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By Jeni Klugman, George Schieber, Timothy E. Heleniak

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Extra resources for A survey of health reform in Central Asia, Volumes 23-344

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With a few notable exceptions, the same general pattern emerges of cause-specific mortality in Central Asia and in the other transition states of the FSU and Eastern Europe. 3 In Central Asia the largest increases in mortality have been deaths from heart and circulatory diseases - which is related to stress, diet, sedentary lifestyle and smoking. These diseases account for between 30 and over 100 percent of the increase in death rates between 1989 and 1993 (except in Tajikistan), and the largest share of the overall increase.

Kazakstan, for example, cut its fiscal deficit sharply, from 7 percent of GDP to little more than one percent between 1992 and 1993, but the deficit returned to the previous level in 1994. The deficit in Uzbekistan grew from 6 percent of GDP in 1991 to a mammoth 21 percent in 1993, before adjustment sharply reduced the deficit down to 4 percent of GDP in 1995. On the expenditure side, extensive government subsidies to support enterprises and farms, and to finance low consumer prices for goods and services, were adjusted downward, in some cases rapidly, and elsewhere more slowly.

Recent demographic trends are not entirely a drastic reversal of the past but rather a rapid acceleration of some trends that have been occurring for several decades. Birth rates have been declining slowly since the 1960s. Immigration of Russians and other nationalities began to reverse in the mid-1970s. Nevertheless, population growth is quite high relative to Western countries. 1 See D. Jamison et al, Disease Control Priorities in Developing Countries, Oxford University Press, New York, 1993.

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