| Project Detail |
Project Name
Maternal and Child Health Integrated Care Project - Additional Financing
Project Number
51010-004
Country / Economy
Tajikistan
Project Status
Approved
Project Type / Modality of Assistance
Grant
The AF will support expanding respective outputs with additional components.
Output 1: Improved integrated delivery of quality MCH services in project districts improved. The output will be strengthened through further support for (i) HRH planning, management, and capacity development; (ii) tools and processes to improve MNCH service quality and integration; and (iii) development and testing of more efficient hospital financing mechanisms:
(i)HRH planning, management, and capacity development. The AF will be used to (a) update district hospital-level staffing norms and job descriptions; (b) enhance the existing HRH electronic-registry (developed under ongoing project) with additional analytical and reporting features, support its roll-out in additional three districts, and develop an implementation roadmap for its nation-wide scale-up (including cost, institutional support, and training requirements); and (c) engage the Post-Graduate Medical Institute to design, develop, and implement a program of training and continuous medical education in MNCH-relevant areas for health staff in project districts (doctors, nurses, facility managers), including mobile specialist teams for on-job training and supervision.
(ii)Tools and processes to improve MNCH service integration and quality assurance. To support MNCH service integration and care coordination across different healthcare levels, the AF will be used to (a) review and revise the national referral protocol and patient pathways on perinatal services, and (b) roll-out the perinatal electronic-referral system (developed under ongoing project) in the additional three districts. To support MNCH quality assurance, the AF will be used to engage Khadamot (State Service for Monitoring Health Services) for training and implementation of continuous quality improvement and supportive supervision in additional project districts.
(iii)More efficient hospital financing mechanisms. The ongoing project is supporting piloting of hospital case-based financing (CBF) in project districts, which needs further methodological refinements and enhancements to the CBF information system. The AF will be used to enhance the piloting of CBF in ongoing project districts and expand the pilots to additional selected districts of Sughd Region to synchronize with other development partners initiatives supporting healthcare strategic purchasing.
Output 2: Infrastructure and equipment for MCH services in project districts rationalized and improved. Under this output, the AF will be used to expand support for MNCH-related hospital infrastructure and supply of medical equipment in three additional districts. The AF will support new constructions entailing an 80-bed maternity hospital in Dangara; a 40-bed maternity hospital in Ayni; and a 100-bed central district hospital in Darvoz. To ensure appropriate inventory, functioning, and maintenance of medical equipment, the AF will support establishing a digital asset management system (OpenMedis) and relevant training in project districts through the Republican Center for Maintenance and Repair of Medical Equipment.
Output 3: Knowledge on MCH and health seeking behaviors improved. Under this output, the AF will support training and capacity development in behavior change communication (BCC) for MNCH and outreach staff in the three additional districts, including printing and distribution of BCC materials.
Project Rationale and Linkage to Country/Regional Strategy
Demographic and epidemiological context. Tajikistan is a landlocked, primarily rural, lower-middle-income country with a gross domestic product per capita of $1,054 and a national poverty headcount ratio of 22.5%. It has the youngest and fastest-growing population in Central Asia, with an average annual population growth rate of 2.1% and a fertility rate of 3.2 births per woman. Over the past decades, Tajikistan achieved laudable improvements in health outcomes and performed well relative to other lower-middle-income countries. However, the country faces a combined burden of disease, where despite non-communicable diseases being the leading cause of death, maternal and neonatal disorders still comprise a large share of the disease burden. Amid high birth rates, levels of infant and neonatal mortality remain among the highest in the region, along with wide disparities in maternal health access by geography and socio-economic status. To further improve MNCH indicators, population access to quality maternal and child health services needs expansion, especially in underserved areas.
Impact
Health status and well-being of mothers and children in the project districts improved (Sustainable Development Goal 3)
Accessible and quality health care provided to all citizens (National Health Strategy 2030) |
