again this has been a priority identified by the densaulyk programme multiple waves of policy reforms have sought to expand access modernise service delivery arrangements and reduce reliance on inpatient care the system continues to face many challenges in part reflecting its postsoviet legacy of underinvestment in primaiy health care and relative focus on the treatment of communicable diseases others constraints are more contemporary including the unavailability of the adequate information systems the seemingly limited accountability for delivering results in all parts of the country and insufficient emphasis on developing services and programmes that address the current burden of disease effectively