Rafoat Sanginova, a family nurse with 34 years of experience, has witnessed significant improvements in health care throughout her career. “In 1989, home births were common, and pregnant women rarely registered at health facilities. The mortality rate among women and children was high,” Rafoat recalls.
Today, the health landscape in Tajikistan has transformed. The country has reoriented its health strategy towards a primary health care (PHC) approach, bringing essential services closer to communities. The health facility where Rafoat works now embodies this PHC model, providing a variety of services, including dentistry, non-communicable diseases, and maternal and child health, all in one location close to where people live.
“I came to Rudaki District Centre to see my doctor. The doctor helped me. They have all the necessary facilities,” says Safarova Manija, a patient benefiting from local PHC services.
Tajikistan’s long-term investment in PHC has significantly reduced maternal and infant mortality rates and the prevalence of various diseases, marking a successful journey towards universal health coverage (UHC). As Tajikistan continues healthcare reform, PHC remains central to its pursuit of a healthier future for its population.
Over 20 years ago, the Government of the Republic of Tajikistan adopted a PHC model based on family medicine, investing in PHC infrastructure, systems, and training for its health workforce.
In 2021, Tajikistan adopted the ‘Strategy on Healthcare of the Population of the Republic of Tajikistan for the period to 2030,’ emphasizing a strong PHC component to accelerate healthcare reform and ensure comprehensive service delivery. Reforms have included service delivery, financing, integration of vertical programs, and strengthening the health workforce.
The World Health Organization (WHO), through the UHC Partnership, has collaborated with the Government of Tajikistan since 2016, aiding in policy development, design, and implementation of PHC. In the last five years, WHO has supported the government in developing national health workforce strategies based on comprehensive health labor market analyses. These strategies aim to address critical issues such as health worker availability and the quality of medical and nursing education.
WHO has also facilitated policy dialogues and capacity-building initiatives to enhance strategic purchasing and resource mobilization. This collaboration has helped create political consensus on health financing reforms and strengthened the Basic Health Benefit Package at the national level.
Improving PHC services has been a key focus, with WHO assisting in developing a new national PHC plan to address service delivery bottlenecks and strengthen partner commitment and coordination. Efforts include transforming per capita funding into a payment mechanism for PHC and improving PHC reporting forms to create an integrated information system for health financing reform.
WHO has played a crucial role in strengthening the strategic collaboration of health development partners in Tajikistan. WHO’s leadership has significantly enhanced the Development Coordination Council on health, facilitating regular information exchange and aligning projects and programs to improve health and well-being in the country.
“Over the past decades, Tajikistan has made great strides to make essential healthcare and services more accessible to the population. WHO will continue to support Tajikistan to prioritize primary health care as this is a fundamental necessity for building resilient and equitable societies,” says Dr. Victor Olsavszky, WHO Representative in Tajikistan.
The UHC Partnership assists over 125 countries in accelerating progress towards UHC through funding provided by the European Union (EU), the Grand Duchy of Luxembourg, Irish Aid, the Government of Japan, the French Ministry for Europe and Foreign Affairs, the United Kingdom Department for International Development, and the Kingdom of Belgium.
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