Enhancing Primary Health Care Services Project, Tajikistan
Project Abstract
Background
The Swiss Agency for Development and Cooperation's Enhancing Primary Health Care (PHC) project is implemented by the Swiss Tropical and Public Health Institute in consortium with Save the Children.
Now in its second phase, the project supports the Ministry of Health and Social Protection (MoHSP) in the Republic of Tajikistan to improve Family Medicine-based PHC delivery through stronger and more transparent planning processes. In so doing it seeks to build management capacity at rayon and health facility level, and to raise awareness of resource use. In addition, the project empowers communities to take more responsibility for their health and facilitates greater health literacy by supporting the involvement of PHC staff in health promotion and disease prevention activities. In this context, the project targets the community as a key stakeholder for simulating demand and increasing access to quality PHC services.
A Project Implementing Unit of 10 staff is maintained in Dushanbe, Tajikistan.
Objectives and Aims
Embedded in the Tajik National Health Strategy 2010-2020, the overall goal of the Enhancing PHC Services Project is: Women, men and children in rural areas enjoy better health thanks to improved and transparent family medicine-oriented primary health care services and community involvement in health.
Expected outcomes are:
- The MOHSP and its associated institutions command stronger management and planning capacity which, in combination with better Rural Health Centre infrastructure in selected rayons, improves PHC delivery.
- Communities are increasingly health literate and hold primary health services accountable to the population.
Methods/Approaches
The Project has worked with MoHSP to develop a template to facilitate Rural Health Centre and Rayon level health planning. Representatives of communities are associated to the health planning and monitoring processes to foster greater accountability. In addition, a one year modular course for PHC managers has been established at the Post Graduate Medical Institute to systematically build capacity. Infrastructural and equipment investments for rural health facilities are also made to enhance the effectiveness of the other project activities. Systematic synergies and complementarity are sought with the Swiss Agency for Development and Cooperation's other support for the health, governance and water sectors in Tajikistan. This includes in particular the Medical Education Reform Project (MEP) as well as other partner initiatives and projects.
Results
The MoHSP has established a Department at the Republican Clinical Centre for Family Medicine that is dedicated to rolling out the Business Plan approach to health planning.
Together with the Republican Centre for Healthy Lifestyle a national document has been prepared: Guidelines on Methods for Working and Partnership between Healthy Lifestyle Centres/PHC institutions with communities for empowerment and enhancing their capacity in health promotion. This incorporates best practice of community work from Swiss TPH, Aga Khan Health Services and Save the Children in Tajikistan infused with experiences from the Community in Health Action Project in Kyrgyzstan.
A modular course in PHC Management has been established at the Post Graduate Medical Institute and is now in its third iteration.
Target Groups
Rural populations of Tajikistan, PHC Managers, PHC staff at facility level
Next Steps
Community Health Teams are being capacitated according to the National Guidelines on Working and Partnership with Communities and have the opportunity to apply for small grants to address social and environmental determinants of health in their localities.
Other Important Information
The project has regularly been carrying out surveys to track the Quality of Care, Out of Pocket Expenditures and Health Literacy. These are being published in the scientific literature associating local researchers and make an important contribution to fostering evidence-based policy making.
