Enhancing Primary Health Care Services in Tajikistan

Health indicators in Tajikistan are among the poorest in Central Asia. The health system suffers from poor quality of health care services, chronic underfunding, and the implementation of the ongoing reforms is slow. The SDC project supports these reforms by increasing the planning and management capacities of health institutions at all levels, investing in basic rehabilitation of infrastructure, and by empowering the population to take responsibility for their own health and to hold the state accountable.

Country/region Topic Period Budget
Medical services
Primary health care
Health systems strengthening
Basic health infrastructure
Infectious desease
01.04.2017 - 31.03.2021
CHF 4'200'000

Poverty remains a central development issue in Tajikistan, and Health indicators are among the poorest in Central Asia. The soviet-style health system was comprehensive but highly centralised and inefficient. The current National Health Strategy 2010-2020 restates the Government’s commitment to continue the profound health care reforms initiated in 2000. These reforms aim at optimizing health care by focusing on an effective Primary Health Care (PHC) system based on family medicine. However, the implementation pace of health reforms in Tajikistan has been slow, due to a combination of factors including poor governance and chronic underinvestment which stem from poor human capacity to plan, execute, and monitor attributed to every level of health service provision.


Women, men and children in rural areas enjoy better health.

Target groups

The project will target staff of the lead health institutions, health care managers from 140 primary health care facilities and community groups in 5 rayons. Indirectly, 1.2 million people out of total 8.4 million living in Tajikistan will have improved access to better quality primary health care services.

Medium-term outcomes
  • Ministry of Health and Social Protection and its associated institutions command stronger management and planning capacity which, in combination with better rural health care infrastructure in selected rayons, improves primary health care delivery
  • Communities adopt good health behaviour and hold primary health services accountable to the population

Results from previous phases:  

  • Scaled up the family medicine model from two pilot rayons in 2003 to 8 in 2016: 1.2 mio population benefit
  • 168 rural health facilities rehabilitated and supplied with basic equipment
  • The Ministry of Health and Social Protection decided to initiate a nation-wide upscaling of the business planning tool introduced by the project at PHC centers level
  • An innovative primary health care management course has been developed and established at Postgraduate medical institute
  • An innovative approach to involve communities in business planning and keep primary health care services accountable has been introduced
  • Vision of Healthy Life Style Centre to work collaboratively on health prevention and promotion with their communities has been anchored in dedicated guidelines ready for adoption by the Government of Tajikistan

Directorate/federal office responsible SDC
Credit area Swiss cooperation with Eastern Europe
Project partners Contract partner
Private sector
Swiss Academic and Research Institution
  • Foreign private sector North
  • Swiss Tropical and Public Health Institute

Other partners
  • Communities and women’s groups
  • Local health authorities at rayon and oblast level
  • Ministry of Health
Coordination with other projects and actors

SDC-financed projects: Medical Education Reform Project, phase 3, Community Based Family Medicine Project, Integrated Health and Habitat Project in Rasht Valley.

Other actors involved in the health care reform in Tajikistan: WHO, WB, Aga Khan Development Network, USAID, EU.

Budget Current phase Swiss budget CHF   4'200'000 Swiss disbursement to date CHF   3'500'000
Project phases Phase 6 01.04.2017 - 31.03.2021   (Current phase) Phase 5 01.04.2013 - 31.03.2017   (Completed)