Tajikistan faces several healthcare challenges. There are insufficient health workers. Limited health financing has stalled continuing medical education opportunities for in-service professionals, resulting in the use of outdated and ineffective clinical practices. This is compounded by geographical imbalances in healthcare resources and financing, contributing to poor maternal, newborn and child health outcomes in rural areas. COVID-19 has further stressed Tajikistan’s health system.
The Aga Khan Foundation (AKF) and the Aga Khan Health Services (AKHS) aim to enable people to optimise their health and well-being to reach their full potential. We accomplish this through integrated interventions in communities, schools, facilities and health systems. Over the past six years, 650,000 individuals have gained access to improved primary healthcare services through the capacity-building of 668 doctors and nurses, and the construction or rehabilitation and equipping of 273 primary healthcare facilities.
650,000
650,000 people have gained access to primary health care in the last six years
AKDN / Christopher Wilton-Steer
We engage in health promotion, facility rehabilitation and equipping, pharmaceutical procurement, distribution and sales, and training in new clinical and managerial practices.
Each intervention is designed to protect and promote the health status of the most vulnerable in Tajik society, and to shift from a focus on curative care to primary and family care, supported by facility-based services. We are professionalising nursing and family medicine with the introduction of a business planning and management module at the primary healthcare level. In a public-private partnership arrangement, AKHS manages the upgraded diagnostic services in the Khorog Oblast General Hospital.
Care for Child Development focuses on developing the physical, cognitive, emotional and social functions of children under three years.
eHealth improves access to and the quality of health care by overcoming the barriers of distance and time. eHealth brings together providers based at separate institutions to offer coordinated care to clients. It gives health professionals working in remote facilities access to continuing professional development and training.
AKDN works with international donor agencies, in partnership with the Departments of Health of Gorno-Badakhshan, Rasht and Khatlon, and with active community participation.
Our cross-border health project aims to improve the quality of health care in the communities on both sides of the Afghanistan and Tajikistan border. The project, which started in 2010, shows that it is possible to treat critically ill patients from Afghan-Badakhshan in Tajik hospitals, for Tajik health professionals to provide health care in Afghanistan and for policy makers from both countries to make study tours across borders to observe other healthcare systems.
The increasing patient volumes, focus group discussions and in-depth interviews held with health professionals, patients, border authorities and policy-makers confirm that cross-border health care is achievable.
In Shidz, Tajikistan, the Mountain Societies Development Support Programme (MSDSP) trains volunteers as Community Health Promoters (CHPs) to help encourage healthy practices and assist in the distribution of contraceptives, micronutrients and oral rehydration solutions among others.
AKDN / Jean-Luc Ray
We support teachers and students to incorporate hygiene, sanitation and nutrition into their lessons, lead school-based cooking demonstrations and organise awareness-raising events via school councils.
We partner with primary healthcare professionals and over 1,600 community health promoters to improve community health, with a focus on breaking the intergenerational cycle of stunting through intensive nutritional interventions.
We have pioneered the Central Asia Stunting Initiative (CASI), which aims to mitigate stunting and under-nutrition across 447 remote communities in Pakistan, Tajikistan and Afghanistan. We focus on the first 1,000 days of a child’s life, monitoring their growth and providing holistic early childhood development support until they are five years old.
We promote healthy behaviours and awareness amongst women of reproductive age and adolescents in nutrition, sexual and reproductive health. We ensure access to quality gender-responsive services and supplies.
Interventions are integrated into other platforms: we support the nutrition of mothers through early childhood programmes, and improve the knowledge and skills of adolescents to navigate social and physiological changes and pathways to adulthood.
AKDN / Christopher Wilton-Steer
We enhance continuing professional development systems for healthcare professionals, strengthening the response capability of health systems at both primary and secondary levels. Our clinical excellence programme promotes the adoption of best clinical practices and family medicine services, with an emphasis on clinical audits to ensure adherence to evidence-informed protocols.
We provide basic medical equipment to improve services for mothers, children and adolescents. This includes testing and implementing gender- and adolescent-responsive approaches, including eHealth, mHealth and other digital platforms. These ensure access to health services and information.
We connect secondary facilities with national and international tertiary health facilities through teleconsultations and e-learning. This gives health professionals access to information on new medical developments and technical support managing complex cases.
Meanwhile, our low-cost community-based health financing model is promoting universal healthcare coverage by mobilising existing resources and governance structures, with minimal reliance on external assistance. Two hundred and thirty-nine schemes in six districts have accumulated over US$ 330.6 million, ensuring an estimated 80,000 people have funds immediately available in times of critical need.
AKDN / Christopher Wilton-Steer
We work with communities and young people to mobilise and support influencers to maximise their contributions to adolescent health and well-being. This includes increasing young people’s access to core services and support networks, thus improving their transition from childhood through adolescence to adulthood.
Through an extensive human-centred design process, AKF is implementing a pilot intervention to improve communication, understanding and trust between adolescents and adults. Specifically, it will strengthen knowledge and skills of caregivers on how to support adolescents, raise community awareness of supporting adolescents and equip adolescents with knowledge and skills to navigate social and physiological changes.
A new AKF supported water system with private connection to houses in Ghorjwin, Tajikistan.
AKDN / Christopher Wilton-Steer
AKF and AKHS work with communities to ensure access to safe drinking water and sanitation along with improved hygienic practices. The construction of 176 drinking water systems has served 140,000 rural community members with safe water, contributing to the prevention of waterborne and water-related diseases and reducing the burden on women, children and adolescents of fetching water. We have established 1,460 public and private sanitation facilities, serving 76,400 individuals.
Qurbonbi Ashurova, a mother of nine children in Kulob, used to spend almost two hours walking to the Yakhsu river and back in order to bring home water.
Qurbonbi Ashurova
Safe drinking water supply systems installed near her home relieved Qurbonbi’s water burden. They enabled her to construct an indoor washroom and eased her daily household chores. She no longer has to worry about her children fetching water from the river and allocates more quality time to their upbringing and development.