The Department of Economic Affairs and Budget Planning of the Health Sector and Social Protection of the Population is one of the key departments of the MoHSPP of the Republic of Tajikistan. The main task of the department is to promote policies in the field of healthcare financing and social protection.
In regards to the work of the Department of Economic Affairs and Budget Planning of the Health Sector and Social Protection of the Population interview was held with the Head of the Department S.Hafizov:
– Could you tell us how significant is the contribution of development agencies and international organizations to the financing of health sector in the Republic of Tajikistan?
– To date, a number of reforms are underway in the field of financing, including per capita financing in primary health care facilities, state-guaranteed financing of programs in cities and regions of the country and health case-based financing in hospital facilities of pilot districts.
I can confidently say that reform would certainly not have been possible without the support of development partners and international organizations. Their contribution is very significant. These include the World Health Organization, the World Bank, the European Union, the Swiss Agency for Development and Cooperation, USAID, the German Development Bank (KfW), the Asian Development Bank and the Aga Khan Foundation.
– As we know, on March 29, the project “Maternal and Child Health Integrated Care” was launched under the Ministry of Health and Social Protection of the Population of the Republic of Tajikistan (Asian Development Bank grant-0627-TAJ (SF)). Could please tell us a little about this project?
In accordance with the Decree of the President of the Republic of Tajikistan “On the Grant Agreement between the Republic of Tajikistan and the Asian Development Bank” implementation of the “Maternal and Child Health Integrated Care” Project has begun in health facilities of Rasht and Faizobod districts of Republican subordination and Shamsiddin Shohin of Khatlon region.
The main objectives of the “Maternal and Child Health Integrated Care” Project are to improve comprehensive maternal and child health care services, to improve infrastructure in hospitals and primary health care facilities through construction, repair of facilities, provision of equipment and medical furniture, equipment management system and capacity building of technical service, to improve planning and strengthening of human resources with the development of planning strategy and proper staffing, introduction of an effective patient registry system between primary health care and hospitals, integration of vertical programs into the structure of primary health care, and introduction case-based financing mechanism.
It should be noted that ADB’s contribution to health care reform in the country is significant, and this new project will serve to improve comprehensive services for maternal and child health.
– Today, the Government of Tajikistan is committed to provide per-capita financing and case-based financing. What are your achievements and progress in this area, and what needs to be addressed in this sector?
-With the purpose of introduction of per capita financing in PHC facilities of the republic the Decree of the Government of the Republic of Tajikistan was issued from December 31, 2015 № 827 «About introduction of per capita financing in primary health care facilities».
As part of this Decree, a number of regulatory documents were developed on the introduction of per capita financing at the national level, which were approved by joint orders of the Ministry of Health and Social Protection of the Population and the Ministry of Finance of the Republic of Tajikistan, including: Step-by-step transfer of primary health care facilities to per capita financing at the level of cities and regions of the Republic of Tajikistan;
As for the normative distribution of budget funds based on the principles of per capita financing for rural health centers and medical centers, where the recommended minimum of funding standards is established by a joint order of the Ministry of Health and Social Protection of the Population and the Ministry of Finance of the Republic of Tajikistan. and is reviewed annually;
A number of normative documents and methodological recommendations on per capita financing of medical institutions network have been developed, which include all the legal documents on per capita financing.
Since 2016 per capita financing in PHC facilities is gradually being implemented. Currently there are 88 primary health care facilities throughout the country.
In 2019 per capita financing was fully introduced in 88 (100%) of the country’s primary health care facilities. The rate of per capita financing in 2019 is 55.96 somoni for urban facilities and 45.54 somoni for district centers.
Further steps to develop per capita financing in primary health care facilities requires continuous support for per capita financing, monitoring and evaluation, preparation of per capita financing as part of the cost item, restructuring and optimization of medical institutions, as well as improving the calculation of per capita rates.
– What is your perspective on financing primary health care facilities through case-based financing mechanism?
– In 2017, Pprimary health care facilities of the pilot regions started to use the financing mechanism based on the new Instruction, approved by the Order of the Ministry of Health and Social Protection of the Population of the Republic of Tajikistan dated November 29, 2016, No. 900. Consequently, all health staff were covered by training sessions on the new module. The new guidebook describes how to use computer software, installation and documentation, and how to use funds effectively..
During the first 9 months of 2019, total funding was $ 24.3 million. 70% of them are for staff compensation and 30% for infrastructure development of PHC facilities..
The next step is the implementation of case-based financing at primary health care facilities, which could be a new incentive model at the primary health care facilities.
– How do you assess the contribution of foreign projects to improve the level and quality of medical services in the Republic of Tajikistan?
Of course, the contribution of projects by international organizations are serving for improving the level and quality of medical services in the Republic of Tajikistan. With technical and financial support, the implementation of reforms in the development of medical and social services is improving..
–Thank you for the interview!
