Aga Khan Health Services

Tajik and Afghan doctors perform a Tajikistan surgery at a Comprehensive Health Centre in Afghan Badakhshan. The Cross-Border Health Project aims to improve the quality of health care and medical human resources throughout the entire region of Badakhshan.

Partners generates funds that can be used for cases were treated by Tajik procurement, delivery and distribution specialists at comprehensive health Act Central Asia Agency for Technical Cooperation and of additional good quality and affordable centres in Afghan Badakhshan. Development (ACTED) essential drugs to the community. In addition, a project supported by Counterpart International Patients are increasingly paying higher Tajik health professionals served Department of Health, GBAO percentages of the cost and it is hoped over 1,590 patients and performed Department of Health, Khatlon European Commission Office for that the fund will be completely self- more than 390 surgeries in three Humanitarian Aid (ECHO) sustaining in the near future. comprehensive health centres of Government of Japan Afghanistan. Vaccination campaigns International Federation of Red Cross and have been conducted by Tajik health Red Crescent Societies (IFRC) Cross-Border Health Aga Khan Health Services Mercy Corps professionals in Darwaz districts of Ministry of Health, Tajikistan AKHS believes that cross-border Afghanistan, covering over 4,090 Norwegian Ministry of Foreign Affairs collaboration can lead to sustainable mothers and 3,430 children. Swedish International Development Agency Tajikistan’s health indicators, The objectives of the Health • Increasing access to quality (SIDA) improvements in the health status of especially concerning the country’s Programme include: health care and increasing Swiss Agency for International Development communities as it allows for pooling of and Cooperation (SDC) Looking Forward growing younger population, indicate the capacity of healthcare scarce resources and economies of US Agency for International Development that much greater investment in the • Enhancing primary healthcare professionals in Afghan scale. The Cross-Border Health Project AKHS plans to strengthen its (USAID) country’s health care systems is services through a Family Badakhshan United States Department for Agriculture/ aims to improve the quality of health programme and to increase its Education Diary and Nutrition Project required. Medicine model care in Badakhshan, which spans geographic reach in the coming years. (USDA/EDNP) Tajikistan and Afghanistan, by providing In partnership with the Department Family Medicine and Clinical World Health Organization (WHO) The Aga Khan Health Services • Establishing quality assurance access to health care and improving of Health, AKHS plans to enhance its Excellence (AKHS) and other AKDN agencies processes and improving the skills Contact information the capacities of health professionals. community-based activities of health are making a number of such of health professionals Provision of primary health care promotion and disease prevention, and Aga Khan Health Services, Tajikistan investments. AKHS is working has become a priority under the AKHS, AKF and relevant possibly extend the Family Medicine 2 Azizbek Street, 3rd floor to improve the health status of • Improving the health behaviours Health Sector Reform initiative of 736000 Khorog, GBAO Governmental officials are facilitating model, Rational Pharmaceutical communities in several provinces of communities through a network the Government of Tajikistan. AKHS Tajikistan the provision of healthcare services to Project to Khatlon Region and Tel: +992 35 2224202 in Tajikistan, as well as in the of Community Health Promoters established the Family Medicine Afghan communities by Tajik doctors. Community-Based Health Financing Fax: +992 35 2223128 Badakhshan region of Afghanistan. and Clinical Excellence projects in During 2010, some 20 emergency scheme to other parts of GBAO. A particular focus is on women of • Increasing access to health care GBAO in order to improve the quality Aga Khan Development Network 8-10 Gani Abdullo Street reproductive age and children under through Community-Based Health of health care, increase the use of 734003 Dushanbe the age of five. AKHS works closely Financing schemes primary healthcare services and Tajikistan with communities, encouraging establish a culture of professional Tel: +992 37 2246500/2246508 Fax: +992 37 2510066 them to take responsibility for their • Making available low-cost, high development. Website: www.akdn.org own health, and provides technical quality essential pharmaceuticals assistance to the Government to and helping rationalize the use of The Family Medicine component of the The Aga Khan Development Network (AKDN) is a group of private development agencies working to empower communities and individuals, often in strengthen its healthcare system. medication project, which was initiated in 2008, disadvantaged circumstances, to improve living conditions and opportunities, especially in Africa and Asia. Its agencies work in over 30 countries for the common good of all citizens, regardless of their gender, origin or religion. Its underlying impulse is the ethic of compassion for the vulnerable in society.

AGA KHAN DEVELOPMENT NETWORK www.akdn.org behaviour change communication, nine pilot Village Organisations (VOs) Selected AKHS Accomplishments AKHS trains volunteer Community including television, health fairs and in Rushan District. The scheme aims in GBAO from 2001 to 2004 Health Promoters to serve as a posters. CHPs are actively involved in to provide a mechanism to finance encouraging community members to health care during an emergency. communication and advocacy link • Children under 5 who are between communities and local adopt good, healthy behaviours. A predetermined monetary amount is collected by VOs members on a underweight decreased from healthcare centres. CHPs also serve as communication regular basis. This financial pool can 35% to 23.1% and advocacy links between the then be drawn upon by members • Children (0-6 months) local communities and local health to cover the costs of emergency immediately breast fed increased authorities. They relay health healthcare services. The VOs members problems of their communities to themselves collectively decide on from 72% to 90.5% higher-level authorities and refer the cases for which these funds may • Children exclusively breast fed community members to appropriate be used. Once an appropriate and for four months increased from health facilities when needed. sustainable model for health financing 58.5% to 81% “The Community Health Promoters involves the rehabilitation of AKHS developed and implemented is developed, AKHS intends to roll it out (CHPs) are very hard working healthcare facilities, training of family a nursing curriculum in all medical At over 195 existing primary to other districts of GBAO. • Women reporting use of modern healthcare centres (PHCs), the and enthusiastic; they like gaining medicine health professionals and colleges in Tajikistan. contraceptive methods increased awareness-raising programs. Project has trained staff members knowledge and feel it is their duty Rational Pharmaceuticals Project from 38% to 45.1% Family Medicine Centers serve as The curriculum encompassed a range on a range of basic health topics to share the information they learn gatekeepers for secondary care of disciplines such as sociology, including safe motherhood, The Rational Pharmaceutical Project • Children receiving at least with the community. They said that institutions and reduce the cost of psychology, research methods, immunisation, nutrition, prevention was developed in GBAO to ensure the one course of worm medicine of HIV and STIs and integrated availability of high quality, low-cost, they would continue this work, even healthcare services. nursing management, family health, increased from 0% to 92.3% if AKHS is no longer supporting communication, health promotion management of childhood illnesses. essential pharmaceuticals in primary care facilities. AKHS also participates • Households with iodised salt the project. Many said it was their In partnership with the Tajikistan and safe motherhood. AKHS has also Department of Health, AKHS partnered with institutions such as The Growth Monitoring and Promotion in dialogues with the Department increased from 2.5% to 77.3% responsibility to their community. established the Khorog Family the Aga Khan University’s School of (GMP) component of the Project of Health and other non-profit • Children 6-12 years with urinary Medicine Training Center to provide Nursing in Karachi, Pakistan and the trains PHC staff and mothers in organisations in order to facilitate CHPs have been very successful continuous training for family medicine Tajik Postgraduate Medical Institute to the community on how to monitor the provision of pharmaceuticals at iodine >30 increased from 46.7% in improving the cleanliness of doctors and nurses. AKHS also provide nurses with the opportunity to the health and nutritional status of all levels of the healthcare system. to 69.3% their environment, educating conducts workshops for Department enroll in short courses. children under five years of age. The project provides training to local the community on prevention of of Health staff members and other Since the introduction of GMP, over healthcare professionals to enable health professionals on a variety of 8,000 children have been reached. them to make better diagnoses diarrhoea and increasing use of Community Health Project healthcare topics, such as family and to prescribe pharmaceuticals oral dehydration salts. As a result medicine, health promotion and The Community Health Project aims more rationally. the morbidity and mortality from Community-Based Health disease prevention, and how to to empower community members to Financing diarrhoea has been greatly reduced.” address medical emergencies. As of address their own healthcare needs The project introduced the Revolving early 2010, the Family Medicine project and to increase the quality of primary AKHS is also searching for solutions Drug Fund in 1997 in GBAO, which — Excerpt from an Assessment of has trained 19 doctors and 23 nurses, healthcare services in GBAO and to the shock of sudden health-related requires patients to pay a small costs. It has initiated a Community- percentage towards the cost of the Community Health Promoter and rehabilitated 14 health facilities. four districts (Shurabad, Muminabad, Khovaling, Nurek) of Khatlon Region. Based Health Financing scheme in pharmaceuticals. This requirement Strategy of the AKDN Community The Clinical Excellence component of Health Programme by Susan Ross, the project aims to establish quality The project trains volunteer Community August 2007 assurance processes in order to Health Promoters (CHPs) and health ensure the provision of high quality professionals on a range of healthcare health care. topics including safe motherhood, The Community-Based Health immunisation, nutrition, prevention Financing scheme provides Village AKHS facilitates clinical audits, of HIV and sexually transmitted Organizations a mechanism to promotes continuing professional infections, integrated management collectively save for emergency development through monthly of childhood illnesses and growth healthcare expenditures. presentations, and releases health monitoring. Since its inception, the updates and holds training sessions Project has trained over 460 CHPs in at its Clinical Excellence Centers. GBAO and 490 CHPs in Khatlon

Cover Photo: AKHS in partnership with the In the past, AKHS also focused on AKHS develops and distributes Tajik Postgraduate Medical Institute trains improving the formal education of educational brochures containing Family Medicine doctors in order to improve the quality of health care and increase the nurses in Tajikistan. In partnership culturally-appropriate health use of primary healthcare services. with the World Health Organization, messages, and uses other forms of