Hyatt Regency Hotel, Dushanbe, 14 February 2023
Ozan Sevimli, World Bank Country Manager for Tajikistan and Turkmenistan,
Chair of the Development Coordination Council in Tajikistan
Your excellencies,
- Madam Guljakhon Abdufattohzoda (Head of Directorate for Social Sector Development of the Executive Office of the president of the Republic of Tajikistan)
- Madam Sumangul Said Tagoizoda (Chair of Committee for Health, Family and Social Affairs of Majlisi Namoyandagon of Majlisi Oliy of the Republic of Tajikistan)
- Minister Jamoliddin Abdullozoda (Minister of Health and Social Protection),
- First Deputy Minister Gafur Muhsinzoda (MOHSP)
- Madam Deputy Minister Zulfiya Abdusamatzoda (MOHSP)
- Deputy Minister Shodikhon Jamshed (MOHSP) and
- Deputy Minister Abdukholiq Amirzoda
- Pavel Ursu (Head of the Division for Data, Analytics, and Delivery for Impact of WHO),
- Victor Olsavszky (Representative of WHO in Tajikistan)
Ladies and Gentlemen,
It is my great honor and pleasure to be here today as Chair of the Development Coordination Council. The Joint Annual Review represents an excellent tradition and unique opportunity to facilitate communication, knowledge exchange, and collaboration with all critical stakeholders in the health sector.
DCC members appreciate and count on the Government of Tajikistan’s and the Ministry of Health and Social Protection’s leadership and efforts to realize the objectives of the 2021–2030 National Strategy on Healthcare of Population of the Republic of Tajikistan.
The greatest wealth of any nation is the HEALTH of its people. An educated, healthy, productive population is essential to reducing poverty and achieving sustainable economic growth and prosperity.
The growth and development of nations – and indeed their capacity to innovate and solve their own problems with locally driven solutions – all depend on the quality of their human capital. At the same time, building Human Capital unleashes the potential of individuals to be successful in society – it is the most important long-term investment a country can make for the future of its citizens and their quality of life. For Tajikistan, a fast growing country, both in terms of population and economy, real improvements to ensure that every citizen has the opportunity to earn a fair income, live a healthy life, and contribute to society, can only be achieved if investment in the Tajik people becomes the number one priority.
We are here today to discuss the health sector and investments in health are critical to closing the human capital gap:
- Health is a precondition for learning. Child health affects brain development and is the foundation for all learning.
- Healthier individuals boost household resilience. Strong health systems are necessary to translate social safety nets into resilience via better health.
- Healthier workers increase workforce productivity, reduce business overhead costs and increase national productivity gains.
Tajikistan has achieved remarkable progress in human development sectors after its independence:
- Life expectancy increased from 59 years in 1990 to 71 years in 2019;
- Maternal mortality decreased by 60% from 2000 to 2017;
- Infant mortality declined by 60% from 1990 to 2018;
- Reduction in child stunting from 26% in 2012 to 18% in 2017;
- There is also almost universal access to key services such as immunization;
But challenges remain. Let me highlight some of the challenges in the health sector:
Access to cost-effective quality healthcare remains a critical constraint, particularly in rural areas and among the poorest citizens. This issue is closely tied to the lack of qualified and well-trained healthcare workers where they are needed the most but there are also infrastructure constraints, and WASH and preparedness for disaster must also be improved. According to the Minister of Health Dr. Abdullozoada’s July 2022 press conferences, Tajikistan still lacks 3,024 doctors and 1,701 nurses—mainly family doctors, intensive care anaesthesiologists, and paediatricians. This is partly due to the brain drain. Thus, measures to prevent departure of the workforce and to develop human resource management systems (including agree on salaries for doctors and health practitioners that are commensurate with their qualifications, responsibility, and work pressure) are key to improving the provision of cost-effective quality care, particularly at the primary care level.
Improve value-for-money in the health sector. Resources in the health sector are still not used optimally. The way financing is allocated tweaks funding and healthcare use toward expensive hospital specialized care while cost-efficient primary care remains woefully underfunded and underused. At the same time, the number of hospital beds in Tajikistan, which are occupied 65 percent of the time, is four times greater than the lower-middle-income country average. Structural reforms, particularly, in the area of health financing and service delivery, are needed to address these challenges.
Protect the population from impoverishing health expenditures by allocating more public financing to the health sector. The share of Tajik families that spend more than 10% of their household budget on health care expenditure, is increasing. To reduce this trend, more resources must be invested into the health sector, so that the basic package of health services that the population is entitled to for free can be provided universally. This includes domestic financing to programs, such as the National Program to combat HIV/AIDS, that are currently funded almost exclusively by development partners. It is also true for other sectors that contribute to human development, including education and social protection. In sum, more domestic resources must be invested in human capital sectors.
In the past years, the Ministry of Health and Social Protection (MOHSPP) has developed and adopted the Strategy on Healthcare of Population of the Republic of Tajikistan up to 2030 that provides the strategic direction to address the issues mentioned previously. The Ministry of Finance and the MOHSPP have also spearheaded the development of the Prioritized Investment Plan (PIP), that provides costed, prioritized activities to implement the strategy. These documents provide a solid foundation for a coordinated strategic response to existing challenges. I want to congratulate the Government and everyone in the room who contributed to these key documents and particularly the PIP, which will be important for the coordination of assistance to the sector. In fact, such document does not exist in any other sector in the country and not even in more developed countries in the region. It is best practice that I hope other sectors follow.
In conclusion, I would like to say that nothing can be more important than the development of human capital. Unfortunately, a child born in Tajikistan today will only be 50% as productive when they reach adulthood as they could be if they received quality health and education services. But I am hopeful. I hope to see tangible results as we now implement the national strategy and closely track the results, through the PIP, on a yearly basis. I am hopeful, that we will continue to see lots of progress in the health sector. Let us together take the steps towards a better and brighter future for people of Tajikistan.
And finally, it is with gratitude I am able to confirm, today, the development partners’ sincere appreciation for the Government of Tajikistan and the Ministry of Health and Social Protection for their leadership and commitment to human capital.
Thank you.