296 Teaching The Teachers: Developing Primary Health Care In Uzbekistan

ATUN Rifat, Imperial College Management School, Imperial College of Science, Technology and Medicine, United Kingdom (r.atun@ic.ac.uk), HIEW Stephen, Thames Postgraduate Medical and Dental Education, University of London, United Kingdom
The NIS (CIS) countries inherited a Soviet health system characterised by centralised planning, a vast system of health structures, and oversupply of health professionals. In 1998 the Uzbek government with support of the World Bank, USAID and the UK Department for International Development launched reforms to improve the quality and efficiency of the health care services, and to improve the health of vulnerable groups particularly those in rural areas. In our paper we analyse the development of Family Medicine and general practice through external co-operation funded by World Bank and the British Department for International Development between 1998 and 2000. The paper will focus the experience and lessons learnt on:
a) design, development and implementation a one-year programme to train a new cadre of GP trainers;
b) working with the new cohort of GP trainers to design, develop and implement a one-year re-training programme for training of 130 rural doctors already working in new primary care clinics (SVPs);
c) the approaches taken to assist the cohort of GP trainers to train further cohorts of GP trainers;
d) design, development and implementation of an undergraduate teaching programme in primary care;
e) establishment of national guidelines for licensing and accreditation of GPs;
f) establishment of methods for continuous and summative assessment of trainers.
All proposed activities in the two-year period have been completed. Family medicine has been established as one of 13 main specialities in Uzbekistan. Medical institutes are developing master's degree courses. The results of our work and this paper has relevance to transition countries especially those of Newly Independent States that are implementing similar Projects in fields of general practice and family medicine.