In the health system, the UNDAF works to strengthen the capacities of the Ministry of Health, particularly in governance, financial and human resource management, and provision of safe blood supplies. It also enhances service delivery capacities in the areas of maternal and child health; and in the combating (and in the case of malaria, eliminating) of communicable diseases, particularly HIV/AIDS and tuberculosis.
Partners and Coordination: The main partners are the MoH, MoF, regional and district health departments, service delivery institutions, and non-governmental organizations. Work towards these results will be coordinated by the Health and Food Security and Nutrition Groups. Work on HIV/AIDS is coordinated by the UN Theme Group on HIV, in close cooperation with the National Coordination Committee on HIV/AIDS, TB and Malaria. Certain activities are funded through a pooled funding mechanism and overseen by the Joint UN Team on AIDS; this funding is disbursed directly to implementing partners.
Challenges: The health care system is a key sector in meeting the MDGs. National health priorities, with respect to the MDGs, are to reduce infant, child and maternal mortality rates; to achieve universal access to reproductive health; and reverse the spread of major communicable diseases, particularly HIV/AIDS, tuberculosis, and malaria among returning migrants. At 34 per 1,000 live births (as of 2012, DHS), the infant mortality rate (a key health indicator) is among the highest in the region. The main challenges facing the health system are weak governance and inadequate, inefficiently used resources. This has led to a significant weakening of health facilities, particularly those providing primary health care, and limited public awareness about healthy lifestyles.
The UNCT has accumulated years of experience working in health at all levels in Tajikistan. Important contributions have been made to the normative environment, particularly building health system capacities in stewardship and service delivery, as well as providing physical resources.
In this regard, UNCT has following results to show:
A National Health Strategy for 2010-2020 has been developed.
The implementation of the National Health Strategy has been supported by UN Agencies individually.
A Joint Annual Review is regularly conducted. It monitors the NHS implementation annually and makes the input of each agency visible.
The UNCT also supports the health system to increase the effective coverage of basic health services for the most vulnerable in selected districts. This has resulted in a substantial decrease of maternal and child mortality rates over the last ten years. UNICEF, WHO and UNFPA have been launching a number of joint initiatives and working on:
HIV/AIDS Prevention in Vulnerable Youth;
Strengthening the Health Systems Reforms in Tajikistan;
Improving Child Nutrition in Tajikistan;
Making Pregnancy Safer;
Advocacy/public awareness in RH/MCH
The UNCT works closely with the health system, civil society organizations, and local communities (focusing specifically on returning migrants) to improve knowledge about how to avoid health risks and practice healthy behaviors. This will lead to improved health and nutritional outcomes for women and children, and for those who have, or are at-risk of contracting, a communicable disease.
In addition, efforts are made to better prepare the health system to deal with emergency situations. This will be achieved through the development of emergency management guidelines and appropriate procedures/practices. Support will be provided to enhance emergency care capacity of pre-hospital and hospital response to disasters and emergencies. To achieve this, UNCT will ensure that there is a national policy in place on reorganization and integration of Emergency Medical Systems and emergency care for disaster response. Essential health services will be supplied with minimum necessary equipment and supplies.