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Uzbekistan to Launch Nationwide State Medical Insurance System in 2026

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Uzbekistan will begin introducing a nationwide state medical insurance system from 2026, part of a broader overhaul of the country’s healthcare financing and service delivery. The reform will introduce digital referrals, a national health insurance fund, and a guaranteed package of essential medical services funded through the state budget. Officials say the changes aim to improve efficiency, expand access, and reduce informal payments.

“State health insurance is a social protection system designed to guarantee access to quality healthcare services,” said Zokhid Ermatov, executive director of the State Health Insurance Fund.

Discussions about state medical insurance in Uzbekistan began in 2017, but implementing such a system required years of preparation. The State Health Insurance Fund was formally established in December 2020, and pilot programmes launched in the Syrdarya region in 2021 tested new financing mechanisms, regulatory frameworks, and digital health systems. In November 2025, the Cabinet of Ministers approved regulations governing how medical care funded through the state budget will be provided in public and private medical institutions, with the rules set to come into force on January 1, 2026.

At the centre of the new model is stronger primary healthcare. Patients will first visit their assigned family clinic, where doctors provide consultations, prescribe tests, and determine whether specialist care is needed. If necessary, patients will receive an electronic referral to hospitals or specialists. Emergency and urgent care will remain available without referrals.

The reform introduces a patient-centred financing model, where healthcare providers are paid by the State Health Insurance Fund based on services delivered. Primary healthcare will be funded through capitation payments, while hospital treatment will follow case-based payments, a structure designed to improve efficiency and treatment outcomes.

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A fully digital referral system will allow patients to choose hospitals from a list of institutions contracted with the State Health Insurance Fund using a government portal or mobile app. Referrals will remain valid for 60 days, and waiting lists and hospitalisations will be managed through a unified electronic health information system.

The insurance system guarantees essential healthcare services, including family doctor consultations, diagnostic tests, outpatient treatment, preventive screening, some medicines, hospital care, and certain rehabilitation services. Patients will not be charged additional fees for services included in the approved package.

Funding for the program will come primarily from the state budget, ensuring citizens do not pay direct insurance contributions. Priority access will be given to socially vulnerable groups, including children with disabilities, orphans, pensioners, pregnant women, unemployed citizens, and low-income families. The State Health Insurance Fund will allocate resources across regions to strengthen medical services and reduce inequalities.

International organisations have praised Uzbekistan’s approach, noting that general tax financing and universal coverage can improve financial protection and ensure predictable healthcare funding. Jessika Yin, Health Policy Adviser at the World Health Organization in Uzbekistan, said the reforms align with global trends toward universal health coverage.

If implemented successfully, Uzbekistan’s state medical insurance system could represent a major step toward universal healthcare, ensuring that people receive care without facing financial hardship.

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Taking the Stairs Could Cut Risk of Heart Disease Death, Study Finds

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Taking the stairs instead of using a lift could significantly reduce the risk of cardiovascular disease and premature death, according to a major study examining the health benefits of regular stair climbing.

Researchers from the University of East Anglia and Norfolk and Norwich University Hospital found that people who regularly climbed stairs had a 39 percent lower risk of dying from cardiovascular disease than those who rarely used stairs. They also had a 24 percent lower risk of death from any cause.

The study found that regular stair climbing was also associated with a lower risk of developing serious cardiovascular conditions, including heart attacks, strokes and heart failure.

The research team analysed health data from more than 480,000 people aged between 35 and 84. The findings were based on nine high-quality studies, with participants followed for a median period of 14 years.

Vassilios Vassiliou of Norwich Medical School at the University of East Anglia said stair climbing was a practical way to add physical activity to everyday routines. He described it as an activity that is often overlooked despite being easy to perform without special equipment or facilities.

Unlike structured exercise at a gym, climbing stairs can be included naturally in daily activities at home, at work or while travelling. Sophie Paddock, also from Norwich Medical School, said the activity could be particularly useful for people who have limited time or do not have convenient access to exercise facilities.

The researchers said even short periods of stair climbing several times a week could provide measurable health benefits. The activity can improve cardiorespiratory fitness and help lower cholesterol, both of which are linked to better cardiovascular health.

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The amount of stair climbing also appeared to matter. Some of the studies reviewed by the researchers found that people who climbed more stairs generally experienced greater health benefits. However, even smaller amounts of activity were associated with positive changes.

The findings are particularly relevant as more than a quarter of adults worldwide do not meet recommended levels of physical activity. The researchers said encouraging simple forms of movement in everyday environments could help address this problem.

Workplaces, homes and public buildings could all play a role by making stair use easier and more appealing. Choosing stairs over lifts when possible may provide an accessible form of physical activity without requiring people to set aside additional time for a workout.

The findings were presented at a scientific congress of the European Society of Cardiology. Researchers said the results highlight how small changes in daily routines can contribute to better long-term health and may help reduce the burden of cardiovascular disease.

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Children Who Play Alone May Still Feel Happy and Connected, Study Finds

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Children who spend much of their school day playing alone may not necessarily be lonely or unhappy, according to a new study from researchers at the University of Georgia in the United States.

The research suggests that some children simply enjoy their own company while maintaining satisfying friendships and a sense of belonging among their classmates. Researchers say the key factor may not be how often a child chooses to be alone, but whether they still feel connected to others.

The study involved 473 children aged between nine and 11 at several elementary schools in Georgia. Participants were asked to identify classmates who often played alone despite getting along with other students. They also answered questions about the importance they placed on belonging and their satisfaction with friendships and relationships within their classes.

Researchers found a clear difference between children who preferred solitude while still valuing social connections and those who placed little importance on belonging to a peer group.

Children who enjoyed spending time alone but considered belonging important generally reported being satisfied with both their close friendships and wider relationships at school. Researchers said these children may accept enough invitations to remain socially connected while choosing to spend some of their free time alone.

Rachael Pfanz, the study’s corresponding author and an elementary school psychologist, said these children can prefer doing their own activities without having difficulty getting along with classmates.

The findings were different for children who did not consider belonging important. They were more likely to report weaker relationships with friends and classmates.

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Researchers warned that repeatedly turning down invitations can eventually affect a child’s social opportunities. Classmates may stop asking them to join activities, potentially leaving them with fewer chances to develop or maintain friendships.

Michele Lease, a professor of educational psychology at the University of Georgia and a co-author of the study, compared social interaction with other activities that benefit people even when they may not always feel like participating.

The researchers said adults should avoid assuming that every child who plays alone needs to be encouraged to join a large group immediately. Pressuring a child into a busy activity could make the situation uncomfortable rather than helping them build connections.

Instead, adults could introduce children to smaller groups or classmates who share similar interests. A child who enjoys drawing, reading, building or another individual activity may find it easier to connect with peers who have the same interests.

Pfanz said joining a large playground game, such as soccer, may feel overwhelming for a child who already prefers playing alone.

The researchers said the findings are particularly relevant to fourth- and fifth-grade students, a period when friendship groups become more established and children become better at recognising whether classmates are choosing solitude or experiencing social exclusion.

The study suggests that solitude itself should not automatically be viewed as a problem. What may matter more is whether children have meaningful relationships and continue to feel that they belong.

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Good Vascular Health in Midlife Linked to Longer Dementia-Free Life

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Maintaining healthy blood pressure, avoiding diabetes and not smoking during middle age may help people spend more years of their lives free from dementia, according to new research.

A study of more than 12,000 participants found that people without the three major vascular risk factors between the ages of 48 and 68 could gain nearly 13 additional years without developing dementia compared with those who had all three conditions.

The findings highlight the importance of managing cardiovascular health during midlife as researchers continue to examine ways to reduce the growing global burden of dementia.

Dementia affects millions of people worldwide, with about 10 million new cases diagnosed each year, according to the World Health Organization. The number of people living with the condition is expected to exceed 150 million by 2050.

Researchers are increasingly examining factors that can be changed earlier in life, including smoking, high blood pressure and diabetes, because these conditions can affect blood vessels and contribute to problems affecting the brain.

The study, published in Neurology Open Access, defined good vascular health as having no diabetes, hypertension or smoking history during middle age.

Researchers found that participants with all three risk factors faced almost three times the risk of developing dementia compared with people who had none of them.

At age 55, people with no vascular risk factors could expect to live an average of 30 more years without dementia. Those with one risk factor had an average of 26 dementia-free years, while people with two had about 21 years.

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Participants with all three risk factors could expect just over 17 years without dementia. The difference between those with no risk factors and those with all three was therefore about 13 years.

The researchers said the results suggest that protecting vascular health during midlife could have a substantial effect on brain health later in life.

“Our findings argue that people need to actively avert these factors in midlife as a strategy for preserving brain health for more than a decade,” said senior investigator Josef Coresh.

The study also identified differences between men and women. Women generally had more dementia-free years than men across the groups. Among participants with all three risk factors, women averaged about 18 years without dementia, compared with 16 years for men.

The researchers said the findings reinforce the importance of preventing or managing high blood pressure and diabetes and avoiding smoking during middle age.

Coresh said the results could encourage people to pay closer attention to their vascular health from their late 40s onward, potentially helping them maintain cognitive health for longer as they age.

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