Uzbekistan - Emergency Medical Services Project

Overview & Synopsis

Ratings of the Emergency Medical Services Project for Uzbekistan were as follows: outcome was satisfactory; Bank performance was moderately satisfactory; monitoring and evaluation quality was modest. Lessons and recommendations are as follows. Clarify dispatch governance early by defining institutional hosting, operational authority, and data ownership for call intake and dispatch functions at project design, using Uzbekistan’s model as a reference, to avoid later delays. During institutional transitions, intensify engagement across government levels to sustain reform momentum and build buy-in, treating leadership changes as opportunities to re-anchor ownership rather than risks to be endured. Sequence physical investments with enabling regulatory and governance reforms so that clinical protocols, referral rules, and training are adopted before equipment and technology arrive, ensuring rapid operational use. Anticipate data interoperability and data governance at design by specifying data standards, interfaces, ownership, quality assurance, and cross-system reconciliation as requirements for all digital components, and fund a dedicated data governance function from effectiveness. Treat procurement in multi-agency approval environments as a core risk by mapping each clearance step, setting realistic timelines, and adopting mitigations such as early bid document support, pre-agreed interagency protocols, and use of framework or partner-facilitated procurement for complex equipment. Strengthen fiduciary supervision of major equipment contracts through milestone-based management that covers delivery, installation, and user training, with explicit remedies for non-performance—including performance security calls and referral to the Integrity Vice Presidency—applied in a timely manner rather than relying on closing date extensions.