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Uzbekistan Aims to Allow Private Medical Institutions to Deliver Babies

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Uzbekistan Aims to Allow Private Medical Institutions to Deliver Babies

Child delivery and abortion are among the very few medical procedures that are exclusively conducted by state medical entities. That could change soon.

Uzbekistan Aims to Allow Private Medical Institutions to Deliver Babies
Credit: Depositphotos

Uzbekistan may soon authorize private medical institutions to practice the delivery of newborns starting from 2025. A draft presidential decree is up for discussion until April 19, but so far, no comments have been received from the public in the online portal.

While this move marks another step in the country’s privatization efforts and aims to address issues such as overcrowding and corruption in state-run maternity facilities, it also presents a new set of challenges.

Uzbekistan has come a long way in loosening the grip of the state on medical services, but with the new government in charge since 2016, things have been changing very fast. Previously, private medical entities were restricted to offering only 50 out of 177 types of services. However in 2017, Tashkent expanded the list of services that can be offered by private medical facilities to 168. Additionally, from 2021, medical professionals with a university degree are no longer required to have at least five years of experience to join private clinics. 

Child delivery and abortion are among the very few medical procedures that are exclusively conducted by state medical entities under the above mentioned 2017 presidential decree. These practices, along with others such as organ and blood donation procedures, treatment of tuberculosis, rabies, or leprosy, and any form of medical-forensic examinations, are restricted from private sector involvement. Presumably, these restrictions are meant to prevent human and organ trafficking as well as to prevent a sanitary-epidemiologic crisis given there is a risk of medical negligence and corruption. 

Human trafficking has decreased in recent years significantly, from 574 cases registered in 2012 to just 93 in 2022. However, there continue to be reports of babies being sold. Just in March, a 27-year-old woman was sentenced to eight years (under the article 135 of the Criminal Code of Uzbekistan on human trafficking) for attempting to sell her own child for around $800. Between 2017 and 2021, 206 such cases were identified by the police. There are many cases of baby sales that are arranged with the help of medical personnel, and the fear is that in private medical institutions, without proper government oversight, this might escalate. 

In Uzbekistan, adopting a baby is difficult and for many, impossible. In 2021, Commander of the National Guard Rustam Jurayev said that there were 504 children in orphanages and 5,792 people on the waiting list for adoption. Annually, only about 200 children are adopted through state institutions and preference is given to relatives of adoptees, their step-parents, and those who previously lost a child. That’s why some families who cannot have their own child try to buy infants, mostly before the child turns 1 year old.

Medical personnel are sometimes involved as a mediator in the process, forging abortion procedure paperwork, as well as death and/or birth certificates for the adoptees. Given the low salary of medical personnel (the nominal accrued average monthly wage in the healthcare and social services industry is $200 in Uzbekistan) and the high corruption rate in the country, this comes as no surprise. 

One reason for Tashkent to reverse course on the issue of births in private medical facilities could be the growing number of newborns. In the early 2000s, 500,000 to 600,000 babies were born annually. However, in 2023, almost 1 million births were registered. If this trend continues, public maternity facilities might struggle to accommodate the growing demand for the services. In 2007, there were 26.9 hospital beds per 10,000 women aged 15-49 for labor and delivery purposes. As of 2022, this number stands at 19.4.

Made with Flourish

Some officials also hope that the introduction of private maternity complexes will reduce corruption in the system, which has been a longstanding issue. Corruption and bribery at maternity complexes is often criticized. This is especially common in Tashkent.

In some cases, doctors and nurses, if not given some cash for taking care of a new mother and a newborn – for being a bearer of good news (“suyunchi”) – neglect them. If obstetricians are not properly bribed in advance, chances are high that they will push women to have an unnecessary C-section. Although the state covers all medical expenses for birth-care, some corrupt doctors request pregnant women or their relatives pay. Fathers are still “asked” to donate blood “to increase the blood supply of the maternity ward” or pay for it. Partial privatization of birth-care might reduce these practices, since private entities will operate as a business. 

How successful this proposed plan will be is yet to be seen. Back in 2019, Uzbek authorities announced that private maternity hospitals would be allowed to operate, if they met certain conditions. It’s not clear if any were able to do so. Now the new decree suggests another governmental push to expand the number of facilities able to offer maternity and birth care.