Tajikistan moves towards universal health coverage (UHC)

WHO/Tahmina Alimamedova

Over the last decade, Tajikistan has undertaken a series of comprehensive health reforms to move towards UHC. With the support of international partners, the Government has developed a number of health policies and programmes, including a health-financing strategy for 2005–2015, to improve equity and efficiency in the health sector.

Nevertheless, more work is needed. Improvements in key areas – such as health outcomes, the quality and availability of health services, the reduction of excess capacity in the hospital sector and increased public health spending – remain a high priority.

Course on strengthening the health system

As part of work for reform, WHO/Europe, the WHO Country Office, Tajikistan, the Ministry of Health and Social Protection of Population of the Republic of Tajikistan, the European Union (EU) and the German development aid agency GIZ agreed to hold a four-day flagship course on strengthening the health system and a senior policy seminar. The course aimed to renew commitment and gain consensus on the best way towards UHC, and provide a platform for more than 50 health-sector stakeholders from Tajikistan to discuss international experience and its relevance to the challenges facing their country.

Step by step

The course was hosted by the Tajik Minister of Health and Social Protection, and the participants comprised representatives of the ministries responsible for health, finance, economics, labour and migration; oblast health departments; health facilities; and development partners.

Keynote speeches by a senior WHO/Europe staff member, a professor from the University of Dublin, Trinity College, Ireland and a health finance expert were followed by a lively discussion. The Deputy Minister of Finance highlighted the importance of adjusting international experiences to the Tajik context and making step-by-step changes.

Strategic plan agreed

The course was the culmination of a year-long intensive campaign. The Ministry of Health and Social Protection carried out a study of the feasibility of comprehensive health-financing reform in Tajikistan through the introduction of mandatory health insurance. The results were then developed into a roadmap, with a team of experts speaking with key stakeholders in Tajikistan in the weeks leading up to the course.

As a result, it was agreed to translate the roadmap into a detailed strategic plan for further health-financing reforms in Tajikistan until 2018 while moving towards UHC. The Government of Tajikistan agreed to approve the plan within a few months of the course.

WHO implemented this activity within the framework of the European Union funded "Technical Assistance in Support of Health Care Reform in Tajikistan" project.