Uzbekistan's Ambitious Health Plans

The Uzbek leadership has set impressive targets for cutting maternal and child mortality rates, but it is hard to gauge whether they will be achieved given the systematic use of over-optimistic data which distorts reality and conceals problems.

In late September, the local news site podrobno.uz reported that the government plans measures that will reduce child mortality by two-thirds and maternal mortality by one-third by 2015.

The report said the country had already made impressive progress in this area of healthcare.

"The mortality rate has fallen by 80 per cent for children under five, and by 60 per cent for those less than one year old since 2001," it said.

The improvements are attributed to the introduction of flour containing iron and folic acid supplements, which have reduced the incidence of anaemia and iodine deficiency.

Some independent experts, however, say the main cause of deaths in children under five is respiratory disease.

A World Health Organisation report published in May 2009 said child mortality rates has fallen by an average of 27 percent worldwide in the last 20 years, but not in the poorest countries including Uzbekistan.

In 2003, the United Nations children’s organisation UNICEF expressed concern that governments in Central Asia were covering up the true statistics on childhood mortality. Local observers say the misuse of statistics continues in Uzbekistan.

"Health ministry staff ask us to reduce child mortality rates by 30 per cent in any given period that we’re reporting on. So we refrain from recording some deaths of children in the column for child mortality," a doctor at a Tashkent maternity hospital said. “The same happens with maternal mortality rates."

An expert in demographics in Tashkent said no accurate statistical data existed as child and maternal maternity were off-limits.

"No one will provide give accurate data," he said. "The figures sent to the joint statistical committee of the Commonwealth of Independent States are false."

Rasul, a veteran doctor in the eastern town of Fergana, agrees that the data are flawed. In reality, he said, healthcare services were poor because hospitals were badly equipped and staff insufficiently qualified.

Other observers are similarly sceptical about claims that mortality rates are falling.

Dilmurad Kholmatov, an analyst in Tashkent, recalled that President Islam Karimov recently told the United Nations General Assembly that maternity mortality rates had fallen by more than 100 per cent and childhood mortality by 200 per cent.

Kholmatov said officials could make any claim they wanted as long as the figures could not be verified as access to them was restricted.

"I wouldn’t be surprised if the targets are achieved by 2015," he said. "Many people realise they will only be achieved on paper."

This article was produced as part of IWPR’s News Briefing Central Asia output, funded by the National Endowment for Democracy.