The article examines initiatives and projects for the development of the healthcare system at the turn of the XIX- XX centuries on the example of materials of the Nizhny Novgorod Provincial Zemstvo. The key areas of initiatives and projects are highlighted: the organization of sanitary and hygienic conditions, the development of veterinary services, the increase of doctors' allowances, the organization of psychiatric care, medical education of the population and increasing the availability of medical care.
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