Strengthening clinical management practices in Uzbekistan

Clinical management of cases is fundamental for health systems’ response to a pandemic. The COVID-19 pandemic has highlighted the importance of having well-trained frontline health workers to rapidly and appropriately provide care for patients with severe acute respiratory infections. Pandemic Influenza Preparedness (PIP) Framework implementation in many countries has helped prepare frontline health workers in advance of the COVID-19 pandemic, including in Uzbekistan. In recent years, Uzbekistan has made significant improvements in caring for patients with severe acute respiratory infections. These have been essential steps to strengthening national pandemic preparedness capacities which were demonstrated during the response to the COVID-19 pandemic when existing courses were swiftly adapted to fully adopt specificities of COVID-19 clinical care and a series of short courses were rapidly rolled out to ensure well-trained frontline health workers.

How did Uzbekistan do it, and how did the WHO Secretariat support Uzbekistan?

Since 2015, under the umbrella of the PIP Framework Partnership Contribution, the Ministry of Health of Uzbekistan has been working with WHO to improve treatment of cases with severe acute respiratory infections caused by influenza, for example, through training of frontline health workers. For several years, Uzbekistan has applied WHO’s critical care training short course to sharpen the skills of intensive care clinicians and thereby strengthen the country’s capacity to manage patients with severe acute respiratory infections. In 2018, with support from the PIP Framework, the Ministry of Health used the short course to develop and adopt its National Guidance on Management of Patients with severe acute respiratory infections.

Two years later, in the face of a new global pandemic, the Ministry of Health and WHO leveraged the partnerships established under the PIP Framework implementation to form a collaborative group of experts and develop a new training programme on managing critically ill COVID-19 patients. The programme was built in line with WHO recommendations on clinical management of patients with severe acute respiratory infections and was designed to enable frontline health workers to better manage severe COVID-19 cases. The new course, which can be delivered in just 36 hours and thus is optimally designed for ensuring rapid readiness of frontline health workers, was created by professionals from the National Advanced Training Center for Medical Doctors in Tashkent, Uzbekistan, in collaboration with WHO country and regional offices, with support from the United States Agency for International Development (USAID).

The new training in critical care, which is closely linked to the national COVID-19 clinical management protocol, has since been formally approved by the Ministry of Health. It provides a systematic approach to case management, highlights the importance of infection prevention and control measures for health workers, sets up new standards of care, emphasizes the importance of pandemic preparedness and ethics, and provides best practices for managing patients in intensive care units. The course materials are being printed in three languages—English, Russian and Uzbek—before being launched for use across Uzbekistan. 

The achievements in Uzbekistan demonstrate that health systems preparedness and readiness to adjust to emerging threats is fundamental. Further strengthening of essential health systems capacities remain a top priority as Uzbekistan reflects on the lessons learned from COVID-19 and how to leverage this experience to further strengthen systems and capacities in preparation for the next pandemic and other health emergencies.

Photo Credit: © WHO Country Office in Uzbekistan

Photo Caption: COVID-19 clinical management protocols in print.