Paragraph 11 of the Decree of the President of the Republic of Uzbekistan of November 12, 2020 ‘On measures to introduce fundamentally new mechanisms in the activities of primary health care institutions and further improve the efficiency of reforms in the healthcare system’ provides for the implementation by the Anti-Corruption Agency together with the Ministry of Health of the Sphere without Corruption Project in the health care system.

Within the framework of this project, the Agency, together with the Ministry, conducts field studies on the provision of free and paid medical services in healthcare institutions, the current state of healthcare facilities, the availability of medicines and medical equipment, etc.

In particular, in February of this year, the implementation of the Sphere without Corruption Project was studied regarding the proper organization of human resources management policy in the Bukhara Regional Health Department, during which a number of problems and shortcomings were identified:

In total, the regional health department and its institutions have 40,163 medical workers. And in the last two years 1,984 of them inspected for various violations and corruption.

Labor contracts were terminated with 2,575 employees who improperly performed their professional duties. 2,651 medical workers were brought to disciplinary responsibility.

According to the analysis, one of the main factors contributing to corruption is the poor organization of human resources management policy in the regional healthcare system, which does not include clear rules aimed at preventing corruption risks in hiring, appointment and rotation.

In particular, when studying the length of service in the regional healthcare system, 22 (67 percent) of the HR Department heads out of 39 have worked in positions for more than 6 years, including 7 of them for 25-27 years, 4 of them for 10-20 years, and 11 for 5-10 years.

This situation can also be seen in the context of the heads of regional medical institutions: four of them work for 10-20 years, and three heads for about 10 years.

12 bribery cases were detected in the medical institutions of the region in 2020, and 16 cases in 2021.

For example, an official from the HR Department of the Shofirkon District Medical Association has been working since 1998 (23 years), and in 2020-2021 he committed two crimes related to bribery.

The head of the HR Department of the Regional Dermatovenerologic Dispensary, who has been in office since 1994 (27 years), committed two crimes related to employment for a bribe.

Incorrect forecasting in the system of targeted training of personnel with secondary specialized education led to a disproportionate formation of personnel units in the region. In 2020 alone, 1,391 students graduated from medical colleges in the region, and only 194 of them (14 percent) were employed.

Another factor contributing to corruption in human resources management policy is the fact that close relatives work in most medical institutions, contrary to the requirements of labor legislation. In particular, in 493 cases in medical institutions various positions are occupied by relatives, of which in 214 cases they are directly subordinate to the management of the institution.

For example, 18 relatives work in the Regional Psychiatric Dispensary. Similar cases are observed in almost all medical institutions.

The revealed facts of corruption are also related to the concealment of vacancies in medical institutions and the untimely provision of information about them to the general public.

In particular, in 2020-2021, 33 violations related to the concealment of vacancies were identified in the system. Last year alone, 13 crimes related to employment in medical institutions were committed. The analysis showed that in 7 cases the institutions had real vacancies.

The senior HR inspector at the family clinic №3 in Bukhara was arrested in October 2021 for accepting a USD 600 bribe to hire a woman as a nurse.

It should be noted that similar systemic problems in the healthcare sector remain the main factor in the commission of corruption offenses not only in the region, but also in the country as a whole.

Accordingly, in order to increase the effectiveness of activities implemented in the healthcare system within the framework of the Sphere Without Corruption Project, it is proposed:

1. Open a separate section on the official website of the Ministry of Health, which will post information about vacancies in all institutions of the system, and monthly enter the relevant information;
2. Develop a specific action plan to eliminate bureaucratic barriers when hiring in medical institutions and introduce a recruitment procedure based on an open competition and test events via the Internet;
3. Conduct research in republican and regional medical institutions in order to identify areas of healthcare with high corruption risks;
4. Introduce a modern management system in the activities of medical institutions of the healthcare system;
5. Define electronic medical services as priority areas and develop specific proposals to reduce the human factor at all stages of the provision of medical services to the population, increase the number of electronic services;
6. Introduce a system of per capita financing in all medical institutions in order to establish strict public control over the misuse or theft of budgetary funds.

Press Office

The Anti-Corruption Agency