical services for citizens across the country”, said Elvira Anadolu, a Task Team Leader for the World Bank-supported health projects in Uzbekistan, welcoming the event participants in Samarkand.  

“The Emergency Medical Services Project is built on the achievements of early World Bank-financed projects at developing medical services in Uzbekistan. It aims to improve the EMS, which is one of the Government's priorities in this sector of public services. The country has already begun reform of this sector, in particular, the authorities have developed a regulatory framework for the proper functioning of the EMS, prepared concepts for an integrated dispatch system across the country, and also modern Advance Life Support ambulances are being purchased under a previous World Bank-supported project. Thanks to the new project, the improved EMS system will be able to treat about 6 million cases of trauma and medical emergencies per year”, added Elvira Anadolu.

During the workshop, participants were briefed on the project components, issues related to the project management, procurement of goods and services under the project, as well as the World Bank's social and environmental safeguard policies, which should be respected during its implementation.

In Uzbekistan, the World Bank is implementing 18 projects totaling over US$ 3.3 billion with the aim to support the Government’s ambitious social and economic reforms. These projects support macroeconomic reforms, development of agriculture and water resources management, healthcare, education, water supply and sanitation, energy, transport, and urban sectors. They contribute to the country’s economic growth and higher living standards for the people of Uzbekistan.