Dushanbe, May 6, 2014 – The Tajikistan Health Services Improvement Project, which will pilot innovative ways to improve the quality of services of primary health care facilities, was officially launched today in Dushanbe by the Minister of Health and Social Protection of Tajikistan Salimzoda Nusratullo Faizullo and World Bank Country Manager Marsha McGraw Olive. Representatives from civil society organizations and the donor community also took part in the launch event.
This US$19.8 million grant aims to improve maternal and child health outcomes by providing incentive payments for better performance in coverage and quality of basic primary health care services in rural health facilities of Tajikistan. The new project is being financed through a US$15 million grant from the International Development Association (IDA) and a US$4.8 million grant from the multi-donor Health Results Innovation Trust Fund (HRITF). The Government of Tajikistan will contribute an additional US$3.2 million to the project. The project will be implemented over the next 5 years by the Ministry of Health and Social Protection of Tajikistan.
“The World Bank is pleased to launch this project today, which aims to improve the quality of health services for the population,” said Marsha Olive, World Bank Country Manager for Tajikistan. “By making primary health care facilities, including those in remote areas, more effective in providing services to the population, we strive to make families healthier and better off in the future.”
The Tajikistan Health Services Improvement Project seeks to increase the coverage and quality of basic primary health care services through result-based financing (RBF). RBF is a change from paying for inputs, such as training and equipment, to paying for results achieved, such as the number of fully vaccinated children, the number of malnourished children properly counseled, the number of pregnant women fully covered with antenatal care and women who have given birth covered with postnatal care, the number of hypertensive patients detected and registered, and others. It helps countries get more from their own and donors’ funds: early research shows that countries that use RBF can get 20 percent more health care for the same amount of money with a higher quality of care.
Under the project, primary health care facilities will be rewarded with additional payments based on their performance in meeting certain pre-agreed maternal, child and other health targets. Payments will be subject to a rigorous and independent verification by UNICEF every six months. Facilities that do not meet performance standards will not receive the additional payments.
The first phase of the implementation has begun in Spitamen district of Sughd Oblast. Starting in early 2015, implementation will be scaled up to seven additional districts, covering a total of 1.86 million people in eight districts of Khatlon and Sughd and representing around 25 percent of the population.
In addition to taking an innovative performance-based payments approach, the project will also offer more traditional support for strengthening primary health care. It will provide training to doctors and nurses, support physical rehabilitation and renovation of selected rural health centers, including provision of basic medical equipment and it will build the capacity of health sector institutions at the central, regional, and district levels to manage and implement the performance-based financing scheme.
Since 2000, the World Bank has been supporting Tajikistan in strengthening the country’s health sector through the introduction and implementation of health reforms, including per capita financing for primary healthcare, strengthening capacity of medical workers, and rehabilitation of infrastructure.
The active portfolio of the World Bank in Tajikistan currently consists of 13 projects with a net commitment of US$222 million. The largest share of the portfolio is in agriculture and rural development (40 percent), followed by water and sanitation (15 percent), human development (14 percent), energy (13 percent), the public sector (12 percent), and the private sector (6 percent).