DUSHANBE, June 23, 2015, Asia-Plus – ON Monday June 22, the World Bank Board of Executive Directors approved an allocation of additional financing of US$10 million from the International Development Association for the Tajikistan Health Services Improvement Project, which, since August 2013, is working to improve the coverage and quality of basic primary health care services in Tajikistan.
According to the World Bank Dushanbe Office, the Tajikistan Health Services Improvement Project aims to improve maternal and child health by piloting a performance-based financing (PBF) scheme, under which incentive payments are provided to rural health facilities for better coverage and quality of basic primary health care services. Currently it is implemented in eight districts of Khatlon and Sughd provinces, covering 314 health facilities and approximately 1.86 million people.
“As a result of the project pilot in Spitamen district, health facilities already reported an increased number of postnatal care visits and fully vaccinated children,” said Patricia Veevers-Carter, World Bank Country Manager for Tajikistan. “I am glad to see this project expand to additional districts, as more effective and responsive health facilities make families healthier and better off in the future.”
The project reportedly focuses on the following main activities: piloting the use of performance-based incentives to primary health care facilities; training of primary health care doctors and nurses; reconstruction of selected primary health care facilities and provision of basic medical equipment; and building capacity at the central, regional, and district levels to manage and implement the PBF scheme. The additional financing will support the scaling up of these activities to an additional four districts in Khatlon, the districts subordinate to center, and the Gorno Badakhshan Autonomous Region (GBAO). It will also finance the reconstruction of over 20 additional primary health care facilities.
Up to date, the project has demonstrated positive results in improved performance of primary health care facilities on such indicators as contraceptive use, number of children fully vaccinated, and number of postnatal visits. The total incentive amounts earned by the 17 facilities in Spitamen district increased almost fourfold in just a few months – from US$5,534 in August 2014 to US$19,315 in December 2014. In January 2015, the PBF scheme was rolled out to 297 primary health facilities in the remaining seven project districts, with 326 health administrators and staff trained on PBF. In addition, more than 1,000 primary health care providers were trained in Family Medicine and updated clinical protocols and PBF principles since the start of the project. The original project and additional financing will finance the reconstruction of over 32 rural health centers.
Currently, designs for the re-construction of twelve health facilities are in progress with actual civil works expected to start in early 2016.
The original Tajikistan Health Services Improvement Project is financed through a US$15 million grant from IDA and US$4.8 million from the multi-donor Health Results Innovation Trust Fund. The Government of Tajikistan contributed an additional US$3.2 million to the project.
The World Bank’s active portfolio in Tajikistan includes 21 projects with a net commitment of US$ 323.4 million (including regional projects) that aim to support economic growth through private sector development, while investing in better public services for people, such as education, health, municipal services an d social protection. Since 1996, the World Bank provided over US$1 billion in grants and highly concessional credits from the International Development Association and trust fund resources to Tajikistan.
